Coloradans’ State of Mind: The Pandemic’s Impact on Mental Health

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As we continue to make our way through the coronavirus (COVID-19) pandemic, it’s become clear that we must also prepare for what some are calling the “secondary pandemic” – a mental health crisis.

To be sure, though, this crisis isn’t new. We’re losing more lives to mental health challenges than ever before, and the state of mental health in Colorado is worsened by the arrival of COVID-19. The threat it poses to our individual and collective well-being cannot be ignored.

The virus brought with it new realities many never imagined – sudden job losses, school closures, isolation, fever checks at businesses, rationing of personal protective equipment and even an inability to hold funerals for loved ones. Each of these constraints comes with layers of stress, fear, grief and exhaustion, and the emotional toll has real mental health implications.

Coloradans’ State of Mind

Coloradans widely report that the pandemic is having a negative effect on their mental health, according to our representative survey in April. Partnering with Healthier Colorado, we sought a better understanding of the experiences, concerns and needs of people across the state in the context of the coronavirus outbreak. Some of the most concerning data relates to mental health (check out our visual brief).

Simply put, many Coloradans are suffering. Some more than others:

  • Over half of all Coloradans say the coronavirus has negatively impacted their mental health.
  • Many Coloradans are concerned about lasting negative impacts to mental health.
  • Coloradans are worried that help won’t be available for those who need mental health support. In fact, seven in 10 survey respondents are very or somewhat worried.

These perspectives are even more prevalent among people living on low incomes ($30,000 or less), people who have lost a job, income or hours as a result of the pandemic, and women.

“I worry about money. I can’t pay my bills.” – Female, Adams County, White, 18-29 years of age

What’s Eroding Mental Health

Here are a few of the culprits, according to our survey:

  • A majority of Coloradans say their lives have been significantly disrupted by the coronavirus outbreak.
  • Coloradans fear the worst is yet to come. People of color, people living on low incomes and women report this perspective more than others.
  • Coloradans living on low incomes and young people (18-29 years of age) are facing financial hardship. Many report that their financial situation has gotten worse since the outbreak.
  • Since the outbreak, more than one-third of Coloradans report having difficulty paying for food, housing, utilities and health care. 

“It is a mixed of emotions. I feel sad and paranoid that this pandemic crisis will get worse.” – Male, Denver County, Asian, 35-39 years of age

Deepening Long-Present Disparities

The survey results confirm what we have known to be true for a long time: people with historically less power and privilege are hit the hardest by societal stressors, often because their life experiences are tied up in a multigenerational web of structural racism and systemic oppression. Take, for example, the impact of the pandemic on Latinx Coloradans, Black/African American Coloradans and people living on low incomes.

It’s no surprise the data shows that people living on low incomes are more likely to report concern about the long-term impacts of COVID-19 on mental health, or that people of color fear the worst is yet to come. We know they have shouldered the weight of the pandemic the most. And now, our nation is relying on these folks more than ever.

In a period of their lives marked by grave uncertainty about the future, Black, Latinx, Indigenous, immigrant and refugee communities make up the essential workforce at higher rates than the White population – particularly in lower wage jobs. Delivery drivers, grocery and food pantry stockers, janitors, farmers and farm hands, supply chain warehouse workers, nurses and medical aids are essential to the health of our communities.

The crisis has put the spotlight on disparities that have existed since the dawn of our country – such as higher rates of illness and death in people of color and greater barriers to quality education for children of low-income households. It’s also exposed that these populations endure increased stress and risk associated with potential virus contraction and the inability to remain home to care for young children.

What Our Mental Health Partners Are Telling Us

The pandemic has revealed widening cracks in an already fragile mental health system. Here’s some of what we’re hearing from the field:

School counselors are going the extra mile to check on students as parents report increased stress related to remote learning and technology limitations furthering feelings of loneliness and separation.

An April report released by Colorado Education Initiative and Colorado Department of Education named students’ social emotional needs as a critical request by districts across the state.

Older adults are also vulnerable as many who were already living alone, yet still getting out for health services and shopping needs, are now so limited in their interactions that mental wellness could decrease. 

Colorado’s immigrant and refugee communities are experiencing extreme distress. Recent federal policies such as changes to the public charge rule already amplified fears. One provider partner shared that patients are expressing despair over job losses and, for many, post-traumatic stress disorder symptoms from the early period after immigration have resurfaced.

The crisis has also led to a rise in racism against Asians. Providers say clients are sharing all-time high stress levels and folks are opting out of services because of stigma-related fear and anxiety.

What’s less clear is whether mental health supports will be available for those who need it. In an already under-resourced system, many behavioral health workers are having trouble with their own mental health as they attempt to keep up with skyrocketing demands. For example, the hotline operated by Colorado Crisis Services saw a 57% increase in calls in March of this year compared to 2019.

“I have been seriously affected. My son was affected. He is single. He lost his job, and it affects him emotionally. My second son is a first responder. He is firefighter, and he is exposed to the patient, so he his endangered.” – Female, Grand County, Black/African American, 65+ years of age

We Cannot Afford to Stand on the Sidelines

The “secondary pandemic” is already here and our response in the coming weeks and months is critical. To make matters worse, behavioral health services are under threat due to our state’s looming budget crisis.

We have a responsibility to act courageously in supporting the mental health of individuals and families. As funders, we can use our influence, investments and voice to prioritize the following:

  • Keep the spotlight fixed on disparities rooted in racism and socioeconomics – and the conditions that prolong them. Factors like loneliness and lack of belonging (individual-level), culturally-incompetent care and fragmented supports (systemic barriers), and disproportionate division of resources and infrastructure, housing and food insecurity, racism and intergenerational trauma (community conditions) all contribute to loss of mental health.
  • Identify ways to shore up our state’s behavioral health safety net system. Colorado’s main provider of behavioral health and substance use services for underinsured, uninsured and people on Medicaid, is made up of a system of 17 community mental health centers and two specialty clinics across the state. The pandemic has upended their model of delivery and financial footing, and they are expected to bear the brunt of the state’s dramatic budget cuts.
  • Encourage meaningful ways to listen to individuals impacted by mental health challenges and engage them in solutions to design a new future for mental health in Colorado. Rather than creating solutions for individuals, we must shift to solutions that are with and by folks with lived experience, and that acknowledge the resilience, wisdom, skill and expertise of consumers and providers in the mental health community.
  • Reinforce training and talent pipelines. It’s always been difficult – even before this pandemic – to hire and retain behavioral health providers due to the stress of the profession.
  • Scale up creative and highly effective service delivery mechanisms, like placing peer support specialists in public libraries and other places where people can easily access help. Additionally, we must aid the expansion of telehealth services and help ensure individuals have the devices and internet connection necessary to make use of this option.
  • Call on friends, family, coworkers and decision-makers to develop deeper empathy for people who shoulder more burden than individuals with greater privilege.

It’s going to take all of us to meet Coloradans where they are. Mental Health Awareness Month may be ending, but our need to be vigilant in our response to community needs must persist.

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