The pandemic has caused an estimated 53 million new cases of major depressive disorder and 76 million new cases of anxiety disorders, according to a recent report in The Lancet. While these numbers are staggering, they are not surprising for those in the mental health industry, where mental illnesses were among the leading causes of disability even before the pandemic.
To fully understand this issue, we need to take an honest look at where mental health was prior to the pandemic
Even in the 21st century, society has shown little appreciation or empathy for the prevalence of mental health conditions, despite the significant impact and toll on those suffering with such diagnoses. Generally, people perceive mental illnesses like depression and anxiety as affecting a relatively small percentage of the population. This misperception is confounded by the fallacy that this small population only suffers from mental health challenges on an occasional or part-time basis. These misunderstandings have led to the general belief that if isolated issues can be resolved, and only a small population is affected, then everything will be alright.
The reality is considerably different. Neuropsychiatric conditions such as depression and addiction have always been the leading causes of disability worldwide. In the United States, 10 percent of insured individuals account for 70 percent of total health care costs, and 57 percent of the high-cost individuals are categorized as behavioral health. Mental health problems only intensified during the pandemic, especially amongst young adults.
The pandemic has made a multi-faceted impact in our lives, which has exacerbated existing mental health issues and created new cases of depression and anxiety disorders. We have had to deal with the effects of the virus on the brain as well as the body. We endured loneliness from extended shutdowns, sheltering in place and social distancing. The loss of daily structure of our pre-pandemic lives and the insecurity we experienced in its wake. Many experienced loss of income and long-term unemployment. Sleep difficulties are more prevalent, due to overwhelming anxiety, changes in structure and increased weight. The pandemic has stressed us emotionally, physically and financially.
This combination of stressors sends the perfect storm of patients seeking treatment to an already overwhelmed levee of qualified professionals. There are record-high rates of people unable to find help. One in two people struggle with mental illness, without enough appointments available for patients to see a qualified healthcare professional.
Why are there not enough appointments available? The short answer is because we do not have enough therapists and psychiatrists to meet the need. People simply cannot get in to see a therapist, much less a psychiatrist, due to the unprecedented demand. Most people do not realize that a provider shortage already existed before the pandemic. The demand increased in the pandemic era, creating a serious mental health crisis.
Even when an available therapist or psychiatrist can be located, they may not take insurance. Given the heightened demand, mental health providers can opt to solely work with patients who can pay out-of-pocket, creating barriers for equal access. The rise of telehealth promised to bring more mental health care options to more people, but most mental health problems cannot be realistically addressed in a remote therapy session.
Illnesses such as major depression, obsessive-compulsive disorder (OCD), panic disorder, social phobia, psychosis, bipolar mania and substance use disorder are serious conditions that cannot be fully evaluated or treated by a clinician who is never in the same room. Similarly, digital therapeutics or computer delivered therapy is meant to aid the clinicians caring for patients, but not to substitute the responsibility for thorough evaluation and patient care.
Primary care doctors have also been stretched thin throughout the pandemic with an uptick of COVID-19 patients and issues. They are now being asked to provide more mental health treatments than ever before, due to this shortage. General practitioners only know a basic level of mental health care.
To address this mental health shortage requires realistic and sustainable solutions. The pandemic has put a spotlight on the mental health crisis. As we are now almost two years in, it is clear that the virus is not going away soon. We will be dealing with it in some form or another for a long time, and we may have another agent to deal with at some point. We should be thinking of SARS-CoV-2 as endemic — like the plasmodium cause of malaria carried by mosquitoes.
As the mental health crisis has been accelerated and spotlighted by this endemic, we must create sustainable solutions and relief for the millions struggling with mental illnesses. We need to solve the shortage in affordable, quality mental healthcare and expand accessibility and visibility to alternative methods of effective treatment. Mental health is a critical cornerstone of how we function individually and as a society.
Dr. Aron Tendler is the chief medical officer of BrainsWay, developers of Deep Transcranial Magnetic Stimulation (Deep TMS) is the only TMS treatment FDA-cleared to treat four indications: Depression, Anxious Depression, OCD and Smoking Addiction. As CMO, a medical doctor and a psychiatrist with decades of experience, Tendler’s research has been published in numerous peer-reviewed journals.