What is the current state of mental health in the United States?

Associate Professor of Counseling and Educational Psychology Kristina DePue looks mental health issues related to the pandemic and what we can do about them

United States flag held upside down at dusk

What is the current state of mental health in the United States?

Associate Professor of Counseling and Educational Psychology Kristina DePue looks mental health issues related to the pandemic and what we can do about them

United States flag held upside down at dusk
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The COVID-19 pandemic, increased workloads and increasing tension all seem to collectively be adding more stress on Americans. But where are we mentally and what can we do to address what seems like a growing mental health crisis? Let’s explore.

Ever since mass lockdowns and social unrest, many Americans feel that mental health is on the decline. Is this true or a misguided perception?

First, it is important to recognize that we have experienced a shared trauma over the last two years. The impact that the COVID-19 pandemic has had on our collective mental health will take time to fully understand. People often compare the lasting impacts of COVID-19 to other natural disasters, so it is absolutely true that we have had a decline in mental health.

Where are we now?

We have seen all-time high burnout and stress levels for many professionals, such as doctors, nurses, teachers and mental health treatment providers. In addition, the pandemic impacted certain individuals differently than others. For example, we know young adults that stayed socially connected during the pandemic were less likely to suffer from mental health issues. However, the pandemic and resulting isolation created a reduction in coping mechanisms for many people. We need to know more about attempts or motivation levels to find new coping mechanisms during the pandemic. As we know, individuals suffered in different ways due to work overload or a lack of work opportunity - the tourism and entertainment industries were especially impacted. We also know that substance use has increased throughout the pandemic, including an increase in overdose deaths. We know that women were more negatively impacted by the pandemic than men, mainly due to the need to take on multiple roles in the family and/or at work.

How did we get here?

It would be easy to blame our mental health decline on the isolation and loneliness caused by the pandemic, but it is important to remember that a global pandemic was co-occurring. How can we separate the direct impact that the spread of COVID-19 had on our mental health from the impact that the protective measures we used to defend ourselves from COVID-19, like isolation and social disconnectedness? It’s almost impossible to separate these, and we must think systemically. Most of us have known people who died from COVID-19. What happens when we then contract the virus and test positive? That impacts our mental health and could cause lasting effects from the trauma.

There is also an overload of information on social media platforms; specifically, we have been flooded with information about things that were not in our direct power or control to change. That feeling of powerlessness and helplessness is important to recognize, as it can affect our mental health and coping abilities. Social media is linked to a host of negative outcomes, so again, we are unsure of the lasting impact of this on subpopulations. However, an important consideration is how social media influenced civil unrest and family/friend divisions. I have supervisees working with clients that don’t speak to their families any longer due to political conflicts that cause mental distress. These divisions create additional isolation and upset the homeostasis that exists in family systems.

How likely is it that mental health will suffer further declines in the future?

We live in a culture that essentially rewards workaholism or work addiction. A person in sales may be rewarded for working extra hours and producing higher sales numbers in the same year that their family member passed away; however, that person may not be rewarded for taking time away to deal with the trauma of their family member’s death. Many would argue the systems that cause burnout must be dismantled. We must remember that mental health is about more than therapy - mental health support, or lack thereof, is entrenched in every aspect of our lives. As such, public health measures and policies are needed that support workers, especially when we cannot work. I think we may be at a trajectory where we need to collectively consider what is a reasonable amount of work. I hear a lot about work-life balance, but what does that look like? How can we find that if we have worked 40-plus hours a week throughout our lives with family responsibilities on top of that?

How do we break the stigma around mental health, especially during a pandemic?

Stigma can be thought of as a negative judgment that we have placed on a person due to an attribute they possess. The stigma toward those with mental health concerns exists because our culture views mental health issues as problems that “sick” people have; thus, individuals with mental health issues arguably carry this stigma, whether we like it or not. We all have mental health, and it exists on a continuum. Therefore, all people can and will struggle with their mental health at various points in life. To remove the stigma, we can begin by examining our own biases, as the onus is on the public to change the way we view mental health. The emotional response to a stigmatizing judgment can be considered dependent on whether we think the “thing” someone is struggling with is in their control or not in their control. So, for example, if someone has Alcohol Use Disorder, I am more likely to discriminate against them if I view that disorder as in their control. Normalizing mental health as something we must all work towards is a natural first step, and we must also examine our beliefs and biases. Be curious about why you come to certain conclusions about people. Ask yourself - why do I believe this? Why do I have this reaction to certain people?

Are there suggestions on how someone can improve their mental health on their own?

Yes, many! Getting outside, exercising and eating well can all help. Also consider self-help books, online resources and journaling about your thoughts and feelings. Most of us are experiencing high levels of stress. Meditation and breathing exercises have been proven to decrease stress levels. Behavior tracking and behavior replacement is also quite helpful, and there are resources online to help with this. In addition, lists are important. Make lists of people, places, and things that bring you peace, joy and happiness. Then, make lists of the people, places, and things that bring you down. Can you pull back from some of those negative influences? Can you plug into the positive ones more? Lastly, break the cycle. Our brains like to create patterns; therefore, our brains have adapted to functioning during COVID. That could mean we are hypersensitive to others and life circumstances. We can break the cycle by taking small, daily steps in a forward direction. The brain is highly adaptable, and we can facilitate brain plasticity!

At what point should an individual seek professional help regarding mental health?

Mental health professionals can help you at any point on your journey. Mental health is like physical health - we don’t need to be at our worst to seek out additional support. However, a key indicator that you need professional help is if you have tried some of these self-help exercises, and they aren’t helping. If you find yourself hopeless or have urges to harm yourself or others, please seek out professional support immediately. Support groups offer free help for people dealing with specific concerns, like substance use or grief, and are highly effective in conjunction with individual therapy.

Kristina DePue, Ph.D. is an Associate Professor of Counseling and Educational Psychology at the University of Nevada, Reno. Kristina’s research goals are motivated by her clinical observations within the addictions counseling field, which has resulted in two research areas: (a) chemical and process addictions, specifically concentrating on the role of negative experiences in behavioral change; and (b) counselor development and supervision, focusing on how both counseling trainees and clients change.

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