Through the years we've recognized Mental Health Awareness Month by sharing the history of the month, where it all began and why we should take a moment to recognize its importance. This year, in the shadow of COVID-19, it has become clear than we all need to take better care of our mental health.
Mental Health Awareness in 2020
A fundamental shift has occurred in the number of mental health cases in just the past six months. So this year, rather than a 2020 vs 2019 comparison, we'll look at how things were before COVID-19. Prior to the pandemic, 1 in 5 adults reported a mental illness. Today during COVID-19, 47% have reported experiencing negative mental health effects. This is a result of increased stress and anxiety as well as social isolation and job loss due to the pandemic. The Mental Health America (MHA) Screening Program, which provides free, anonymous mental health screens, thus far show roughly 18,000 more people seeking help for anxiety or depression since the pandemic began, and nearly 14,000 who considered suicide or self-harm in March and April.
A Severe Lack of Providers
To date, there has never been such a profound demand for mental health-related services, but how does the ability to care for those in need stack up next to primary care practices? In the United States, there are 230,187 primary care practices. In stark contrast, there are 11,682 mental health practices and 15,136 substance abuse centers. Even combined that's just 11% the size of the primary care market. Telehealth applications and changes in laws for boundaries and billing have helped immensely but there remains a substantial gap in coverage for providers in mental health.
Common Reactions to the Pandemic
For those with increased risk of exposure or illness, it's important to help them understand it's common to have concerns regarding protecting themselves from infection. If they live alone or in a community not allowing visitors, certain individuals are more likely to feel socially isolated. Additionally, it's common to feel a level of guilt if family members are helping take care of them during the pandemic. Increased levels of distress are also to be expected if they had any mental health concerns prior to the outbreak. A language barrier creates its own kind of socially isolating experience and can lead to feelings of depression or anxiety. Low-income housing occupants also report increased levels of distress due to these areas often being in close proximity to their neighbors. Sadly, if someone experiences stigma because of age, race or ethnicity, disability, or perceived likelihood of spreading COVID-19, the CDC reports this is responsible for increased levels of distress as well.
How Providers can Help
The CDC recommends that providers let older adults and people with disabilities know it is common for people to feel distressed during a crisis. Remind your patients that asking for and accepting help is a sign of strength. Providers should also have a procedure and referrals ready for anyone who shows severe distress or expresses a desire to hurt him- or herself or someone else.
How you can Help Yourself
Start by remembering it's completely normal to get stressed during times like these. It's also important to not self-diagnose, as worrisome thoughts are part of anxiety. However, people with an anxiety disorder can experience more exaggerated feelings of worry and tension. Speak to a mental health professional if you experience:
Uncontrollable worry or dread
Stomach and digestion problems
Trouble with concentration, memory, or thinking clearly
Increased heart rate
Changes in energy and difficulty sleeping
Irritability and/or restlessness
Focus on What you can Control
Social distancing makes it much easier to find increased comfort from unhealthy foods and snacks, so try to monitor your diet and keep it healthy. For many, working from home means sitting for 10-12 hours or more is now a daily experience. Try to balance your mental stress with physical exercise, which produces endorphins that reduce the production of cortisol, the stress hormone. Take note of your vices and refrain from excessive drinking and smoking. Caffeine, sugar, nicotine, and alcohol each have unique effects on our neurochemistry and there really is too much of a good thing. Maintain self-care and personal hygiene. Even if no one's watching it's just as important to maintain appearances for yourself as it is for others. Finally, take care of your mental health, if you're feeling prolonged periods of depression or anxiety please speak to a trained mental health provider.
If you feel like you are struggling with your mental health, visit mhascreening.org for a free screening of your symptoms. If you find yourself experiencing emotional distress related to the COVID-19 pandemic, crisis counselors are available around the clock, seven days a week. You can reach them by calling 1-800-985-5990 or texting, "TalkWithUs" to 66746. Lastly, if you're in a crisis or are facing suicidal thoughts, get connected to a local crisis center and talk with someone immediately. Call 1-800-273-8255 (TALK) or text "MHA" to 741741.