Is 988 Launching During a Mental Health/Addiction Epidemic?

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The new national mental health crisis number, 988, launches on July 16. The new hotline launches as we are seeing more people seeking help for alcohol and other substance abuse concerns, as well as other mental health challenges. But do increased calls for help reflect more addiction and more mental illness, or a greater willingness to reach out?

An Overburdened Mental Health System

Mental health providers throughout the United States consistently express concern about what they view as a growing mental health crisis. According to a recent report in The New York Times, nine out of 10 therapists say the number of clients seeking therapy is on the rise, with many having long waiting lists of more than three months, or having to turn people away altogether. Many also reported that all the therapists they know are full and that mental health professionals are overstretched and burnt out professionally, while still having to manage the impact that the pandemic has had on their own personal circumstances and well-being.

Greater Incidence of Poor Mental Health, or More Self-Reporting?

Additional stressors—including factors related to the pandemic—increase demand for therapy. Many people who had managed to live with anxiety or depression before COVID-19 found that they needed to seek help when the pandemic cut off coping mechanisms such as working out, travel, and socializing.

The changed circumstances tended to bring emotional challenges into the open. The uptick in demand may reflect a greater willingness to get help rather than brand-new challenges.

Anxiety, depression, family challenges, and relationship issues that may have been just manageable became too difficult to handle alone. How about alcohol abuse and other forms of substance abuse?

The Argument for an Increase in Addictions Linked to COVID-19

Theodoros Daglis notes a marked increase in the prevalence of addictions as a direct result of the impact of COVID-19 on society. Between the fear of contagion leading to self-abstention of social activities and externally imposed lockdowns, Daglis suggests that the reality of extended isolation caused many people to try to alleviate their stress and anxiety through addictive behavior and substance abuse. Binge drinking is also related to unemployment levels, which were, of course, sky-high throughout the pandemic.

After substance abuse spikes in response to external triggers, it tends to remain elevated even when the triggers are reduced.

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Drinking and other substance abuse tends to stay elevated after the external shocks subside. Unfortunately, substance abuse tends to be “sticky.” That is, it tends to persist even when the external factors that promoted addictive behaviors are mitigated. Once people go back to work or start going into the office regularly, the alcohol or substance abuse issue usually doesn’t just disappear.

Increased detection leads to increased access to mental health services for alcohol abuse and other challenges. Even if no new challenges would have surfaced as a result of COVID-19, the pandemic forced families to confront aspects of their lives that were dysfunctional.

Before the COVID-19 lockdowns, most of us had more distractions in our lives and much less prolonged, intense interaction with our families. It was easier to ignore issues that were unhealthy or inconvenient. However, the mandated isolation created by repeated lockdowns forced nuclear families to spend more time together, when any unhealthy or dysfunctional behaviors could no longer be ignored.

Coupled with the additional stressors of the pandemic itself, an inordinate number of people who had previously not addressed their issues finally started reaching out for help. Spouses, parents, and children often saw for the first time just how much their parents drank or abused other substances and insisted that they get help. Family "detection" of drinking problems can push people to seek help to moderate their drinking.

Destigmatization of Therapy Among People of Color

Another finding mentioned in the report is that more people of color are contacting mental health services than ever before. This is not to say that the issues they’re presenting haven’t always been there, but rather that they’re more comfortable seeking therapy than they were previously.

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One major reason cited is to seek help with xenophobia against the backdrop of reported racially motivated hate crimes. The other reason most often given relates to the public revelation by prominent iconic sports figures or public personalities sharing their own struggles with mental health, which serves to reduce the stigma associated with mental health:

To have celebrities talking pretty openly about how they seek treatment…has helped create a window of acceptance for therapy in the Black community. — Eldridge Greer

A New Mode of Operating

In many ways, mental health professionals across the United States have indeed seen a staggering increase in demand for their services. Some of this demand is driven by romantic partners or relatives who prompted loved ones to finally seek help when their reality became unbearable. People always had issues; this might just be the first time that so many, and even subgroups, are reaching out for help on a large scale.

Not only is therapy no longer as threatening as it once was, but it’s also now more accessible than ever before, with online therapy allowing people to discreetly and conveniently access the support they need from the comfort and privacy of their own homes. My practice has seen a definite uptick in people willing to consider getting help for alcohol abuse and for addressing the mental health challenges that often power addictive behaviors.

Some might be alarmed at the increased demand for mental health services. Seen in another light, the growing trend to open up dialogue and address uncomfortable topics can also be quite encouraging. Where many people were previously resigning themselves to accept the reality of their life or circumstances, more people than ever before are now owning up to taking responsibility for their lives and confronting the issues that were pulling them down. In this context, the increased availability and willingness to access professional and confidential online therapy can help people face their challenges.

© 2022 Dr. Arnold Washton. All Rights Reserved.

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