Introduction
The pandemic’s effects on psychosocial well-being and mental health have attracted the attention of the WHO. The World Health Organization asserts that such measures as isolation and confinement have affected people’s regular activities, habits, and way of life (WHO). This could result in a rise in loneliness, depressive disorders, anxiety, insomnia, alcohol and drug abuse, and self-injury or attempted suicide. Researchers state that the damaging influence of the pandemic has a two-sided effect. On the one hand, the virus damages nervous cells, causing diverse mental disorders at a physiological level.
On the other hand, the measures taken to combat the virus, such as self-isolation and distancing, together with the economic consequences of the pandemic, cannot but negatively affect Americans’ psyche. The American society should be well aware of the mental health problems after the COVID pandemic is over and work out the ways to overcome possible health consequences. Psychiatric and psychological help should be freely available to Americans suffering from post-COVID symptoms, and there should be elaborated a comprehensive insurance system that would cover all cases of post-COVID mental disorders.
Background
The United States is among the hardest hit by the pandemic. Indeed, according to WHO, in the United States of America, “from 3 January 2020 to 3 May 2023, there have been 103 266 404 confirmed cases of COVID-19 with 1 124 063 deaths” (WHO). One of the critical problems faced by the American healthcare system at the beginning of the pandemic was the lack of beds for patients with a new coronavirus infection. Over the past decades, the American state has stimulated the transfer of treatment from hospitals to outpatient clinics to save money. This situation resulted in a drastic shortage of medical facilities during the epidemic.
The other reason for the high infection rate in America is that many Americans do not have medical insurance. Thus 2019, 10% of Americans did not have health insurance. The worst situation was observed among American Indians – 21% of them were not insured in any way. This share was 20% among Hispanic Americans, and among African Americans, it was 11%. The situation of white Americans and Asians is better – the share of uninsured persons among them is 7% (KFF, 2019). At the same time, people who do not have adequate access to healthcare services are more likely to suffer from mental issues since a lack of help aggravates their illness.
Overall, in the pandemic, the USA has faced a situation where practically every third citizen has been ill with COVID-19. Many of these people have suffered from mental complications of the disease, especially among poorer groups. The scale of the problem and its relevance leave the government no choice but to intervene. To make this intervention effective, a relevant healthcare policy should be elaborated.
COVID-19 Virus’s Effect on Americans’ Mental Health
To date, according to researchers, more than a third of those who have had the coronavirus, to one degree or another, face negative consequences for the psyche. The range of disorders is extensive, from apathy to prolonged depression, panic attacks, and memory problems. A group of researchers from the USA found out that 34% of those who went down with COVID complained of anxiety and personality disorder within six months (Rogers et al., 2020). Moreover, there has been a mild correlation between the severity of the disease and the pronunciation of the psychological consequences.
The most common coronavirus reaction has been stress of some kind. An emotional reaction caused by stress is a series of accompanying emotional experiences that lead people into a negative emotional state, such as depression, anxiety, panic, frustration, or fear. The primary behavioral changes caused by coronavirus included anxiety, inattention, decreased ability to solve problems, slowness of actions, frequent anger, and alcohol abuse.
COVID-19 has affected people not only on a psychological but also on a physiological level. The lack of oxygen in the body provoked by COVID-19 leads to its shortage in the brain. Such an effect can result in various consequences for the nervous system. Typical symptoms are flashbacks, nightmares, partial amnesia, emotional instability, and panic attacks. These manifestations can occur immediately after illness and months or even years later.
Another negative factor is the side effects of drugs that are used in the treatment of COVID—19. For example, glucocorticosteroids (GCS) are widely used in modern anti-virus therapy. They are often prescribed in high doses and for a reasonably long time. At the same time, GCS can cause hallucinations, delusional states, depression, and even manic-depressive states and paranoia. Taking other medications used in the treatment of COVID-19, such as antiviral drugs, may also hurt the psyche.
There have been numerous data on the impact of a new coronavirus infection on the human nervous system. Thus, in a retrospective study in Wuhan, 36% of patients had central nervous system disorder symptoms, including dizziness, headache, loss of smell, loss of taste, muscle pain, and weakness. There was evidence of delirium (65%) in patients in the intensive care unit with a new coronavirus infection. Moreover, every fifth resuscitation patient was diagnosed with altered consciousness.
COVID-19 Social and Economic Consequences and their Impact on Americans’ Psyche
The outbreak of a new coronavirus infection has led to the fact that many countries asked people to self-isolate at home on a quarantine. Quarantine is often an unpleasant experience for those who go through it. Separation from loved ones, loss of freedom, and uncertainty about the status of illness and boredom sometimes they can lead to dramatic consequences. People in quarantine reported fear, nervousness, sadness, guilt, and confusion (Brooks et al., 2020).
