This post was co-authored by Meredith Eis, a graduate student from the Gerald R. Ford School of Public Policy at the University of Michigan

In a nutshell:

• The United States was already experiencing a mental health crisis before the onset of COVID-19 with high rates of mental health disorders, suicide, and substance abuse.
• COVID-19 has negatively impacted the mental health of people throughout Michigan – especially frontline workers.
• The long-lasting impact of the pandemic on mental health is likely to drive the need for additional mental health care supports and services

We’ve learned a lot about COVID-19 in recent months – its effect on lungs, hearts, blood vessels, and the senses. But this new disease is having a profound effect on something that can’t necessarily be seen under a microscope: mental health. 

As the pandemic spread, many individuals found themselves isolated at home and dealing with new stresses. Job loss, upturned schedules, isolation, fear – these are challenging for anyone, but especially for those already dealing with existing mental health issues. Calls and texts to crisis hotlines and text lines have soared in recent months. Even now, as restrictions have eased in Michigan, high anxiety and ongoing mental health concerns continue for many individuals.

The Mental Health Crisis

Before COVID-19, the U.S. was already experiencing a mental health crisis, characterized by high rates of depression, anxiety, drug use, and suicide and limited options of treatment. 

According to 2019 research by the National Alliance on Mental Illness, over 1.3 million adult residents of Michigan have a mental health condition and it is likely that this number will increase due to the effects of the pandemic. Among kids and teens in Michigan, nearly one in five have been diagnosed with depression, anxiety, or attention deficit/hyperactivity disorder. More than 4.2 million Michiganders live in an area with a shortage of mental health providers, making it hard (if not impossible) to seek and find treatment for mental health conditions. 

For those battling the effects of depression, anxiety, or other conditions, seeking help can be a difficult burden to bear alone. Stigma surrounding mental health, as well as misinformation/miseducation about treatment leave many people unable to recognize when they (or someone they know) needs help. These impediments make it less likely that individuals will access what limited help and support is available.

The Impact of COVID on Mental Health

Mental health has continued to worsen as predicted over the course of the pandemic. According to the Kaiser Family Foundation, 47 percent of adults sheltering in place have experienced a negative impact on their mental health as a result of the pandemic, even more for those who have experienced job or income loss. Dealing with anxiety, being unable to access help, trying to understand states’ differing reopening plans, and ongoing uncertainty about the future all take an individual toll on a person’s emotional well-being; the cumulative impact of these factors drive the need for direct mental health care.

Teachers and students at schools and universities are expressing concerns, fears, and anxiety about the safety of returning to classrooms and campuses (inviting further consideration of the unique mental health challenges facing young people).

Evidence suggests that frontline workers are at high risk for mental health problems after a disaster. For instance, those working in healthcare have been shown to work under higher rates of stress that impact mental health and life quality as well as increased rates of suicide. These individuals are now enduring heightened stress levels, more anxiety, and working longer hours in faster paced situations with COVID-19.  

Finally, mental health counselors are experiencing strain as they balance their personal concerns with those of their clients; this workforce of supporters may itself need more support. For example, crisis hotline counselors are experiencing more mental health distress and that will lead them to require more care as orders lift and the pandemic ebbs and flows.

(Author’s note: I work as a crisis worker on a crisis hotline and have done so during the pandemic.)

Improving Mental Health Services

Even though Michigan is still working to contain the pandemic, mental health is also an ongoing concern that warrants attention.

Some actions have already occurred. A recent supplemental appropriation provides grants to inpatient psychiatric hospitals (a $100 per diem increase). Similarly, community mental health organizations were granted new funding. These are great first steps, but they cannot possibly address the full scope of the mounting problem facing Michigan.

Many mental health providers rely on public sources for some, if not most, of their reimbursement for services. This means that public policies in Medicaid and community mental health affect the entire behavioral health provider ecosystem. One option to increase service availability might be revising Medicaid rates to match state investment with the true cost of care and public demand for services. Low reimbursement rates certainly contribute to the shortage of mental health providers in the state. Expanding reimbursement to community health workers and peer support services may be another strategy to expand access. 

Frontline healthcare providers also need support and care as the pandemic goes on. Mental health services should be made available to healthcare professionals (without stigma). In developing strategic plans, hospitals and other centers might consider hiring additional mental health professionals, including psychologists or psychiatrists, to support employees as well as patients.

Addressing the crisis at hand is essential, but efforts must also be made to resolve the ongoing issues that existed long before COVID-19—issues that have made us more vulnerable during this pandemic.

Since young people bear such a large mental health burden, the schools and universities they attend may be an important setting to provide support. These institutions have many options to assist students with mental health concerns, such as providing access to counseling and offering mental health training to teachers and staff. 

Because Michigan’s public mental health system has been systemically underfunded, opportunities for community mental health agencies to acquire and direct fiscal resources to community investment and/or crisis preparation should be considered to prepare for future needs. A broad array of policies to address the shortage of mental health services and providers should also be considered.

While the government has a clear role in the structure and finance of services, its role is not as clear when it comes to addressing ongoing stigma that prevents people from seeking care for mental health. Nonetheless, public information campaigns are an invaluable tool to raise awareness and spread information about accessing help.

Ultimately, the best solution for ending stigma lies in the compassion and empathy of each citizen, and in our capacity and willingness to support (rather than judge) our friends, neighbors, and other community members who may be in need of some help.

If you or someone you know is in need of help with a crisis or mental health concern please reach out to the National Suicide Prevention Lifeline at 1-800-273-8255.