WASHINGTON — “U.S. mental health is poor and getting worse,” the headline said, noting the rising prevalence of depression and other psychiatric disorders among Americans. Though the assertion would ring resoundingly true today, it comes from an early 2019 report compiled by the American Heart Association and a consortium of corporate leaders.
Just a little under a year later, China would report the first cases of “pneumonia of unknown etiology” in the city of Wuhan. Soon, the outbreak would be attributed to a novel coronavirus, known as SARS-CoV-2. As the virus spread, the world locked down. Schools closed. Offices went dark. Millions of people isolated at home, waiting month after month for the coronavirus pandemic to finally subside.
Only the pandemic continued. Daily figures of the dying, the hospitalized and the sick dominated the news. Every new variant brought with it fresh waves of fear and exasperation, uncertainty and dread. By the beginning of 2022, it seemed that everyone was burned out: the elderly and the young, families and single people, first responders, teachers, students, doctors, airline workers, journalists and even the mental health professionals tasked with keeping burnout at bay.
“What if pandemic anxiety and depression change the culture of humankind more than COVID-19 has?” Gallup chairman Jim Clifton wondered in a blog post from late 2021.
That question has moved to the fore as the threat of COVID-19 has become a background concern for many Americans — including, it seems, for President Biden, who declared the pandemic “over” in a “60 Minutes” interview that aired on Sunday. More than two years of social isolation, combined with a deepening reliance on digital technology, have only exacerbated a crisis that preceded COVID-19 by many years and will almost certainly survive the scuffed social distancing reminders on office building floors.
“People are really, really down,” Biden said in June, acknowledging a point that had become all too obvious. In recent months, the Biden administration has devoted billions of dollars to suicide prevention prevention efforts, initiatives to bolster the ranks of mental health professionals and to address the crisis-within-a-crisis that is young people’s mental health.
“It’s absolutely essential that we deal with it,” Susan Rice, who leads the domestic policy council at the White House, told Yahoo News in a recent telephone interview, arguing that the enormous scope of the problem — at least 52.9 million adults in the U.S. experienced some form of mental distress, according to 2020 estimates — calls for direct and urgent action.
Findings suggest that 150 million people across the country lack ready access to a mental health professional.
“This is something that cuts across all communities,” Rice said, adding that social problems like homelessness are “mightily exacerbated” by long-standing shortfalls in the nation’s mental health care system. The question is whether a White House already dealing with several overlapping political and administrative battles — over Ukraine, inflation, midterms, government funding, education — can give mental health the attention it badly deserves.
“We’re doing a lot of things you’d want to see,” says Susan Borja, a lead researcher at the National Institute of Mental Health. She pointed to the “professional shortages” the Biden administration is trying to ameliorate — the country needs 6,000 more mental health workers, for starters — as evidence of newfound concern for “the basic things” that had long remained unaddressed.
And the administration is intent on seeing the mental health profession attract Black and brown professionals who can work in long-neglected communities where distrust of the medical establishment lingers, and where acknowledging psychological problems can come with social stigma. "It matters less who fixes your hip than who fixes your head," Rice says.
Among the most persistent problems is the difficulty of having insurance companies cover mental health care. Forty percent of all people with untreated mental health problems say they did not get treatment because they could not afford it, while another 22% said their insurance plans either did not cover mental health treatment at all or offered insufficient coverage. The White House believes that the shortfall could partly be addressed through a concept known as “behavioral health integration,” which seeks to bring mental health coverage in line with coverage for purely physical maladies that more readily meet the stipulations of insurance plans.
Perhaps no group saw its mental health deteriorate as sharply and disastrously as young people. High-profile suicides highlighted the extent to which college students suffered during the pandemic. Meanwhile, data from the Centers for Disease Control and Prevention found that in 2021, 37% of high school students attested to deteriorating mental health. Emergency rooms overflowed with teenagers who had tried to end their own lives.
“If you look at young people, they were disconnected from their peers. They were forced to learn by distance,” Rice says, acknowledging the social challenges of remote schooling. “Many saw loved ones die.”
The administration is also blunt about the damaging role social media platforms appear to play in young people’s lives, arguing that tech companies and other platforms need to better regulate advertising and content that improperly target children, like popular Instagram accounts that seem to encourage eating disorders.
“The President believes not only that we should have far stronger protections for children’s data and privacy,” a recent White House brief on mental health said, “but that the platforms and other interactive digital service providers should be required to prioritize and ensure the health, safety and well-being of children and young people above profit and revenue in the design of their products and services.”
The Biden administration has allocated $300 million for youth-focused mental health efforts, as well as $20 million for Mission Daybreak, a project to prevent veteran suicide.
“We are working to move those funds out quickly,” a senior administration official said, speaking broadly of the various White House efforts.
Perhaps the most consequential development so far has been the new 988 suicide hotline number, replacing the more unwieldy 800-273-8255. The change took place in July; the number of calls the following month increased by 45% compared with a year earlier.
Underlying this effort is the conviction that mental health plays an unignorable role in many of the troubling stories and violence that play out nightly on the news.
“Mental health is a force multiplier for a number of areas,” agrees the administration official working on mental health, describing public safety as another area for which psychological distress is frequently a contributing factor. “Getting upstream requires that we address the mental health challenges people face,” the official added, before those challenges manifest themselves socially.
For an administration that has made “equity” and “unity” the beacons of its domestic policies, the ravages of untreated mental health — evident on city streets, at workplaces and in classrooms — is evidence of how much more work remains.