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How COVID-19 changed the conversation on mental health

Two men fishing and taking care of their mental health

A shared experience of loss has made it easier to talk about what mental health is and why it’s so important.

There’s no doubt that COVID-19 has been a tragedy. Millions of people across the globe have died because of it. The repeated and ongoing cycles of lockdowns, loss, worry and stress have impacted nearly every part of our lives.

And that’s especially true when it comes to mental health. According to the American Psychological Association (APA), rates of anxiety and depression among U.S. adults were about four times higher between April 2020 and August 2021 than they were in 2019.1

And yet this wave of shared suffering has brought with it some positive changes about how we understand and talk about our mental and emotional well-being.

“It’s taken away some of the stigma around mental health discussions, and virtual therapy has become more popular. Today, it’s easier to connect with a therapist through a computer or smartphone,” says Debra Katz, MD, senior national medical director for behavioral health at Optum.

So, in many ways, the pandemic has made it easier for more people to reach out for support. “We really have a chance now to transform mental health care as we know it,” adds Dr. Katz.

Understanding mental health vs. mental illness

One positive change is that people have realized that mental health and mental illness are not the same thing. Mental health is your social, emotional and psychological well-being.

But when you struggle with thoughts, moods and behaviors, you may have a mental illness. It can be a serious condition.

The pandemic has made it more acceptable to talk about mental health. It has also reduced the stigma (a set of negative and often unfair beliefs) surrounding mental health, which has made people more comfortable getting support.

You can have poor mental health or not feel your best without being diagnosed with a mental illness. Or you can have a mental illness but go through periods of feeling fine emotionally.

In both cases, you may still need help. It’s becoming more commonplace to get mental health support to maintain wellness and to prevent the progression of conditions, potentially averting a mental health crisis, Dr. Katz says.

And even if your mental health isn’t poor, you can benefit from regular self-directed check-ins. 

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4 ways the pandemic changed mental health care

1. It has made talking about depression and anxiety easier

Since 2020, about one-third of American adults have reported feeling anxious or depressed.2 And almost everyone felt uncertainty, stress and even grief.

Depression was already a common condition worldwide. But the pandemic put a spotlight on the direct link between mental and emotional well-being and overall physical health.

“There’s a recognition now that mental health is connected to physical health. And when there’s an issue, it may require treatment or support from a professional, just like with high blood pressure or diabetes,” Dr. Katz says.

This has also brought about positive changes in the workplace, an area of people’s lives where they spend a lot of time. Employers have become more aware of the effects of stress on their employees.

“That changing perception is reflected in how some organizations are investing in more and better resources to support their employees,” says Dr. Katz.

2. It’s made some therapy options more convenient

The demand for therapy is on the rise. Since the pandemic began, psychologists have reported more patients seeking help for anxiety and depression. That’s according to a survey from the APA.3

But there’s also a shortage of therapists. “This was true even before the pandemic,” says Dr. Katz. “As a result, there were often long waits to talk to a therapist.”

Today, telehealth offers patients the opportunity to get care “virtually” via video, chat or phone. The option to see a provider through a virtual visit expands patients’ access to convenient, professional treatment.

It also provides more privacy to patients who don’t feel comfortable going into an office for therapy.4 

Here's how to find a therapist you connect with. 

3. It’s brought attention to the mental health crisis among young people

Long before the pandemic, many children and teens were dealing with anxiety and depression. Half of all mental illness begins by age 14.5 Millions of children and teens live with mental health issues — as many as one in five.6

And death by suicide rose by 57% among young people from 2007 to 2018. That’s according to a recent report from the U.S. surgeon general.7

“Throw COVID-19 into the mix and it became a crisis of epidemic proportions,” says Dr. Katz. Last October, the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, and the Children’s Hospital Association declared an emergency in children’s mental health.

Federal, state and local governments are taking action to help U.S. youth.

President Biden has pledged to push for $1 billion in new federal funding to help schools hire mental health professionals. And the U.S. surgeon general put out an advisory on the youth mental health crisis in December 2021.

