It is hard to envision silver linings when we are talking about the mental health impact of COVID—19. The acute impact to mental health services is devastating and the long term impact in regard to trauma, anxiety and grief is incalculable. Billions of dollars would be needed to make even an incremental impact.
There is, however, one collective change that seems to be positive in regard to the normalizing of mental health.
For many years, advocates have talked about how mental health concerns and mental illness are as common as many physical health concerns. We have been talking till we are blue in the face about the one in five people that have a serious mental illness ; about how people with serious mental health issues pass away twenty five years younger than the general population; how two out of every three people with a mental health issue never seek treatment and how half of all chronic mental health issues begin by age 14.
Though there have been great collective strides over the years in the recognition of mental health issues, COVID—19 has shaped a new mindset about mental health. Leaders across the country are talking about it openly as never before. Yesterday, Governor Cuomo spent a great deal of time emphasizing the long term impact of trauma and other mental health concerns. Famous fashion designer and the Governor’s Brother In Law, Kenneth Cole has developed the Mental Health Coalition to respond to the stigma of mental health (article below)
COVID—19 will impact us for years to come but let’s hope that one of the positive outcomes will be changes around compassion, caring and the elimination of the discrimination and stigma related to mental health conditions.
Think of how absurd it is that we used to whisper about Cancer as if you said it, you could get it. Don’t you think it is time we did the same about mental health issues
Listed below are a series of articles related to mental health during this time of COVID—19 from The Washington Post, The Guardian and Time Magazine.
Kenneth Cole wants to fight mental health stigma — and he’s enlisted Kendall Jenner and a host of experts to help
May 15, 2020 at 8:32 a.m. EDT
During the height of the AIDS crisis in the 1980s, New York fashion mogul Kenneth Cole worried that the stigma surrounding the disease could kill more people than the virus itself. Discussing HIV was still a taboo in many places, and infected people everywhere faced discrimination and violence, leading some to avoid getting tested at all.
So Cole, then in his 30s, decided to use his budding influence as a businessman and designer to encourage people to talk openly about it. He took out full-page ads in magazines. He rallied celebrities, supermodels and scientists for awareness campaigns. He joined the board of the AIDS research organization amfAR, where he served until 2018.
Now, after more than three decades of work on that crisis, Cole is bringing the same blueprint to mental health.
On Friday, Cole launched the Mental Health Coalition, a collection of three dozen advocacy groups, celebrities and business leaders whose primary goal is to remove the stigma around mental health and help people access the services they need.
The effort is beginning at a perilous time for mental health in the United States, with the coronavirus pandemic giving rise to widespread psychological trauma and straining the nation’s already fragmented and underfunded mental health system. Large portions of Americans have reported that the crisis has harmed them psychologically, and hotlines for people in emotional distress have experienced spikes in calls and texts. Researchers worry that the effects of isolation, job loss, illness and death could linger long after the virus subsides.
Cole, who conceived the coalition before the virus hit, said the realities of the pandemic underscored the need to change the narrative about mental health “to one that’s non-clinical and non-stigmatized.”
“You can’t do something like that unless it’s done collectively,” he told The Washington Post via Zoom. “You need one cohesive path.”
The coalition kicked off Friday morning with an Instagram campaign spearheaded by Kendall Jenner that calls on people to share videos of themselves speaking honestly about their mental health challenges and how they deal with them.
Some of the videos from the initiative, called “How are you, really?”, will be featured on a standalone page after careful vetting from mental health experts to make sure they aren’t triggering for anyone who visits. The first features a quarantined Jenner opening up about her coping strategies on the days when she feels anxious.
“During this quarantine, I have realized that now, more than ever, mental health is so important,” she told The Post in a statement. “I wanted to instill some hope in everyone out there and let them know that they are not alone.”
One of the key players in the coalition is the Crisis Text Line, a fast-growing mental health service that became the country’s first organization to offer round-the-clock support via text when it launched in 2013. Nancy Lublin, the chief executive, said she was surprised when she got a call from Cole in the fall asking if she would join.
