Centers for Disease Control and Prevention survey data indicate 11 percent of U.S. adults had symptoms of anxiety or depression from January to June 2019, according to a Government Accountability Office report. That figure soared to a 38 percent average for April 2020 through February 2021.
CDC also reported drug overdoses jumped 36 percent and suicide attempts rose 26 percent from mid-March through mid-October 2020 over the same period a year earlier.
Meanwhile, help for those in need is diminishing. A National Council for Behavioral Health (NCBH) survey in February of this year found that more than a quarter of its member organizations laid off employees, more than a third cut staffing hours and 45 percent reported closing programs.
“Underlying the global pandemic is a five-alarm fire when it comes to the state of Americans’ mental health,” said Sen. Ron Wyden (D-Ore.), who requested the GAO report. “The pandemic has made access to mental health care more urgent than ever while worsening long-standing shortcomings in the system.” He promised to use his Senate Finance Committee chairmanship to put mental health and physical health “on the same footing in America’s health-care system.”
That equal footing was required in a 2008 law that prohibits health insurance companies from treating mental health and substance use less favorably than other ailments. “However, even before the pandemic, long-standing questions were raised about whether coverage or claims for behavioral health services are denied or delayed at higher rates than those for other health services,” especially for low-income people, GAO said. It cited a federal-court decision, in a 2019 lawsuit, that said a health-care company improperly denied behavioral health benefits.
Since 2013, the New York attorney general’s office has imposed millions of dollars in penalties on health plans and secured millions in reimbursements to patients for mental health expenses that health plans should have covered, according to GAO.
Despite the 2008 law, “many in need of mental health and substance use disorder treatment still struggle for equal access to critical mental health and substance use care,” Arthur C. Evans Jr., CEO of the American Psychological Association, said by email. “Congress can address this issue right now through legislation, such as the Parity Enforcement Act of 2021 (H.R. 1364), which would strengthen the Department of Labor’s authority to enforce the law, increase funding to support stronger federal oversight of insurers’ compliance with the law and close the loophole that has allowed states to opt out of parity requirements for state employees, many of whom are front-line service providers currently responding to the pandemic.”
He also urged Congress to increase funding for health equity programs because “the COVID-19 pandemic highlighted and exacerbated long-standing disparities in access to mental health services, particularly for communities of color.”
On a professional and personal level, Joe Parks, a psychiatrist and NCBH medical director and vice president, knows the virus’s devastation well, including coronavirus-related deaths not in the official count. After having battled alcohol and drug abuse from high school into his 60s, Parks’ brother died of substance abuse during the pandemic.
“I think it was because he couldn’t attend as much of his group counseling and AA sessions as he did previously,” Parks said. “His drinking got worse and worse and he was found dead at one point . . . He was one of those people that really needed face-to-face treatment. Not everybody does . . . but he did.”
For many who struggle with substance use issues, the isolation caused by the pandemic has only aggravated their problems.
In addition to increasing domestic violence and child abuse, Michi Fu, an Alliant International University psychologist, said she has a patient with obsessive-compulsive disorder who “now finds that no amount of cleansing offers her enough reassurance to feel comfortable outdoors.”
Fu estimates her private practice new referral rate has jumped 500 percent since the pandemic began.
Even as the pandemic’s “constant barrage of large and small daily stressors is taking a toll on many if not the majority of our population,” Nancy Molitor, a clinical psychologist at Northwestern University’s Feinberg School of Medicine, said the end of the pandemic also comes with its own mental health issues.
“I am already talking to patients who have forms of ‘reentry anxiety,’ ” Molitor said. “They have become so used to being isolated at home that they can’t get themselves to leave the house at all. I expect we will be seeing much of this kind of anxiety as we move forward.”