Christina, 27, had her first-ever anxiety attack because of COVID-19.
One weekday afternoon in July, she was sitting on her couch in her living room. She’d been furloughed from her job at the front desk of a dental office in early spring, but that hot summer day, her boss called to let her know she’d need to return to the office soon. On the phone, she thought, Thank goodness. They can bring me back, and I don’t have to worry about trying to find another job now.
But then she hung up, and a bazillion other thoughts flooded her brain: how depressed and anxious she’d felt over the past few months, how working with the public is a high-risk gig atm, and how maybe she didn’t feel ready to go back. While paralyzed on the couch playing whack-a-mole with an overload of anticipation and scary scenarios, she realized, Okay, this might be something I need to do something about. So she scheduled an appointment with her primary care physician, who prescribed her Prozac and helped her find a therapist.
Calls to the Disaster Distress Helpline (1.800.985.5990), which is for people going through emotional distress related to disasters including COVID-19, were 891% higher in April than they were in the same month last year.
Obvi, Christina is so not the only one feeling on edge. Since March, Americans’ depression and anxiety levels have spiked—especially women’s and young people’s—while happiness levels have plummeted. Calls to the Disaster Distress Helpline (800-985-5990), which is for people going through emotional distress related to disasters including COVID-19, were 891 percent higher in April than they were in the same month last year. Nope, there’s no decimal point missing in that stat.
And, of course, it’s so much worse for Black Americans. Within a week of the release of the video of George Floyd’s death, “anxiety and depression among African Americans shot to higher rates than experienced by any other racial or ethnic group, with 41 percent screening positive for at least one of those symptoms,” the Washington Post reported in June, in an analysis of Census Bureau survey data.
To sum it up: The past few months have been absolutely horrendous for mental health.
But this problem isn’t new. Waaay before Americans faced these record levels of sadness, anxiety, and grief. Before they were losing jobs AND health insurance. Before they were bumping therapy to the bottom of the essential expenses list behind groceries and rent—finding a mental health care provider who had availability and took your insurance was a b*tch.
Back in 2018, nearly 1 in 5 adults in the U.S. experienced mental illness in the past year, and 23.6 percent of those people didn’t feel like they could get the treatment they needed because of barriers like the cost and not knowing where to go to get help, per a survey by the Substance Abuse and Mental Health Services Administration.
The number one issue with mental health care is and has always been that (a) people can’t find it or (b) people can’t afford it, says Pooja Lakshmin, MD, a clinical assistant professor in the department of psychiatry and behavioral sciences at the George Washington University School of Medicine and Health Sciences and founder of Gemma, a digital education platform for women’s mental health.
And as more people face mental health issues (see: all of *waves hands* the above), this country’s effed-up mental health care situation has the potential to get way, way messier.
There’s really only one silver lining here: Now that mental illness is (FINALLY) in the spotlight, seeking help has been normalized, says Alyssa Petersel, LMSW, founder and CEO of MyWellbeing, a site that helps New Yorkers find their therapist match.
But (sadly) talking about your new anxious feels or your bestie’s ongoing struggle with depression doesn’t make it any easier to get the help you both deserve. To extinguish this emotional dumpster fire, we explain exactly what needs to change and how we can make it happen.
Step 1: Loosen telehealth restrictions forever.
After Kara, 39, and her three kids began sheltering in place this past spring, she began doing mental health care appointments via Zoom and became a big fan of telehealth. “I do not plan on going back to in-person therapy until they make me,” she says. Now Kara doesn’t have to worry about who’s taking care of her kids for the exhausting three hours it takes to get to her appointment, do the work, and get home. “It’s eliminated a lot of stress in my life,” she says.
But at some point, she could be forced back into those in-person appointments. That’s because many teletherapy options are only a thing since the federal government, state governments, and insurance companies eased up on restrictions back in the spring.
Before then, those groups had tighter rules on where mental telehealth can take place from and who can provide that care. So if you live in Vermont, you could suddenly start seeing a therapist who’s licensed in Virginia.
And while this location thing didn’t happen across the board, making this change permanent across the U.S. has never made more sense. Hello! A huge part of our mental health care problem is that people can’t find a therapist in their area who suits their insurance, mental health issues, or budget (not to mention their cultural background, which, more on that in a sec).
If you’re out here like, Well, in-person therapy is probably better anyway, right? lemme just say: not really. For most people, telehealth therapy totally works, per the American Psychological Association (APA).
So, even far into the future when COVID-19 is a thing of the past (Knock. On. Wood.), many mental health advocates are hoping these tweaks stick and that more are coming.
Step 2: Fund programs that support aspiring BIPOC therapists.
