Graduating the Pandemic: A Need to Phase in Mental Health for the Future

With school semesters ending around the nation and virtual graduation celebrations abound, I, an assistant professor, was offered some space for my own reflection. With all these talks about states starting to open I was reminded of a specific conversation I had with students. Another week had passed, the new normal of quarantine became cemented as our new reality, and my students and I met via Zoom, shaky internet connections and all. This was a graduate counseling course and the majority of students were seeing clients (via telehealth) and in their final semesters. Upon graduation, those students would become licensed professional counselors. Given the voluntary nature of the weekly-held meetings, the fact that I had anyone show up was a feat in itself. The space often transformed from “classzoom” to support group. We discussed many things; social issues, using TikTok as a coping strategy, postponed graduation ceremonies, our mental health, and the ambiguity of a return to normal. Now, as that class and the nation braces for a return to normal; the pressure to educate the nation’s future counselors is as daunting as ever.

This month many states started to open up and pull back on the requirements of state-at home orders that were initially decreed. At the beginning of May, following two stay-at-home order extensions, Governor Pritzker introduced his plan for Illinois to phase back to “normal”. The five-phase plan divides Illinois into four regional-districts and outlines what will open in each phase, given that “flattening” continues in that district.  While the plan to re-open Illinois offers a relief and light at the end of the tunnel, are we prepared for the mental health fallout?

Prior to COVID-19, 1 in 5 adults in the U.S. had a mental health condition and approximately 56% of those adults did not receive treatment. The lack of access to care can be caused by various factors such as a shortage in the mental-health workforce, mental health stigma, racialized systems of oppression, and other social determinants of health. COVID-19 can compound existing mental health issues and propagate mental health issues in others. The nation is suffering from the deleterious mental health effects of COVID-19. Polls have shown that 45% of U.S. adults have been negatively impacted by their worries surrounding the virus. Furthermore, Mental Health America reported a 19% increase of clinical anxiety in February and another 12% increase in March. Accordingly, mental health services have tried to keep up with the demand but have been met with an increase of service utilization, sometimes up to 800%. In an attempt to address Illinois’ own mounting mental health concerns, Governor Prtizker introduced “Call4Calm”, an anonymous support line that residents can text and then receive a call from a counselor within 24 hours. While resources such as “Call4Calm” represent a great tertiary approach to addressing mental health repercussions of the virus, we need a better understanding of what we’re up against as we phase back into normalcy

One thing to consider, is how paradigms of mental health have changed over the years, particularly stress and trauma. The way that mental health professionals (MHPs) understood stress and trauma changed after 9/11 due to the frequent news coverage that showed images of the terrorist attacks. As a result, MHPs found that in order to have posttraumatic stress disorder (PTSD) people did not need to directly experience the traumatic event to have feelings of anxiety or to be traumatized from it. Therefore, people could be anxious or traumatized indirectly by events. Individual could experience trauma from talking to people who experienced the trauma directly or from merely seeing images of the traumatic event. When it comes to COVID-19, much attention has been given to the physical impacts and manifestations of the virus. Who’s coughing? Who has it? Who doesn’t have it? One thing is clear, while everyone probably will not contract COVID-19, the virus has touched every individual from a social and psychological perspective. This is especially the case when we use PTSD as a model.

My students and I had a discussion around the social and psychological ramifications of COVID-19. I posed the question, “How might this pandemic be different if the symptoms were purely psychological?” Within our discussion multiple further questions were raised. How much longer would it have taken officials and people to recognize the pandemic as real, given mental health stigma and society questioning the legitimacy of mental health? That question, now juxtaposed amid shutdown protests

seems like an answer. If society is willing to let people of color and the most vulnerable populations die physically, is psychological death certain too? Would we even have the capacity to address society’s burgeoning mental health needs? Society sees physical health as valid and still, initially, did not have the infrastructure to meet all the needs of the people. Society wasn’t handling the mental health needs of its citizens before this surmounting mental health pandemic, so this cynical professor thinks the answer is clear. Perhaps, these graduates will be more encouraged. We walked away—rather logged off from this hypothetical scenario agreeing to one reality, that COVID-19 impacts everyone’s mental health, and it would soon be up to them to find the answers to their own questions.

Congratulations Roosevelt University counseling class of 2020.