“I was like, wait, am I being punked?” she said.
As they talked, she was impressed that Cole seemed well-versed in mental health issues and wasn’t coming with any additional agenda. She remembers telling him: “If you can make it cool to share feelings, do that, because that’s what you know how to do. That’s your swimming lane. Take that lane.”
Cole is the first to admit he has no special expertise in mental health.
“We started convening all these well-informed people, and I’m not any of those well-informed people,” he said. “I’m probably the least informed of the circumstances that surround mental health, and it’s not something I’ve committed my life to. But I am good at committing well-intended resources and inspired by the work they can do.”
While Cole’s past advocacy efforts have won him plenty of partners and admirers, they haven’t been without controversy. His 2005 “I Have AIDS” T-shirt campaign was too blunt for some people. And after a decades-long tenure with amfAR, he stepped down as chairman in 2018 after board members raised concerns about some of the organization’s charitable transactions.
Supporters say Cole’s boldness is an asset, and say his long track record of public service campaigns makes him well-equipped to take on mental health.
Zach Iscol, founder of the Headstrong Project, which provides mental health treatment for military veterans, signed on with the Mental Health Coalition after he and Cole spoke about the challenges his organization was facing.
The biggest barrier to getting veterans treatment was convincing them to seek help in the first place, Iscol said. The coalition can help people take that step, he said.
“It’s not just a hashtag. It’s not just reach out and see how somebody’s doing,” he said. “There are resources here as well.”
Cole said his fascination with the science behind mental health is part of what drives him. He was particularly shaken by research on the psychological effects of quarantine during the SARS outbreak that showed certain groups of people, including front-line workers, experienced post-traumatic stress and depression after being confined for long periods.
“Just imagine the impact that’s going to happen here. That’s going to last so much longer and penetrate so much deeper into our communities after we come through this process,” he said. But there’s also “very clear science and research that shows how you can move forward.”
In the long term, Cole wants the Mental Health Coalition to steer resources and funding to mental health programs, many of which have been left on the brink of financial collapse because of the pandemic. And when the time is right, he said, he’s prepared to hand over the reins of the organization to someone else, likely a mental health expert.
“If I can shine a light on the work that they do,” he said, “there’s so much more that we can accomplish collectively.”
How a pandemic will help us confront America’s mental health crisis.
Could there be a silver lining to Covid-19?
Stigmas surrounding mental health have long forced Americans to suffer in silence. Keeping internal angst private has been a routine practice of the nearly 47 million Americans impacted by a mental health condition. While Covid-19 has undoubtedly caused suffering, death and isolation, its tumult might just remove the cloak of secrecy that has long plagued many mental-health sufferers and their families.
A new study by purpose-driven advertising agency OBERLAND, in conjunction with publishing partner Guardian Labs, the Guardian’s branded content studio, reveals that an astounding 83% of Americans admitted to feeling stressed and overwhelmed since the arrival of coronavirus – and what’s more, 45% have sought out additional mental health help or support. Seventy-six percent said they feel more empathetic toward people going through mental health challenges since Covid-19.
Powered by the real-time market research platform Suzy, the study of 500 respondents throughout the US revealed that the mental health landscape is changing – and brands and employers have no choice but to keep up.
“The fastest ways to end stigmas of any kind have always been first-hand exposure and shared experiences,” said OBERLAND’s co-founder and president Drew Train, a Board member of the National Alliance on Mental Illness of New York City and advocate for mental health in the workplace. “Covid-19 has created both for Americans regarding their mental health. Almost all of us are feeling increased stress and anxiety brought on by a mix of fear, uncertainty, change and misinformation. This is causing people to reflect on their mental health and the issue in general, which has resulted in a growing sense of empathy. My hope is that we can harness this empathy and use it to improve our capacity to treat people effectively and with dignity.”
In this climate, marketers that acknowledge consumer anxiety will be the winners. “Coronavirus is having a significant impact on consumer behavior,” said Train. “Brands that lead with heart and act with empathy, that make themselves more down-to-earth and honest will better be able to reclaim their loyal consumer base post Covid-19.”
