Addressing Mental Health and Substance Use Disorders Amid and Beyond the COVID-19 Pandemic

Abstract

Pre-pandemic, the prevalence of mental illness was estimated at 1 in 5 adults, and the US was facing an opioid epidemic. Despite the high prevalence of mental health concerns and substance use disorders, numerous barriers to treatment and systematic limitations, including a shortage of professionals, limited access, lack of adequate funding, and stigma meant that as many as 70% of people with these conditions never sought treatment. The cumulative and profound physical, psychological, economic, and social toll of the COVID-19 pandemic has exacerbated the mental health and substance use crisis in America. As Czeisler et al. comprehensively outline in the opening article of this issue of Knowing Well, Being Well, there has already been a very significant adverse impact on mental health. By mid-July, more than 50% of American adults reported that the worry or stress related to the coronavirus had negatively affected their mental health. One in 3 adults now report experiencing symptoms of anxiety or depression. More than 40 states have experienced increases in opioid-related mortality, and drug overdoses in the U.S. may reach an all-time high in 2020. There are also new barriers to treatment. The pandemic exacerbated the shortage of mental health professionals and disrupted treatment and recovery programs for substance use. Former U.S. Representative Patrick Kennedy, a long-time advocate for mental health care, said ‘‘This pandemic will fuel the fire of our country’s mental health crisis unless organizations unite in a call to action. There’s no more time for debate and discussion–we need all hands on deck to fast track the strategies we know will work.’’ Indeed, for many employers, increased mental health concerns amid the pandemic underscored the need to ensure more comprehensive benefits and programs and adequate communications about them, as well as a culture that supports taking advantage of those services. Although nearly 80% of employers offer an Employee Assistance Program (EAP), only 10% of employees use it. In response to a survey conducted in April of this year, 65% of employees reported that they did not believe that their employers offered programs or services to support or improve their mental well-being. Another recent survey indicated that 69% of employees reported that it was safer to remain silent about workplace stress at their company. In their article in this issue, Mochari-Greenberger and Pande summarize the recent report by the Health Enhancement Research Organization on best practices in employee mental health and well-being, which include raising awareness about the importance of mental health and available services. Ideally, employers will not silo mental health but will instead build it as a critical component of the culture of their organizations—ensuring it is visibly supported and that senior leadership stresses the importance of mental health and the programs available to increase awareness and