If you’re Black and your therapist is also Black, you won’t have to explain to them what microaggressions are, says Sharlene Kemler, CEO of the Loveland Foundation, which funds mental health care for Black women and girls through partnerships with Therapy for Black Girls, National Queer and Trans Therapists of Color Network, Talkspace, and Open Path Collective.
Kemler says the Loveland Foundation is seeing a huge demand for therapists of color and hopes to eventually start an additional scholarship fund to help BIPOC enter the therapy field: “This year has been extremely triggering for myself, and when I am talking to other Black women, it’s the same thing.”
“You just want a provider you can talk to that’s going to be able to give you the skill sets and advice you need without making you wonder, ‘Was that a slighted comment? Did they really understand what I was talking about?’” says Kemler.
But they’re not easy to find. While orgs like Therapy for Black Girls have created therapist directories, the amount of BIPOC therapists out there literally can’t meet the demand—especially now.
Like the rest of the U.S. health care system, the racial disparity in providers in this country is embarrassingly wide. In 2019, U.S. psychologists were 83 percent white, even though the general U.S. population is 60 percent white. Just 7 percent self-ID’d as Hispanic, 4 percent as Asian, and 3 percent as Black/African American.
The good news is that lawmakers recently proposed increased funding for a program that benefits young people of color through H.R. 5469, the Pursuing Equity in Mental Health Act, which (among many, many other things) allocates more money for the existing Minority Fellowship Program, which supports people of color entering the behavioral health field. Sadly, this bill is likely to sit on Capitol Hill until at least 2021, says Katherine McGuire, chief advocacy officer at the American Psychological Association.
Still, there are other publicly funded programs that already exist to help diversify the pool, like the Scholarship for Disadvantaged Students Program, the Centers of Excellence Program, and the Faculty Loan Repayment Program. All of these rely on continued funding from Congress, says McGuire.
The TL;DR: We need lawmakers to prioritize mental health funding.
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Step 3: Make emergency mental health care even more accessible.
You may have heard of the National Suicide Prevention Lifeline (800-273-8255), which has been around since 2005 and is available 24/7 for people in suicidal crisis or emotional distress. It’s a great resource, but the truth is that most people don’t have that number memorized, which makes sense.
That’s why lawmakers recently passed a bill that makes 988 the official suicide prevention and mental health crisis emergency number nationwide. “If you have a mental health crisis, you have to remember a very long number for suicide prevention assistance or call 911,” says Mary Giliberti, executive vice president of policy at Mental Health America (MHA).
That and, as we’ve seen countless times in the news, calling the police for assistance can be very problematic for people with a mental illness—especially in communities of color, she adds. There’s also the fact that 2 million people with mental illness are put in jail every year, according to the National Alliance on Mental Illness (NAMI), and that’s not even counting the lives lost to police violence, like Daniel Prude and Walter Wallace Jr.
So, yeah, that bill was signed into law—but it won’t be available to everyone until the summer of 2022. “Until 988 is fully implemented, it’s imperative that anyone who is in a mental health crisis or suicidal distress continues to reach out to the current lifeline number [again: 800-273-8255],” says Kimberly Williams, president and CEO of Vibrant Emotional Health, which administers the lifeline. You can also chat with them here—it’s super easy.
The dream for many advocates is that 988 kicks off the creation of an entire mental health crisis response system in the U.S. For example, you’d call 988, get connected with a local crisis center, and a non-law-enforcement crisis team comes to you to provide in-person help.
Unfortch, it will take roughly two years for phone companies to make network changes and for the National Suicide Prevention Lifeline to prepare for an increase in calls following the switch to the 988 system, per the Federal Communications Commission. And A LOT can happen between now and then.
So what the hell do we do now?
Don’t just sit back and watch America’s collective mental health go down in flames. Instead, take these steps.
Write letters.
1. Find your federal, state, and local reps here, and write them letters about the mental health care changes you want to see. If you’d like a little help with the deets, NAMI and MHA have letter templates covering a few different bills and initiatives. (You can also join both of those orgs’ more general advocacy networks here and here to stay posted on the bills that need some help.)
Attend local meetings.
2. Go to your local reps’ town halls and other community meetings, and speak up. “I think engaging locally is important,” Giliberti says. “As your local officials talk about how they’re going to allocate resources and what services and supports are going to be available in communities, I think it’s really important for people to be part of those conversations.”
Give money.
3. If you can swing it, donate to orgs that fill in the gaps: ones that help people afford therapy, like the Loveland Foundation Therapy Fund; advocacy nonprofits like NAMI and MHA; and crisis intervention and suicide prevention-focused orgs like the Trevor Project and the Jed Foundation. There are so many amazing organizations out there, so find the ones that speak to you.
