A Pandemic’s Simmering Pandemic

Meeting a demand while building resiliency.


A Toll No One Knows

At the moment, it’s not possible to accurately measure the all-encompassing impact of the COVID-19 pandemic.

From finance and housing to education and mental health, It has seemingly touched every aspect of life in ways that can only be understood through personal experience.

Going forward, once the pandemic is behind us, we’ll be able to see a detailed picture of the overarching toll. For now, we’re starting to get a glimpse of what that picture will look like.

It will include a generation of children who grew up in a formative period where they could not play with friends or hug their grandparents, could not attend school and could not explore museums and playgrounds like they used to. It will include a startling percentage of women who left the workforce to care for and teach those children at home.

It will also include a nationwide group of frontline healthcare workers who put their lives on the line to try and save others, many times without success. As minority populations experienced a higher rate of infection from the virus, the aftermath of the pandemic will also have a
disparate impact on communities of color with
many empty chairs left at the dinner table.

And overall, it will include a nation that has been
deeply impacted, one that needs to heal in a number
of ways and will very likely need help doing it.

This scratches the surface and begins to describe the genesis of what experts have described as a “pandemic within a pandemic,” a simmering behavioral healthcare crisis that could create a “tsunami” (as several providers have labeled it) of need in the months and years ahead.

75,000 projected additional deaths of despair related to COVID-19.

An expanded behavioral healthcare regulatory landscape has allowed for an evolution of care that could assist with capacity challenges; however, the waning stigma over mental health conditions and treatment is prompting more people to seek help — which could fuel additional capacity challenges.

None of the needs ahead are insurmountable, and — if anything — humanity has shown itself to be a resilient force. Preparing for the unknown based on what is known could shape the trajectory of future outcomes.

A Measurable Impact

The impact of the COVID-19 pandemic is illustrated by the statistically supported themes it is shaping across different populations. Accordingly, each of those themes may benefit from behavioral health intervention, which most experts agree, is most beneficial when delivered in a timely manner — meaning a balanced capacity is crucial for achieving the best possible outcomes.

Generation C

A generation of children growing up with, being born into and feeling the after-effects of a world shaped by COVID-19. Experts debate the span of time but agree the most vulnerable are the 7-9 age group.

(Un)Working Women

American Progress reports women lost at least 1 million more jobs than men during the pandemic, and in December of 2020, women accounted for 100% of the 140,000 job losses that month.

Surging Substance Abuse

Stay-at-home orders correlated with a surge in drug overdoses, according to data compiled by Forbes. In one month alone, May of 2020, overdoses increased by 50% compared to baseline averages the two previous years.

Disease Disparity

CDC figures reveal that minority populations, such as Black American,
Hispanic American and Native American populations, experienced increased
rates of infection, hospitalization and death than white Americans.

Frontline Fatigue

A survey during the summer of 2020 by Mental Health America revealed that 82% of frontline healthcare workers were emotionally exhausted and 68% were physically exhausted. About 10% of healthcare workers have resigned since the pandemic began.

The Rippling Mental Health Effect

When it comes to the stresses and viability of behavioral healthcare clinics and organizations, an analysis of pandemic-related cause and effect, seems to resemble an entangled, blurred loop.

Just as a number of community organizations are facing an increased demand for care, so too are a number facing the crippling reality of lost revenue and potential closure

A survey conducted by The National Council for Behavioral Health in September of 2020 indicated 52% of behavioral health organizations were seeing an increase in demand for services. At the same time, 54% of organizations had to close programs and 65% had to cancel, reschedule or turn away patients.

As an added variable, people have become more comfortable seeking treatment for mental illness in recent years which represents progress but increases demand.

In the wake of the pandemic, clinics and organizations that remain open will be seeing patients with a wide range of mental health challenges, either directly or as a consequence of physical conditions introduced by the illness.

For example, the CDC reports long-term symptoms of a COVID-19 infection could include joint and muscle pain, depression, heart palpitations and other cardiovascular complications, a “brain fog” characterized by an inability to concentrate, anxiety and mood changes, and neurological complications linked to sleep issues and memory problems.

In addition, Harvard Health Publishing reports a notable percentage of COVID-19 survivors who had received ICU care had a profound degree of cognitive impairment, comparable to a traumatic brain injury.

And even for those who have avoided a COVID-19 infection, or who have recovered without complication, they still had to survive the anxiety that comes with a pandemic, the isolation it required and the financial and lifestyle burdens it created. To cope, according to the CDC, about 13% of Americans started or increased substance use. A survey by the Addiction Policy Forum indicates measurable increases in cocaine, methamphetamine, heroin and non-prescribed fentanyl following nationwide quarantine orders

Across the board, the fallout from the pandemic has created a recipe for a perfect storm of needs, and it’s waiting on the doorstep of the behavioral healthcare and addiction treatment communities.

People have become more comfortable seeking treatment for mental illness in recent years which represents progress but increases demand.

— Source: Health Partners

The perfect behavioral healthcare storm

Trauma


Isolation


Job loss


Grief


Substance abuse


Depression


Illness


Mitigating A Crisis. Resiliency through flexibility.

"And so our job now is to make sure that what happened to COVID-19, where we knew it was coming, but we didn’t really quite do what we needed to do to prepare for it, that that doesn’t happen again with respect to the coming epidemic and tsunami of overdose and suicide.”

— — Patrick Kennedy, on PBS Newshour

The Upside to Adding Remote Team Members

  • Alleviate capacity issues
  • Prevent provider burnout
  • Flexibility in scheduling
  • Introduce new specialties
  • Improve access to care

The delivery of behavioral healthcare and addiction treatment has evolved, drastically and quickly, as a result of the pandemic. Where telepsychiatry became a necessity during periods of quarantine, it is increasingly becoming a sustainable choice for an industry facing a number of challenges related to capacity, staffing, demand and complex patient populations such as those living with SMI and co-occurring conditions.

Clinics and organizations that found flexibility throughout the pandemic by integrating remote providers into their in-person clinical teams improved their capacity and decreased noshows while improving access to care for the patients who needed it most.

And by adding a diversity of provider types beyond psychiatrists, including psychiatric nurse practitioners and licensed clinical social workers, clinics and organizations realized the benefits of expanded provider teams that were able to see and offer treatment to children and adults.

In the end, the flexibility of remote care allows providers to break through physical barriers and meet their patients exactly where they are.

The quality of outcomes directly correlates to an ability to access care. Improved access improves outcomes. And improved outcomes define resiliency, which is the ultimate goal.