Based on studies of previous recessions and periods of high unemployment, researchers are calling for policy actions to help mitigate the mental health risks associated with rising unemployment resulting from the COVID-19 crisis. Unemployment is at a record high, creating an urgent need for policies to increase services and support. These include accelerated access to and investment in suicide prevention and telehealth services, implementing insurance coverage protections, and supporting state government and providers with federal dollars in order to reduce the harmful behavioral health outcomes that can accompany an economic downturn.
A paper by Dr. Alison Evans Cuellar of George Mason University’s College of Health and Human Services and colleagues reveals the urgent need to address mental and behavioral health through local, state, and federal programs—only some of which is being done with stimulus legislation. Cuellar collaborated on the review and policy recommendations, published in Psychiatric Services, with Dr. Tami L. Mark of RTI International, Dr. Steven S. Sharfstein of Sheppard Pratt, and Dr. Haiden A. Huskamp, of Harvard Medical School.
“We must extend support and services beyond the time period of the pandemic and beyond direct treatment for COVID-19, particularly to account for the backlog of cases and other factors due to the pandemic,” explains Dr. Alison Evans Cuellar.
“We are most concerned about an increase in suicide,” Cuellar explains. “Although some health indicators improve as unemployment rises—such as reductions in traffic fatalities—suicide increases with unemployment. Gun and ammunition sales have also sharply increased this year, which could lead to increased lethality in suicide attempts. We can expect that more resources will need to be allocated to suicide prevention as the need grows.”
Cuellar and colleagues recommend policy actions including:
- Increased support for substance abuse and mental health treatment, including fully funding the 988 suicide prevention and mental crisis hotline proposed by the Federal Communications Commission
- Expansion of telehealth and increased rates of reimbursement for telehealth services particularly for treatment of mental health and substance use disorders
- Improved broadband access for patients and providers – not limited to COVID-19 cases
- Extension of federal financial support to communities that have been hard hit by unemployment– not just those with higher rates of COVID-19
- Attention areas with mental health provider closures
- Solutions for health insurance coverage for those who lose employer plans
- Support systems that facilitate connections to services for social determinants of health such as food and housing
“While some programs and funding have been put in place with stimulus funding, we need to consider the longer-term impacts resulting from unemployment and that they may not all necessarily be COVID-19 related,” explains Cuellar. “We must extend support and services beyond the time period of the pandemic and beyond direct treatment for COVID-19, particularly to account for the backlog of cases and other factors due to the pandemic,” explains Cuellar.