The COVID-19 pandemic and the resulting
isolation requirements, economic
recession, and record unemployment
rates are creating a perfect storm for
increased reports of worsened mental
health, substance use, and suicidal
ideation. Safety guidelines for the
pandemic including self-quarantining,
social distancing, and limited essential-
only travel keep people anxiously sitting
at home as the death toll climbs,
recently surpassing 200,000
in the
United States alone. Social isolation and
loneliness are linked to poor mental
health and increased risk of suicide and
recent data shows higher shares of
people sheltering in place reporting
negative mental health effects than
those not staying home.
Isolation and stay-at-home orders amidst a pandemic also
breed several behavioral problems including increased
substance use, more frequent opportunities for domestic
and social violence, and reduced access to emergency and
health services, potentially limiting the chances of
intervention before fatal consequences. People with pre-
existing mental health conditions or substance use
disorder (SUD) and those who have experienced violence
are particularly vulnerable in an emergency and have a
higher risk of suicide. An analysis by Well Being Trust and
the Robert Graham Center for Policy Studies projects that
an additional 75,000 deaths due to suicide and alcohol or
drug misuse may occur by 2029.
According to the CDC, younger adults, racial/ethnic
minorities, essential workers, and unpaid adult caregivers
are also disproportionately affected, likely due to
increased stress from social factors including racial
injustice, fear of exposure to the virus, and loss of income
and/or health insurance.
The CDC also found reports of increased substance use
and serious suicidal thoughts in the last 30 days were
higher amongst Black respondents than white and Asian
respondents. Black people are witnessing traumatic
displays of systemic racism and injustice on a global stage
as police brutality protests continue, most recently
following the abhorrent results of the Breonna Taylor case.
Witnessing police commit murder and not be held
accountable time and time again has undoubtedly played a
part in Black communities experiencing worsened mental
health conditions.
Essential workers represent another group whose mental
health conditions have been disproportionately affected.
Increased substance use and suicidal ideation were more
prevalent among employed respondents than unemployed,
and among essential than nonessential. This can be linked
to various factors including fear of exposure to the virus,
worsened by a shortage of PPE for health care workers in
some places. Health care providers in China during the
outbreak reported "feelings of depression, anxiety, and
overall psychological burden," especially amongst nurses,
women, and providers directly involved in treating COVID-
19 patients. Physicians experiencing burnout are also at
higher risk of depression, substance use, and suicide.
Unpaid caregivers staying home are at a similarly
increased risk as well as younger children (18 and under)
or older adults (65 and up) being cared for. Despite being
less likely to report negative mental health impacts due to
worry about the Coronavirus, recent polls still show an
increase in these negative impacts among older adult
respondents who did report. Older adults are already
prone to poor mental health, particularly depression, due
to loneliness and bereavement, both of which can be
exacerbated by the pandemic. Prevalence of depression is
higher in older adults who require home care and is often
misdiagnosed and mistreated. Suicidal ideation is an
especially large concern among older adults during
COVID-19 as they accounted for nearly one out of five
suicide deaths in the U.S. in 2018.
While older white males experience the highest rate of
suicide in the U.S., they are less likely to report mental
health issues than their female counterparts. A poll
conducted in July found that women more often report
worsened mental health due to worry about the
Coronavirus as well as symptoms of anxiety and
depression. This is especially true of women with children
under the age of 18 affected by closures of schools and
childcare centers. Spouses and children spending more
time in the house together amidst disrupted routines and
financial insecurity also allows more opportunities for
violence, further increasing risk of mental health issues,
suicidal ideation, and death.
People with pre-existing mental or physical health issues
and/or substance use disorder (SUD) are at the highest
risk for these negative impacts due to the pandemic. A
recent study warns that "COVID-19 and addiction are the
two pandemics which are on the verge of collision causing
major public health threat." Complications from various
substance addictions including alcohol, cigarettes and
vapes, and opioids increase risk of contracting COVID-19
and worsening effects of the virus. The study examines
the intersections at which the physical, societal, and
behavioral impacts of the pandemic, cycles of substance
use, increased stress, and loss of access to health care
meet.
A number of stressors causing people, especially in
marginalized communities, to begin or continue substance
use are listed including "prolonged home confinement,
depression and panic due to unknown nature of the
disease, fear of contracting infection, vulnerability, work
from home, anxiety regarding low income, and fear of
losing jobs." Addictive substances provide cheap and
simple, albeit temporary, relief to distress. Surges of
addictive behaviors have been reported during this period
as well as increased withdrawal emergencies and death
due to a lack of access to healthcare services, resulting in
users procuring drugs illegally. A recent study found that
"13.3% of adults reported a new or increased substance
use as a way to manage stress due to the coronavirus and
PAGE 11 October 2020 PAGE 17 October 2020
