People are really stressed out right now. A recent national survey reports that “serious psychological distress” — the kind that can lead to longer-term psychiatric disorders — has more than tripled since this time last year.
We are already seeing the consequences in Sarasota County, with the number of opioid-related deaths in the first half of 2020 more than double the number in all of 2019. And based on experience with SARS, experts predict a surge in suicide, particularly among the elderly.
It is hardly surprising that our mental health is suffering: soSial isolation, job loss, economic insecurity, fear about loved ones, and uncertainty about the future are all risk factors for poor mental health. It would be nice to think that once the pandemic is over, we will all go back to “normal.” But research suggests otherwise.
Mental health problems have been on the rise for at least a decade, especially among the young. There appear to be multiple causes. Income inequality and racial disparities have long been linked to poor mental health outcomes. Youths in particular are showing significant “climate anxiety” — a condition linked to fears about the environment. Too much screen time may be affecting our sleep, and school shootings destroy our sense of safety. And a 2019 study found that 4% of the population have had suicidal thoughts due to politics.
If you add in the long-term consequences of the unrelenting stress of COVID-19, we are headed for trouble. The current model of mental health, with its focus on diagnosing and treating symptoms, already can’t keep up. If social stressors continue to escalate, the service system will quickly be overwhelmed.
This situation calls for an entirely new model of mental health. While the instinctive response to escalating needs is to expand capacity, the problem can’t be solved by adding a few more clinicians or a few more crisis beds. We need a model that focuses on building resilience in the entire population, and one that prioritizes support for high-risk populations before they develop severe symptoms.
Our current service system is largely passive — we wait for people to ask for services. We need to create a system that reduces risk and is ready to respond at the first signs of potential problems.
To create a new system, we need to change the way we think about investing in mental health. Mental health is not an expendable service that benefits only a few. It is — or should be — an investment in our social capital. In North America, the annual cost of adverse childhood experiences is $748 billion – almost 3.5% of GDP. Here in Sarasota County, the current economic cost of untreated mental illness is over $86 million. We literally cannot afford to ignore this issue.
We all know that budget cuts are coming, and with it the inevitable scramble to preserve the status quo. Instead of arguing about what to cut and what to save, we should be working together to figure out how to invest upstream — to build a healthier community and a more productive workforce.
Population-based approaches work. In the 1980s, elementary school children in a high-crime area of Seattle were taught social and emotional skills. Not only did the children do better as adults than those in the control group, but when researchers returned 30 years later, the children of original participants were outperforming others on a variety of measures of well-being. Universal prevention programs are also a good financial investment: Studies show programs returning up to $56 for every dollar invested.
In the long run, public policies are needed to address the social stressors that affect our mental health. But solving the climate crisis and fixing our political system are not going to happen overnight. We need to invest in building resilience among our youths now.
Our social service systems are already undergoing major changes due to COVID-19. Now is a perfect time to reset our goals, and to begin scaling up individual and collective resilience. Our future may depend on it.
A former state mental health commissioner, Andrea Blanch was founding director of the Collaborative for Conflict Management in Mental Health at the University of South Florida and the National Trauma Consortium. She works locally with the Charles & Margery Barancik Foundation.