Q&A: How Donors Can Address Mental Health in the Age of COVID

May is Mental Health Month, and a recent poll from KFF (Kaiser Family Foundation) found that nearly half (45%) of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over COVID-19. Even as social distancing and business restrictions measures are relaxed, economic and personal stresses continue. To supplement CHIP’s COVID-19 guidance and get insight into high impact ways donors can help fund mental health this month and during the recovery, we spoke to Kristen Ward, MPH, the project manager for CHIP’s Health in Mind: A Philanthropic Guide for Mental Health and Addiction, published earlier this year.
Why is Mental Health Month different this year?

Ward: I think that mental health is on everyone’s mind in a way that it hasn’t been before. Many people experiencing mental health and addiction issues are now increasingly more vulnerable due to the increased isolation of social distancing and working at home. Not having access to the normal social supports and structures just makes it that much harder.

Health in Mind was released in February, before COVID-19 was a full-blown pandemic. How does it relate to the current situation, and how can donors apply it to the age of COVID?

Ward: There’s so much in Health in Mind that is more urgent than ever as philanthropic organizations and individual donors turn to COVID response. In Health in Mind, we outlined five strategies for how philanthropy can address mental health and addiction, and these still apply.

One example is the impact that COVID has had on youth and family mental health. Kids are spending more time at home than they ever have been. They aren’t seeing teachers, engaging with peers, or visiting clinicians in the same way. Teachers, coaches, counselors, doctors, social workers can have a good pulse on how a child is doing, and are often a trusted support for that young person. They can react to warning signs and help a child get support when needed. But now that safety valve isn’t there.

At the same time, there’s added stress for parents as they try to cope with home schooling and caring for their children while also working or while being out of work. During stay at home orders, people of all ages are lacking social connections. This is not all bad for some families, but for others it elevates current vulnerabilities, creating health risks otherwise alleviated by school environments and work.

Now more than ever we need to deploy what works, and we’re seeing that more people have access to telemedicine, support groups online, or phone-based support. This is a time to find new and innovative ways to reach patients and to expand our capacity to deliver baseline help to those in need.

You just mentioned youth as a group that’s particularly affected, and in Health in Mind you talk about other population groups, such as those with serious mental illness and those who are homeless and incarcerated. In this current pandemic, are these the same groups we should be concerned about, or are there other populations that need special attention?

Ward: Unfortunately, it’s both. The groups that were vulnerable to mental illness and substance use disorders prior to COVID need more support. The issues that they experienced before are still there, but now there are more barriers to care. COVID has led to limited social engagement as well as reduced employment opportunities, increased food insecurity, and other stressors that influence mental health. Additionally, jails and emergency departments are often the default location for many vulnerable individuals to receive care, thereby making an inadequate system worse.

At the same time, there are also groups that newly more vulnerable. For example, healthcare workers and grocery store workers and other people who are working on the front lines. They have put themselves in harm’s way and are experiencing stressful experiences daily. They will need new and more consistent, intensive support now and later.

Another aspect that you talked about in the guide is improving access to mental health care and transforming the mental health system, and now with the rapid adoption of telemedicine, we’re seeing that. What opportunities do donors have to fund transformative change?

Ward: There’s nothing like necessity to force us to change and improve. Over the last two to three months, restrictions on telemedicine and other ways to provide care have been lifted.

We’ve also seen waivers allowing people to maintain access to essential medicines while upholding social distancing guidelines — for example, Medication Assisted Treatment for individuals with opioid use disorder. We know what therapeutic approaches and supports work in mental health, and we know that social supports help individuals who are living with mental illness or substance use disorders to be productive and to find purpose in their life.

As funders address urgent and immediate gaps, we can use lessons learned during this time to improve a health care system that was already inadequate for meeting mental health needs. We can really deploy these measures in a more systematic and appropriate way that reduces inequality, increasing access to care and improving health outcomes in the long term.

So if there’s a donor out there who wants to help improve mental health right now, what are the types of organizations they should be supporting?

Ward: First, support those already providing care to individuals with mental health conditions and substance use disorders to ensure continuation of services. For example, NAMI, the National Alliance on Mental Illness, is adapting all of their programs to be online, including their education programs and support groups for caregivers and families. As COVID exacerbates existing mental health issues, those people in your first circle of support are under greater pressure and will also probably be dealing with their own mental health issues.

Another area to fund is crisis care. So often when individuals have a mental health crisis, they end up in emergency rooms or jails, and this is exactly the time when we need to reduce the pressure on those settings, where COVID transmissions are so prevalent. If we can bolster crisis services that are available through first responders, crisis centers, or health care centers that are better equipped to provide behavioral health care, we can provide a better entry point for individuals in a mental health crisis so they get the care that they need.

Philanthropy also has a significant role to play in addressing the needs of two groups that see high rates of mental health issues: individuals experiencing homelessness and individuals in the juvenile justice system. For example, while individuals with serious mental illness make up 4% of the general population, they represent 25% of the homeless population.

Also, individuals who are engaged in the justice system are disproportionately at risk of contracting COVID due to crowded conditions, and of being affected by mental health and substance use disorders. Different states and localities are taking measures to reduce the populations in prisons, and philanthropy can help fill gaps for individuals leaving detention settings to ensure they have the social network and mental health supports to live safely.

What else do funders and donors need to know right now?

Ward: There is a huge opportunity right now because we are all experiencing our own mental health issues, whether sleeplessness or general anxiety, as well as more serious conditions. I think the amount of attention on the importance of mental health is so significant. It can only help us move forward into COVID recovery and toward long-term system change to make care and support more accessible.

Mental health issues are all tightly related with other important needs. For example, if you care about mental health, you can help by funding to help individuals who are experiencing homelessness or incarceration. If you care about early childhood and educational outcomes for youth, you can help by funding mental health.

Mental health IS health, and that’s still true during the COVID pandemic.

— Interview by Kelly Andrews