The State of Mental Health

Predictions and Preparations for 2021

“Mental health is one of the biggest pandemic issues we'll face in 2021.” That January 4th CNN.com article accurately identifies a very real near- and long-term challenge. As Lisa Carlson, the immediate past president of the American Public Health Association, told CNN’s Kristen Rogers, “…every time we talk about COVID-19, we should talk about mental health."[1]

Despite my many years of clinical, research, health services, policy and management experience both in the U.S. and across the globe—including mental health consulting during the Democratic Republic of the Congo’s Ebola epidemic—the extent of the negative ramifications of a pandemic for our world’s mental wellness is unimaginable. One concerning but not unexpected outcome is post-traumatic stress disorder (PTSD). PTSD is already being recognized in front-line health care professionals who have experienced and witnessed the unimaginable in the war against COVID. A Yale School of Public Health study of 1,132 health care workers from 25 U.S. medical centers showed that 23 percent suffered from PTSD.[2] I believe that percentage will rise steeply this year, as health care workers see people venturing back out into large crowds, or gathering with elderly family members. We should constantly be screening front-line health care providers, to identify those at highest risk for PTSD and ensure that they receive timely treatment.

I also predict that positives will emerge from the psychological pain and suffering that have spread during the past year:

• Mental health will gain a foothold in the overall health care conversation. With so many around the world touched by COVID, the topic of mental health will finally begin to lose its stigma. People will admit to feeling depressed, anxious, or even suicidal—and their families and friends will be more sympathetic and empathetic. Individuals increasingly will research mental health online or seek referrals from their primary care physicians. Therapy will be more available via telehealth until it’s safe to return to in-person sessions.
• Mental health will be recognized as a global health problem. Just as COVID-19 spread around our world, so did this mental health crisis. According to the World Health Organization, countries spend an average of only two percent of their health budgets on mental health.[3] If that is the average, imagine that many countries are allocating little or no resources to mental health. Seeing the mental devastation generated by the pandemic, I am optimistic that countries will demand greater funding for mental health research and treatment.

Help Is Bringing Hope

Thankfully, initiatives began in 2020—and even before the COVID outbreak—that can help us address the COVID mental health emergency locally and globally. Here are just some examples:

• Chicago rapper G Herbo partnered with the National Alliance on Mental Illness, Audiomack, and InnoPsych to launch “Swervin’ Through Stress,” offering mental health resources like a directory, therapy sessions, and a helpline/text line to Black youth.
• Created in 2001 in Australia by a nurse and a mental health literacy professor, Mental Health First Aid is a course that teaches laypeople how to identify, understand and respond to signs of mental illnesses and substance use disorders.
• The World Health Organization, United for Global Mental Health and the World Federation for Mental Health kicked off “Move for mental health: let’s invest” around World Mental Health Day in October, with a virtual 24-hour march, a global online advocacy event, and education materials.
• The APA has issued recommendations on how Gen Zers and students can cope with stress, how parents can support their children, how employers can support workers, and how people of color can build resilience.

Just as we had hope for coronavirus vaccines—and saw a worldwide confluence of expertise, funding, and determination to make them happen in record time—we must couple that same hope with action to tackle the mental health effects of the pandemic. There is too much at stake to just expect them to disappear.