Matt Kudish, executive director of the National Alliance on Mental Illness of New York City (NAMI NYC), suggests that solidarity surrounding mental health has been another important effect of the current public health crisis. He says there is not only “more permission to talk about mental health – to say ‘yeah this is scary,’ ‘I’m freaking out’” but to feel that this is universal and shared. “There’s a really community piece of the experience,” he says, which could also explain the rise in help-seeking behavior.
Pre-Covid studies suggested that the percentage of Americans who sought out help hovered at about 9% percent (17 million Americans). That’s just a fifth of what the recent study reveals, which doesn’t surprise Pamela Bell, the founder and CEO of Prinkshop and a co-founder and creative partner of the Mental Health Coalition. “People who have never even used the words anxiety and depression are now hearing and using these words on a daily basis,” said Bell, whose work with the Mental Health Coalition focuses on reducing stigma. “The coronavirus crisis will ultimately force people, brands and employers to acknowledge that each of us has a mental health and that it must be taken into account in daily life.”
With 41% of survey respondents revealing that initiatives to protect employees is a top action they want brands to take, marketers can’t afford not to listen. Consumers who want more sanctioned time off to take care of their mental health issues are going to be watching to ensure that brands that portend to be purposeful – especially during the coronavirus pandemic – live the external messages they espouse to consumers.
The demand for employers to up their commitment to mental health care might just lead to a new C-level post, per Bell. “I call it the chief mental health officer and believe companies should have entire departments dedicated to the well-being of their employees, including having the resources to help employees navigate mental health conditions.”
Internationally recognized mental health speaker and author Hakeem Rahim – founder and CEO of Live Breathe – echoes Bell’s sentiments. “Companies will now have to make mental health a priority because the awareness of the connection between how we feel and how effective we are is very clear,” insists Rahim. Brands that move from product-centric mindsets to human-centric mindsets will win. “Performance is directly connected to wellness and mental health that must be addressed,” said Rahim, adding that the pandemic has proven that when peoples’ mental health is sound, they are more impactful and focused.
Rahim believes that this fundamental shift will affect every area of our lives – from education, to healthcare, to connecting with family – because the idea that it is abnormal to struggle with mental health will no longer be normal. “How we view mental health and how we address our own mental health on a daily basis is going to prove essential parts of our lives,” said Rahim.
With 63% of Americans revealing in the survey that they won’t feel comfortable going to a concert or a sporting event for at least three months after life reopens and more than a tenth saying they won’t resume activities for a year, putting mental health care in the spotlight is an unexpected but welcome Covid-19 impact.
To view the full report click here.
Could COVID-19 Finally Destigmatize Mental Illness?
BY JESSICA GOLD
MAY 13, 2020 12:52 PM EDT
Dr. Jessica Gold is an assistant professor of psychiatry at Washington University in St. Louis.
There is a research model going around that suggests as many as 150,000 additional people could die from mental health-related outcomes of COVID-19. I could argue the merits of the mathematical model as many of my colleagues have. I could also make the case that discussing the depths of despair and predicting increasing suicide rates over and over could, in fact, lead to copycat suicides. But what if I took an alternative stance, and told you that—though absolutely no one would wish a pandemic on anyone— this is actually what mental health needed to stop being stigmatized and start being valued?
I’m not naïve. As a psychiatrist, I understand the realities of the mental health stressors that exist from this global pandemic and the potential for an increase in psychological care needs now and in the aftermath. However, it’s possible that we emerge from this with innumerable positive mental-health outcomes.
Over the past decade or so, the public perception of mental illness has changed. More and more people are openly speaking about their experiences with care; celebrities are disclosing their diagnoses not just when they have “been outed” by the press but to raise awareness; and television shows now often include characters who have mental health disorders that add to their story (like Randall in This is Us and Devi in Never Have I Ever) and are not used simply to portray them as different or violent. Nevertheless, mental health is still viewed negatively in our culture. I have had patients’ parents throw away their medication when they found it and tell them not to take it. I have also had patients who delayed coming in until they were really sick because they thought “I would just get over it” or “I am just a girl and girls are emotional.”
