TAMEST Convenes Experts to Address Mental Health Impacts of COVID-19

According to the National Institute of Mental Health, nearly one in five U.S. adults already live with a mental illness. As the cases of COVID-19 increase and social distancing guidelines continue, Texas now faces a potential behavioral and mental health crisis like never before.

To explore this issue in-depth, TAMEST hosted a conversation on COVID-19: Mental and Behavioral Health as part of its Forward Texas Digital Series on Thursday, May 28, 2020, to discuss the modeling and study of the mental health impacts of the pandemic, including substance abuse, anxiety, depression and psychiatric treatment.

The session was moderated by TAMEST Member Ellen Gritz, Ph.D. (NAM), Professor Emerita of The University of Texas MD Anderson Cancer Center with a panel of state, national and international experts. The goal was to give an overview on the topic, discuss current research being done in Texas with a plan of action moving forward and to look at the data coming out of China to see what can be learned from their mental health outcomes from COVID-19.

The panelists included Lynn F. Bufka, Ph.D., Senior Director, Practice Research and Policy, American Psychological Association (APA); Andy Keller, Ph.D., President and CEO, The Meadows Mental Health Policy Institute; and Thomas R. Kosten, M.D., Waggoner Professor in Psychiatry, Pharmacology, Neuroscience, Immunology, Baylor College of Medicine.

Dr. Bufka spoke first to offer a national perspective as well as give a general introduction to talking about mental and behavioral health during COVID-19.

“We know that this is truly an unprecedented experience for the average person in our country right now,” she said. “[COVID-19] is having a significant impact on people’s experience of their emotional and mental well-being. The impacts still are unpredictable and potentially quite vast.”

She explained that we are all dealing with some level of uncertainty right now and that uncertainty is compounded by the impacts of isolation, the increase in bias and discrimination, trauma felt by health care workers, PTSD for those recovering from the disease and so much more.

According to APA’s annual survey, Stress in America™, Americans are significantly more stressed than they were in 2019. The top stressors include concern over the government’s response to COVID-19, the state of the economy, parenting during COVID-19 and work.

“It’s important to bear in mind that human beings are resilient,” Dr. Bufka said. “We do adapt to difficult situations and there are things we can do to adapt within these times.”

So, how can we practice better self-care? According to Dr. Bufka, keeping a strong mental and physical foundation is a crucial starting point. That includes a healthy diet, physical activity, enough sleep and maintaining social connections. For those worrying about the stress of quarantine or social distancing, she also recommends perspective and trying to think about the larger implications for our entire population.

In addition, Dr. Bufka said we’ll want to pay attention to how much news we are consuming, limit social media and learn to put boundaries around telecommuting to make our time at home less stressful.

The next speaker, Andy Keller, Ph.D., President and CEO of The Meadows Mental Health Policy Institute (MMHPI), discussed how an economic recession may increase rates of mental health and substance abuse disorders, including state and national estimates of death from suicide and substance overdoses.

“We need to focus on these diseases [and this is] not easy to talk about,” Dr. Keller said. “We’ve lost 100,000 Americans to COVID-19, but we’ve also lost over 100,000 people to substance abuse and mental illness over the past couple of years. We need to be able to talk about [mental health].”

Dr. Keller illustrated that one MMHPI model shows a projection of as many as 160,000 lives lost nationally from overdose and suicide in the next year if there is an economic recession and we don’t address the mental and behavioral health needs of Americans. He was quick to add, however, that this model could easily change depending on many effects and factors.

“One thing we didn’t want to do is to have this become a pawn in some kind of political discussion where people say we either need to save lives from mental illness or save lives from the disease,” Dr. Keller said. “We at the Institute believe that we can do both of those things.”

He said the main step forward is catching mental and behavioral health issues during primary care visits. He stated that studies show a higher than 40 percent remission rate of those whose mental and behavioral health issues were caught by primary care intervention.

“These things all impact us, and they lead to diseases that are treatable,” he said. “We weren’t prepared for COVID-19, but we can be prepared for these impacts.”

To round out the conversation, Baylor College of Medicine’s Dr. Thomas R. Kosten, who is one of the first researchers in the U.S. to study the mental health impacts of COVID-19 in China, offered some insight on what we might expect to see domestically as a result of the pandemic, sharing three studies from China utilizing data gathered both before and after COVID-19 reached its peak in the country.

“With family exposure risk, we saw that depression and anxiety almost doubled among adolescents,” Dr. Kosten said.

In addition to adolescent risk exposure to COVID-19 significantly increasing anxiety and depression levels, Dr. Kosten said another national study of 6,400 individuals from across China in February shows an increase in substance relapse and “internet abuse” as well, which is not a term often used in the U.S. In fact, his study shows an increase of “internet dependence” at a rate that increased from four percent to 25 percent among participants in just the previous month.

Dr. Kosten also mentioned an unexpected finding from China that smokers were seen as contracting the virus at a lower rate than non-smokers. He said that while smoking itself does not protect against COVID-19, the nicotine component does seem to suppress strong immune symptoms without suppressing antibody formation. However, if someone is infected and develops symptoms, smoking does seem to impede the body’s ability to effectively fight the infection consequences, according to Dr. Kosten’s research.

“I’m not saying we should make non-smokers nicotine dependent by using nicotine patches to prevent symptomatic COVID-19 infection,” Dr. Kosten said. “But it certainly opens the door for other types of nicotine-related medications that have not been examined at all but needs to.”

The video and slides from the presentation are archived on our website. Learn more about the Forward Texas Digital Series and future sessions.