Some of the recommendations:

  • Increase mental health care services for youth
    "Right now, more than 2.5 million children in the United States have severe depression. But only about 27% of them get regular treatment.8 “Researchers estimate that we need 47 child psychiatrists for every 100,000 children when in reality we only have 9.75,” says Dr. Katz.9

  • Support parents and caregivers
    The mental health of young people is closely tied to the mental health of their families. “We saw how overwhelmed parents were during the pandemic,” says Dr. Katz. “Many had to juggle work and the demands of remote schooling.”

    It’s important for caregivers to get the support they need. That will help their kids thrive, too.

  • Understand how social media affects young people
    Screen time among children and teens shot up during the pandemic. That may have made mental health challenges worse.

    Social media can be a way for young people to connect with others and get support. But it can also bring on bullying and loneliness, points out Dr. Katz. 

4. It has highlighted the equity gaps in mental health care

The pandemic has made it clear that there is still a lot of work to be done when it comes to helping underserved groups. That includes people of color and people who identify as LGBTQ+.

Even before the pandemic, Black Americans and Hispanic Americans had a harder time getting mental health treatment.10

LGBTQ+ people had more severe mental health effects from the pandemic than non-LGBTQ+ people, research shows. And rising concerns about racial and social justice issues have been sources of stress, too.

Last year, Optum launched an education program for health care providers. The goal is to make LGBTQ+ people feel more respected and comfortable when they visit doctors. Hopefully, that will encourage them to feel more open to talking about their health needs and seeking support.

Moving forward, it’s important to continue investing in education and programs to create a more diverse network of mental health care providers.

“At Optum, we believe people are more likely to seek out help if they have the choice to work with therapists who are culturally sensitive and aware,” says Dr. Katz.

Another goal: Improving screenings for anxiety and depression. People of color are less likely to get a diagnosis for either condition.11

A combination of social and cultural beliefs along with current approaches to screening contribute to missing or overlooking people of color struggling with their mental health.

For example, higher stigma in these communities may be why research shows many Black Americans describe physical symptoms such as headaches, backaches or stomach problems when they talk about depression.

It may also be why Hispanic Americans may be more likely to describe feeling “nervous” when talking about anxiety.

A bright future for mental health care

The pandemic raised awareness of mental health issues. But more work needs to be done. The good news is that it has led to new ways of thinking about how people look for and access support.

Dr. Katz sees a future in which mental health care is more personalized and available to those who need it than ever before. “We want to make sure everyone can get the support and treatment they need,” she says. “The pandemic has given us some insight and progress into how we can do that.”

Learn more about resources for mental health on our Until It’s Fixed podcast

Sources

  1. American Psychological Association. Depression and anxiety escalate during Covid. November 2021. Accessed March 23, 2022.
  2. National Center for Health Statistics. Anxiety and Depression Household Pulse Survey. Mental Health - Household Pulse Survey - COVID-19 Last updated April 20, 2022. Accessed April 25, 2022.
  3. American Psychological Association. 2021 COVID-19 Practitioner Survey. October 2021. Accessed March 23, 2022.
  4. American Psychological Association. Online therapy is here to stay. January 2021. Accessed March 23, 2022.
  5. U.S. Surgeon General’s Advisory. Protecting youth mental health. December 2021. Accessed March 23, 2022.
  6. World Health Organization. Mental disorders. Last updated November 28, 2019. Accessed March 23, 2022.
  7. U.S. Surgeon General’s Advisory. Protecting youth mental health. Last updated December 2021. Accessed March 23, 2022.
  8. Ibid.
  9. Pediatrics Nationwide. Limitations on providers. Beyond a bigger workforce: Addressing the shortage of child and adolescent psychiatrists. April 10, 2020. Accessed March 23, 2022.
  10. Optum white paper. Behavioral health: Before Covid and after Covid. February 2022.
  11. Ibid.

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