Among the consequences of COVID quarantine and related social and physical distancing measures include increased social isolation and feelings of loneliness, alcohol and substance abuse, gambling, domestic violence, and child abuse. All this is closely related to anxiety, depression, and suicide attempts not only during the COVID period but also throughout later life (Mahase, 2020).
Thus, a systematic review made by J.P. Rogers et al. (2020) showed that during acute illness, symptoms such as confusion (on average in 28% of patients), depressed mood (33%), anxiety (36%), impaired memory (34%), as well as insomnia (42%) are common. In the post–COVID stage, insomnia was found in 12%, irritability – in 13%, depressive or anxious disorder – in 15%, memory impairment, and fatigue – in 19%, and traumatic memories – in 30% of people. Moreover, all former patients suffered from a sleep disorder (Rogers et al., 2020).
The Solution
A plausible solution to the challenges COVID-19 infection represents for the mental health of the American population would be the adoption of health practices that would be cooperative, comprehensive, and non-differential for diverse population groups. National public health organizations should create an official, integrated, unified mental health counseling platform to provide psychological assistance to people in need during a pandemic (Huang & Zhao, 2020). Psychological counseling is possible through electronic devices and applications.
One model of such a comprehensive system is the Guidelines on Emergency Psychological Crisis Intervention for People Expended by COVID-19, issued by China’s National Health Commission (National Health Commission of China). According to the principles of emergency psychological interventions developed from the experience of the SARS outbreak in 2003, China recommended providing daily free 24-hour services to the population, including online cognitive behavioral therapy for depression, anxiety, and insomnia, via WeChat.
Healthcare providers also play an essential role in addressing emotional issues during the pandemic response. Medical professionals can offer patients recommendations on stress management and overcoming its consequences and help patients get in touch with social and mental health services (Pfeff Erbaum & North, 2020). Given that the majority of COVID-19 cases are detected and treated in health facilities by workers with little or no mental health training, assessment, and intervention must be carried out in these facilities in connection with psychosocial problems.
Ideally, integrating mental health services into the COVID-19 care system should be addressed at the organizational level through state and local planning (Pfeff Erbaum & North, 2020). WHO recommends health managers send appropriately trained and qualified personnel to institutions where coronavirus patients are treated to manage urgent mental disorders and neurological complaints (WHO). Moreover, it is necessary to ensure the availability of essential generic psychotropic drugs at all levels of medical care.
During the pandemic, it is necessary to provide measures to promote the mental well-being of social groups vulnerable to emotional stress. Preventive measures, such as screening for mental health problems, psychoeducation, and psychosocial support, should focus on groups for adverse psychosocial outcomes. Finally, universal measures should be developed to solve the problems of loneliness and finding friends.
Tracking loneliness, early intervention, and encouraging a sense of belonging are seen as potential defense mechanisms against emotional problems, self-harm, and suicide (Holmes et al., 2020). Moreover, providing free access to evidence-based online resources and activities around the US can benefit the mental health of the American population.
Opposing Argument: Targeted measures Instead of a Comprehensive System
Many voices oppose the adoption of a comprehensive free-for-all system of mental health protection in and after the COVID-19 pandemic. The arguments the opponents give are that it would be too expensive to maintain a comprehensive prevention system for mental deceases development throughout the US. Instead, the proponents suggest a targeted approach aimed at helping the most vulnerable groups.
Thus, they suggest that screening for mental health problems and psychosocial support should be reserved exclusively for risk groups such as medical workers, the victims of home violence, and others. Moreover, critics suggest that psychiatric consultations should be available only on referral from GPs and claim that online socialization groups do more harm than good by fostering people’s desire to get out and see some friends.
Rebuttal
While targeted measures are by all means helpful in the fight against the epidemic, the limited scope of the proposed steps will leave many Americans little options to fight mental issues they may have. However, when ignored, these issues may lead to drastic problems such as suicidal thoughts, depression, and mental disorders that are not so easily treated, the treatment of which will later become a heavy expense for the state.
A comprehensive free-for-all system allows the diagnosis and provide treatment of mental issues at early stages, thus severely curtailing adverse outcomes. Moreover, the coordination of healthcare specialists in different fields, as a rule, ensures better patient outcomes and a healthier society in the long run. At the same time, socialization programs serve to prevent the onset of mental issues and, therefore, by all means, should be supported at all levels of the government.
Conclusion
The work made it possible to assess the depth, scale, and duration of the devastating impact of the COVID-19 pandemic on public mental health. Many people become vulnerable to mental disorders and suicidal behavior. Moreover, the research shows that the consequences for mental health take longer to manifest and reach their peak later than the pandemic itself.Therefore, it is necessary to take measures to minimize and neutralize them. Integrating the work of authorities and health departments should aim to maintain the quality of life, the level of human potential, and human capital as the leading components of the national wealth of any state and the most crucial factor of economic growth.
References
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