The coronavirus pandemic is creating an unprecedented mental health crisis in our communities. What we in the behavioral health industry see daily is being echoed by federal agencies and experts warning that a historic wave of mental health problems is approaching — depression, substance abuse, post-traumatic stress disorder and suicide.
Unfortunately, paralleling the underfunding of public health services, we may not be ready for what’s ahead. Under the pressure of this outbreak, and without sufficient support from our government, we are likely setting our country up for a crisis of access where there aren’t enough mental health care providers available to meet the needs of the coming influx of patients.
Consider that access to and coverage for behavioral health care is already at a critical breaking point. Louisiana is ranked among the Top 10 states in the U.S. for the prevalence of mental health challenges, while simultaneously being ranked among the bottom 10 states for access to care, according to the latest Mental Health America report.
And right now, mental health care providers are struggling. As the CEO of a behavioral health company with hospitals in hard-hit regions like New Orleans, we have experienced a decline in patient volumes as COVID-19 ramped up. That has meant steep declines in the revenue organizations need to keep doors open, lights on and beds staffed.
We know those patients didn’t just disappear or miraculously get better. Given the fear of COVID-19, they deferred in-person care that could mean the difference in appropriately managing a mental health concern and exacerbating a life-threatening illness.
In fact, crisis hotlines have seen increased volumes, some at almost twice the normal rate. The Substance Abuse and Mental Health Services Administration saw a fivefold increase at its National Helpline between the beginning and end of March. The Crisis Text Line says its volume is up 40% in the pandemic, to about 100,000 conversations a month.
Further, the Meadows Mental Health Policy Institute created models that suggest if unemployment rises by 20 percentage points — a projection economic advisers are saying our country could reach by next month — suicides could increase by 18,000 and overdose deaths by more than 22,000.
Thankfully, our organization is positioned to weather the crisis in the near-term, but I know many of our peers are not. The nation, individual states and our industry needs a smart, comprehensive strategy — with dedicated funding — to ensure our mental health care system can meet the demand. If providers are forced to close their doors there will be even less access for the wave of patients that will come in the months ahead.
Unfortunately, of the trillions of dollars in stimulus funding Congress has approved thus far, very little has been directly allocated for mental health providers. There is room at the table for our very deserving colleagues in acute and post-acute care, and the struggling travel and hospitality industries, but it is critical we map out a plan for preserving the behavioral health safety net. Without it, the services that are essential to the wellbeing of millions of Americans with mental illness are in jeopardy. And the lives of people we care about — family members, first responders, teachers, entrepreneurs, artists, civil servants — are at risk. We each know a friend or loved one who at one time has had difficulty accessing mental health care. Imagine if the numbers seeking care double or triple.
Through the next iteration of the CARES Act, we’re hopeful we can see funding set aside for behavioral health hospitals, recognizing that these facilities are also treating COVID-19 patients and seeing a dramatic reduction in patient utilization, similar to acute care hospitals. In the intermediate and long term, we’re also hopeful the next round will make permanent some of the now-temporary telehealth reforms and allow for increased provider training programs.
While no health care provider could have predicted the personal or economic toll COVID-19 would exact, we can predict — and be prepared for — the mental health crisis at our doorstep.
Stuart Archer is CEO of Oceans Healthcare, a provider of behavioral health treatment to older adults and seniors with hospitals in Louisiana, Mississippi and Texas.