For the sake of our mental health, the next lockdown has to be different

Over the past two years, Americans have experienced unprecedented social isolation, leading to a staggering rise in depression and anxiety. 

Government-directed lockdowns intended to slow the spread of the virus also ripped our social fabric and fractured our social support systems. Loneliness led to depression and anxieties that were compounded by a 24/7 news cycle of confusion, hysteria and uncertainty. We were isolated from our communities, schools and places of worship. While this isolation helped us remain physically healthy, it has taken a toll on our mental health. 

Now, as we see a resurgence of COVID cases due to the spread of the delta variant, many are beginning to feel the same worries and fear as before, and support for mental health services are more critical than ever.

The Department of Health and Human Services has earmarked $3 billion to help address mental health issues and reestablish the Behavioral Health Coordinating Council. These are steps in the right direction, but we need further action.

Before the pandemic, mental illness in America was already a rising challenge. The onset of COVID-19 only exacerbated the rise, disproportionately impacting some of our most vulnerable populations. 

The evidence is definitive and quite alarming.  

For example, transitioning to virtual learning has taken a serious mental health toll on adolescents. According to the Centers for Disease Control and Prevention, mental health-related emergency room visits for children ages 12-17 increased by 31 percent between mid-March and October 2020.  Since the onset of COVID and the ensuing lockdowns, youth between the ages of 11 and 21 reported significantly higher rates of “suicidal ideation” and suicide attempts, according to the Journal of the American Academy of Pediatrics. 

Additionally, an article from National Public Radio highlighted growing mental health concerns reported by child psychologists, even as students slowly return to classrooms.

As summer comes to an end, college students already susceptible to anxiety and depression continue to battle the mental effects of COVID-19. A national CDC survey released this summer showed that college students and young adults reported some of the highest rates of suicidal ideation. Alarmingly, emotional distress calls to national help hotlines increased by 1000 percent this year, according to the National Institute of Environmental Health Sciences.

Our youth are resilient, but we cannot expect recovery without sustained action and support. As college campuses invest in comprehensive testing and contact tracing protocols, it is imperative that they also supply students with mental health assistance. 

Our veterans are another population in need of immediate assistance. Many struggle with constant physical and mental pain and are vulnerable to increased stress and anxiety. The pandemic has only exacerbated the challenges. 

The men and women who served our country deserve to be a top priority. The Substance Abuse and Mental Health Services Administration (SAMHSA), a division of HHS, has already been partnering with the VA, but it is clear more needs to be done. Veterans need greater accessibility to mental health treatments and more awareness campaigns to direct them to helpful resources and crisis hotlines. For example, the VA website provides guidance on how veterans can manage stress and anxiety in the aftermath of COVID-19, but many veterans are unaware of the services or unable to access this important information. It is critical that we prioritize their mental health and provide more accessibility for behavioral support services through the VA, in addition to increased funding for telehealth and clinics.

Mental health challenges caused by the pandemic have also led to a stratospheric rise of illicit drug use, including illicit fentanyl. Last year, drug overdose deaths in the United States increased by almost 30 percent. Shortly after the onset of the pandemic, 13 percent of Americans reported starting or increasing substance use as a way of coping with stress or emotions related to COVID-19. Additionally, deaths from stimulants like methamphetamines increased by 46 percent during the pandemic, in many cases due to contamination by illicit fentanyl. 

Increased drug use is not limited to adults. The trauma of the pandemic and adverse impact on many valued aspects of daily life may increase the risk of young people resorting to illicit drugs. 

Humans are social beings; we cannot force isolation upon students and our society. We should invest as much in maintaining contact with each other as we do in contact tracing. If we do not, the consequences of substance abuse, isolation and suicide are inevitable.

It is undeniable that COVID-19 has adversely affected Americans, but so have the policies implemented to fight the virus. These protocols have had an unintended impact on the mental health of some of our most vulnerable communities. We need to take proactive steps that target solutions in order to prevent those most at risk from falling prey to depression, anxiety and fear.  

As the delta variant sparks fears of another lockdown, we cannot afford to let mental health be a secondary focus this time around.  We highly encourage a practical approach to pandemic response, including:

• Maintaining connections with society;
• Funding support networks, and;
• Stemming the tide of illegal and illicit drug use. 

Medical science and innovative technology will hopefully put an end to the COVID-19 virus, but a new, possibly longer-term mental health epidemic due to COVID-19, may just be beginning. 

Eric D. Hargan was most recently deputy secretary of the Department of Health and Human Services after having served as acting secretary. He also served at HHS under the George W. Bush administration. In addition to serving on the Board of Operation Warp Speed, Eric oversaw the set-up and launch of the Provider Relief Fund, and other parts of the U.S. pandemic response.  Since leaving his post at HHS, Hargan has joined the boards of University Hospitals in Cleveland; Alio Medical; Tomorrow Health; and HealthTrackRx. Follow him on Twitter at @EricDHargan

Vanila M. Singh is the immediate past chief medical officer at the Department of Health and Human Services and former acting regional health administrator for Region 9. She served as chair of the HHS Pain Management Best Practices Inter-Agency Task Force in conjunction with the Departments of Defense and Veterans Affairs. Dr. Singh is currently an anesthesiologist and pain management specialist at Stanford University School of Medicine, and clinical associate professor of anesthesiology, perioperative and pain medicine at Stanford University. www.drvanilasingh.com