This is a time of profound uncertainty. When will schools and businesses reopen? Who in our families could be “high risk” for severe illness? How will we keep bills paid and food on the table? What does the future hold?
Our brains are wired to crave predictability. In its absence, we experience stress. With COVID-19, this stress is heightened because the very physical distancing measures that are crucial to slowing viral transmission also separate us from our usual sources of social, psychological and emotional support. Coupled with widespread economic vulnerability, it is not surprising that nearly half of adults in the U.S. report worsened mental health since the pandemic began.
As local mental health leaders, we are concerned about the current state of Utahns’ mental health, as well as the significant challenges and needs that lie ahead.
These concerns are grounded in both the positive and negative realities of where we found ourselves prior to COVID-19. On the one hand, Utah’s suicide rates seem to be plateauing despite a rise across the country, and our state has also seen a marked decline in opioid overdose deaths.
On the other hand, 25% of Utah adults are experiencing poor mental health, there are major barriers to accessing and navigating care and “deaths of despair” by suicide and substance misuse are higher than the nation as a whole.
When COVID-19 arrived in Utah, we convened a diverse team of health system and public health experts to review statewide suicide, crisis and overdose data. Through this collaborative initiative, some interesting findings are emerging.
Utah’s Crisis Line (the local affiliate to the National Suicide Prevention Lifeline) has had an uptick in crisis call volumes over the past two months, with callers describing more severe levels of distress. Intermountain’s free Emotional Health Relief Hotline has supported more than 1,000 community members and health care professionals in its first month of operations. While the number of suicide deaths in Utah appears similar to prior years at this time, the last two months have seen a slight increase in suspected fatal drug overdoses, with a noticeable jump recently in suspected opioid-involved nonfatal overdoses.
These signs of distress are just the beginning. COVID-19 presents unprecedented physical, social and economic turmoil that could increase emotional suffering for many people — particularly the health care workforce and first responders who are at the front lines of this pandemic, as well as people who were already vulnerable due to poverty, social needs, poor mental health, or some combination of these factors, prior to COVID-19. Mental health consequences are likely to be present for longer (and peak later) than the actual pandemic.
As the response and recovery phases continue, COVID-19 will cause distress and leave many people vulnerable to mental health problems, including post-traumatic stress, substance use disorder, domestic violence and child abuse. This happens in the wake of most mass traumatic events, from hurricanes to terrorism. COVID is unique because it is a trauma affecting every person, and because it is accompanied by a ubiquitous economic downturn and high level of social isolation.
However, the mid- to long-term impacts of COVID-19 are not yet written. If we plan and act now, we can mitigate some of the mental health burden. State leaders should be prepared to ramp up prevention efforts, help community groups respond to distress early, and expand access to comprehensive mental health and addiction services. While public and private organizations will face pressure to cut funding for mental health and addiction services, we urge sustained commitment. Cutbacks will cause irrevocable human and societal harm. Long-term support will improve and save lives.
We have come so far. In the last several years, Utah has made significant progress in preventing deaths by suicide and overdose by collaborating and investing where it matters. We must protect those gains. At a time when many things feel uncertain, let’s ensure support for mental health is not one of them.
Greg Bell, President/CEO, Utah Hospital Association; state Rep. Steve Eliason, Utah House District 45; Dr. Doug Gray, University of Utah Department of Psychiatry; Brandon Hatch, chair, Utah Behavioral Health Committee; Morissa Henn, Intermountain Healthcare; Taryn Hiatt, American Foundation for Suicide Prevention; Greg Hudnall, Hope4Utah; Tia D. Korologos, ESI Management Group; Benée Larsen, National Alliance on Mental Illness-Utah