The Mental Health Pandemic: COVID-19 and the Rise of Telehealth
To some extent, all of us have experienced negative mental health effects from the COVID-19 pandemic, whether that is a clinical diagnosis, the implications of less social interaction and isolation, or job loss. Students and employees all over the world have had to adapt to the new pandemic-world; such radical changes to typical life are bound to have adverse consequences on an individual’s mental health. For instance, the number of adults in the United States that have reported symptoms of anxiety or depressive disorders has increased from 11% to 41.1% . In addition to the worsening of chronic conditions, a survey from June 2020 found that 13% of adults have reported new/increased substance use, 11% have suicidal ideation, and difficulty with eating/sleeping have also increased . Several populations in particular face unique challenges in response to COVID-related lifestyle changes, such as low-income or working parents with school-age children enduring the consequences of school closures and lack of childcare services. Older adults are also exposed to increased mental health issues, namely elevated anxiety and depression levels due to their high vulnerability to severe complications from coronavirus and less social support in place for appropriate safety measures.
Loneliness, even prior to the pandemic, has been associated with reduced lifespan and a greater risk of mental and physical illness. A poll from March 2020 also found that the widespread social isolation from those who followed shelter-in-place orders resulted in more negative mental health effects in comparison to those who did not shelter-in-place . One group particularly impacted by this are young adults (ages 18-24), who have reported symptoms of anxiety and/or depressive disorders at a higher frequency than any other adult age group . Given university closures, loss of income, and reduced access to mental health services, young adults are more likely to experience substance abuse, suicidal thoughts, or exacerbated existing mental illness rates. Children also face unique mental health challenges from the pandemic, such as increased child abuse that is less likely to be intervened upon by educators and community figures, as well as the stress of disrupted routines and decreased social interaction . As such, it is important to acknowledge the disparate ways in which different populations have been and continue to be affected by the pandemic and the critical pre-existing issues in mental health that have been emphasized by such a rapid, global lifestyle change.
Not only has the COVID-19 pandemic amplified mental health issues in all populations, but it has also exposed underlying inequities in psychiatric disorders, health care as an industry, and society as a whole. In particular, communities of color have experienced disproportionate mental health effects during the pandemic, with 48% of non-Hispanic Black adults and 46% of Latino/Hispanic adults reporting anxiety and/or depressive symptoms, compared to the 41% of non-Hispanic white adults . These mental health implications are also paired with higher rates of COVID cases and deaths in Black and Hispanic communities. Within such circumstances, it is important to interpret these rates in the context of systematic oppression against these groups. All of the previously mentioned mental health effects are intensified in these communities while simultaneously having less access to mental health resources and increased financial burden. Furthermore, the important distinction between “essential” and “nonessential” workers has placed a heavy burden on workers in the industries that we deem most critical. Those working in the industries of food and health garner greater risks of contracting the virus and additional stressors, resulting in higher rates of anxiety, depression, substance abuse, and suicidal thoughts . Specifically, frontline health care workers have reported adverse mental health issues and burnout, with physicians experiencing an elevated risk of suicide from the added stresses of working in the pandemic and being exposed to patients with the coronavirus . Finally, with regard to the high rates of job loss coupled with the potential inability to work remotely, low income individuals have also reported significant negative mental health effects. Therefore, in addressing the impacts of mental health in the COVID-19 pandemic, we must consider the disproportionate burden that vulnerable populations endure due to higher exposure/stress and the systematic oppression that intensifies pre-existing disparities. Public health responses and intervention efforts associated with mental health conditions should prioritize racial/ethnic minorities, essential workers, young adults, and unpaid adult caregivers; further policies must address the health inequities that contribute to the impacts that have simply been magnified through the pandemic .
As a result of amplified mental health issues in the general population, telehealth counseling appointments have become essential to provide psychological services in the virtual world. This change presents the question: how effective is virtual therapy? Pre-existing limitations to mental health care access, primarily due to a shortage in mental health professionals, have only escalated in the pandemic, so delivering health care remotely has allowed providers to reach more people. Studies have shown that telehealth is just as effective as face-to-face therapy, but with higher retention rates . However, with novel methods of care come additional barriers. In navigating this new form of therapy, providers must ensure that patients have access to comfortable, private, quiet spaces with stable internet access, which may present issues for low-income communities who already face issues receiving treatment. Moreover, clinicians must now master the technology as part of their responsibilities and compensate for the difficulty in picking up nonverbal cues virtually. Even as more people get vaccinated and states begin opening up, telehealth will likely remain to reach more patients and in navigating the psychological impacts that will endure even after the physical pandemic is over.
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