Friday, May 29 2020

On May 29, Johns Hopkins HealthCare (JHHC) sponsored a virtual discussion panel to explore the effects of the COVID-19 pandemic on mental health. Internal experts shared professional observations and personal reflections, predicted future challenges, and discussed tools, resources, and perspectives that can assist us in caring for our mental health through this crisis and beyond.

Panelists:

• Dr. James Tisdale, Special Needs Coordinator (Moderator)
• Dr. Mary Cooke, Vice President of the Johns Hopkins US Family Health Plan
• Jason Collender, Manager of Behavioral Health
• Dr. Cordelia Grimm, Medical Director and Clinician Lead for Johns Hopkins Employer Health Programs
• Frances Callahan, Assistant Director of mySupport

Observed Effects of the Pandemic So Far

Experts discussed the changes they have seen in the physical and mental health of plan members, populations, and communities this year.

• At the beginning of the pandemic, JHHC experienced lower utilization of behavioral health services as people focused on physical safety and adapting to new logistics. Now people are using these services more as they have become very tired. Our bodies’ internal alert systems are designed to save us from acute immediate threats, but are not equipped to sustain that level of urgency through a prolonged unknown threat. People are burned out.
• Alcohol intake has increased: alcohol sales between March 14 through the end of April went up 55%.
• People are so afraid of COVID-19 right now that they are not going to the hospital when they have non-COVID-19 medical emergencies. In some jurisdictions, 911 calls are down by 25%. This is not good — people are dying at home from conditions that could have been treated in the hospital.

Predictions for the Near Future

Although nobody knows exactly what to expect, our expert panelists shared insights based on their education, experience, and observations.

• Crises have predictable phases, and COVID-19 is no exception. What we cannot predict is how long each phase will last.
• The next phase will involve people having lower energy. Anxiety will likely continue, but more people will suffer from depression. People are taking more time for self-reflection, paying attention to their daily life rhythms, and reaching out for help.
• People have been using alcohol as an unhealthy coping mechanism and because of this, we will see increased substance abuse treatment needs and anxiety issues.

How We Think About Mental Health

Panelists observed that the stigma surrounding mental health in our culture is an obstacle for people developing skills to manage their mental health or seeking help they may need. Outcomes could improve if we change the ways we think.

• The current stigma around mental health is an outdated concept. The word “stigma” comes from an ancient Greek word meaning “brand” — they believed that people afflicted with mental health concerns were branded by evil spirits, being punished for having bad character, and other superstitious ideas that have no place in modern medicine.
• Raising your hand for help is not a sign of weakness. If you feel you need help, recognizing this is a strength.
• To rethink the stigma around mental health issues, compare depression to diabetes. Both are diseases, and both have nothing to do with morals or a person’s character. Every disease should be treated equally and unemotionally.
• The distinction between somatic and mental health is artificial: in fact the two are intertwined and interdependent. For instance, stress can raise blood pressure and blood sugar.

How We Can Care For Ourselves

Specific coping skills can help us cope with the unknowns of our current situation. Panelists discussed the importance of controlling what we can: our outlook, our emotions, and seeking care for physical and mental health.

• Two types of coping strategies are problem-solving and emotional coping. When we try to apply problem-solving coping strategies to issues we don’t have much control over, such as COVID-19, the utility is limited.
• Emotional coping strategies are important now. To cope better, don’t focus on what you can’t change; instead, focus on yourself, your emotions, and how to help yourself deal with the situation. You can use positive self talk, give yourself breaks if you cannot be very productive, be mindful, focus on opportunities, step back and get some perspective, and reconnect with children and other family members. Ask yourself: Where am I here and now? What do I have control over? How can I take care of myself?
• Do not ignore your symptoms or be afraid of the hospital. Hospitals are using more and more precautions to protect patients, providers, and staff from COVID-19.
• If you have any symptoms, call your doctor first.

Remember: We have the right to feel the way we feel. If the feelings are too big for us, we have the right to get help.

Note: Effective July 10, 2023, Johns Hopkins HealthCare is now Johns Hopkins Health Plans.