The stigma can also directly impact people’s job opportunities and livelihoods. In many states in the U.S., state licensing applications to practice medicine ask physicians to disclose if they have ever had a mental illness in their lives, right next to questions of if they have committed any serious crimes. This not only equates mental illness treatment to felonies, it makes physicians, who have some of the highest rates of suicide of any profession, fear seeking treatment because of what it might mean to their license and any other possible repercussions at work. These are the messages we send about mental health—that disorders are somehow a weakness or even your fault, that having one makes you different or not as capable at your job, and that you should be able to get better without treatment.
Mental health is often considered categorically unequal to physical health. This is perhaps best evidenced by the fact that the fight to create parity between the way insurance covers mental-health/substance-use disorders and other medical conditions is ongoing.
In my practice, I often have to get prior authorization for coverage of the first line or generic medications (or hospital stays) I believe would best help my mental-health patients. In many cases, “physical” problems are treated very differently by insurance companies. For example, if a patient has shortness of breath, it is unlikely they would need prior authorization to get a CT scan to rule out that they have a pulmonary embolism or blood clot. However, if I suspected that anxiety or panic were the underlying cause of the shortness of breath, I would likely have to get on the phone with their insurance company, trying to convince the provider to cover counseling and mental health medications. As a result, mental health patients often are limited in terms of which care providers they can see, and even when they do find someone, they often have to pay higher costs because they are denied services not considered “medically necessary.”
The COVID-19 pandemic is a sort of equalizer. Nearly everyone is self-isolated at home, trying to work while managing a household, and dealing with uncertainty and grief. To some degree, everyone is experiencing what life with anxiety is like. This includes those in management, who are dealing not only with their employees’ stress but also their own. Though depression is already the number one cause of disability worldwide, this is the first time many employers and managers are thinking and openly talking about mental health in the workplace.
This change is now visible on social media. Typically, social media can cause depression in young adults due to what those in the field sometimes refer to as “social comparison.” In my patients, this manifests as feeling like no one else is stressed or sad or struggling in college because they look happy and appear to be having a lot of fun on social media; by comparison, my sad and stressed patient feels like “something must be wrong with me.” Some students maintain a “finsta” (a “fake-Instagram” account) they share with a select group who have “earned” seeing their true selves. However, during COVID-19, nearly all people—from influencers to celebrities to students—are finally being vulnerable about their lived experiences and emotions. They are removing the perfectly curated images, in part, because they have to, without makeup or stylists or even access to haircuts and shopping. But the trend may also be due to fact that this moment calls for people to just be more real. Perhaps this will lead to more social connection, or even a decrease in depression and loneliness. Hopefully, this vulnerability stays long after the pandemic ends.
The coronavirus crisis has made clear just how inextricable mental health is from physical health. You cannot talk about a lack of personal protective equipment (PPE) without talking about the mental health repercussions, and you cannot talk about patients who are dying of COVID-19 without talking about grief. You also cannot talk about unemployment or social isolation without talking about anxiety and depression.
In the U.S., almost half of all adults will experience mental illness during their lifetime. These are rates similar to people who suffer from heart disease. Imagine saying to someone with heart disease that they are weak for having it, or that they cannot get care because their care is less important or valued. That is what we have always done with mental illness, and hopefully, because of this pandemic, it will finally stop.
Instead of looking at the post-COVID-19 mental health future through a lens of inevitable doom, we can, and should, use this moment as the impetus for the changes that mental health care has always pushed for. Let’s invest in expanding access to affordable mental health care coverage in our communities, companies, hospitals, and through the use of tele-health platforms. Let’s finally enforce parity and make mental health care coverage and reimbursement equal to physical health care. And, let’s say once and for all that having a mental illness is a disease that requires treatment, just like any other illness.