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  • Havana syndrome fits the pattern of psychosomatic illness – but that doesn’t mean the symptoms aren’t real

    Mass psychogenic illness is a condition whereby people in a group feel sick because they think they have been exposed to something dangerous – even though there has been no actual exposure.

    In early September 2021, a CIA agent was evacuated from Serbia in the latest case of what the world now knows as “Havana syndrome.”

    Like most people, I first heard about Havana syndrome in the summer of 2017. Cuba was allegedly attacking employees of the U.S. Embassy in Havana in their homes and hotel rooms using a mysterious weapon. The victims reported a variety of symptoms, including headaches, dizziness, hearing loss, fatigue, mental fog and difficulty concentrating after hearing an eerie sound.

    Over the next year and a half, many theories were put forward regarding the symptoms and how a weapon may have caused them. Despite the lack of hard evidence, many experts suggested that a weapon of some sort was causing the symptoms.

    I am an emeritus professor of neurology who studies the inner ear, and my clinical focus is on dizziness and hearing loss. When news of these events broke, I was baffled. But after reading descriptions of the patients’ symptoms and test results, I began to doubt that some mysterious weapon was the cause.

    I have seen patients with the same symptoms as the embassy employees on a regular basis in my Dizziness Clinic at the University of California, Los Angeles. Most have psychosomatic symptoms – meaning the symptoms are real but arise from stress or emotional causes, not external ones. With a little reassurance and some treatments to lessen their symptoms, they get better.

    The available data on Havana syndrome matches closely with mass psychogenic illness – more commonly known as mass hysteria. So what is really happening with so–called Havana syndrome?

    A mysterious illness

    In late December 2016, an otherwise healthy undercover agent in his 30s arrived at the clinic of the U.S. Embassy in Cuba complaining of headaches, difficulty hearing and acute pain in his ear. The symptoms themselves were not alarming, but the agent reported that they developed after he heard “a beam of sound” that “seemed to have been directed at his home”.

    As word of the presumed attack spread, other people in the embassy community reported similar experiences. A former CIA officer who was in Cuba at the time later noted that the first patient “was lobbying, if not coercing, people to report symptoms and to connect the dots.”

    Patients from the U.S. Embassy were first sent to ear, nose and throat doctors at the University of Miami and then to brain specialists in Philadelphia. Physicians examined the embassy patients using a range of tests to measure hearing, balance and cognition. They also took MRIs of the patients’ brains. In the 21 patients examined, 15 to 18 experienced sleep disturbances and headaches as well as cognitive, auditory, balance and visual dysfunction. Despite these symptoms, brain MRIs and hearing tests were normal.

    A flurry of articles appeared in the media, many accepting the notion of an attack.

    From Cuba, Havana syndrome began to spread around the globe to embassies in China, Russia, Germany and Austria, and even to the streets of Washington.

    The Associated Press released a recording of the sound in Cuba, and biologists identified it as the call of a species of Cuban cricket.

    A sonic or microwave weapon?

    Initially, many experts and some of the physicians suggested that some sort of sonic weapon was to blame. The Miami team’s study in 2018 reported that 19 patients had dizziness caused by damage to the inner ear from some type of sonic weapon.

    This hypothesis has for the most part been discredited due to flaws in the studies, the fact there is no evidence that any sonic weapon could selectively damage the brain and nothing else, and because biologists identified the sounds in recordings of the supposed weapon to be a Cuban species of cricket.

    Some people have also proposed an alternative idea: a microwave radiation weapon.

    This hypothesis gained credibility when in December 2020, the National Academy of Science released a report concluding that “pulsed radiofrequency energy” was a likely cause for symptoms in at least some of the patients.

    If someone is exposed to high energy microwaves, they may sometimes briefly hear sounds. There is no actual sound, but in what is called the Frey effect, neurons in a person’s ear or brain are directly stimulated by microwaves and the person may “hear” a noise. These effects, though, are nothing like the sounds the victims described, and the simple fact that the sounds were recorded by several victims eliminates microwaves as the source. While directed energy weapons do exist, none that I know of could explain the symptoms or sounds reported by the embassy patients.

    Despite all these stories and theories, there is a problem: No physician has found a medical cause for the symptoms. And after five years of extensive searching, no evidence of a weapon has been found.

    Havana syndrome fits the pattern of psychosomatic illness – but that doesn’t mean the symptoms aren’t real
    Mass psychogenic illness – more commonly known as mass hysteria – is a well-documented phenomenon throughout history, as seen in this painting of an outbreak of dancing mania in the Middle Ages. Pieter Brueghel the Younger/WikimediaCommons

    Mass psychogenic illness

    Mass psychogenic illness is a condition whereby people in a group feel sick because they think they have been exposed to something dangerous – even though there has been no actual exposure. For example, as telephones became widely available at the turn of the 20th century, numerous telephone operators became sick with concussion-like symptoms attributed to “acoustic shock.” But despite decades of reports, no research has ever confirmed the existence of acoustic shock.

    I believe it is much more likely that mass psychogenic illness – not an energy weapon – is behind Havana syndrome.

    Mass psychogenic illness typically begins in a stressful environment. Sometimes it starts when an individual with an unrelated illness believes something mysterious caused their symptoms. This person then spreads the idea to the people around them and even to other groups, and it is often amplified by overzealous health workers and the mass media. Well-documented cases of mass psychogenic illness – like the dancing plagues of the Middle Ages – have occurred for centuries and continue to occur on a regular basis around the world. The symptoms are real, the result of changes in brain connections and chemistry. They can also last for years.

    The story of Havana syndrome looks to me like a textbook case of mass psychogenic illness. It started from a single undercover agent in Cuba – a person in what I imagine is a very stressful situation. This person had real symptoms, but blamed them on something mysterious – the strange sound he heard. He then told his colleagues at the embassy, and the idea spread. With the help of the media and medical community, the idea solidified and spread around the world. It checks all the boxes.

    Interestingly, the December 2020 National Academy of Science report concluded that mass psychogenic illness was a reasonable explanation for the patients’ symptoms, particularly the chronic symptoms, but that it lacked “patient-level data” to make such a diagnosis.

    The Cuban government itself has been investigating the supposed attacks over the years as well. The most detailed report, released on Sept. 13, 2021, concludes that there is no evidence of directed energy weapons and says that psychological causes are the only ones that cannot be dismissed.

    While not as sensational as the idea of a new secret weapon, mass psychogenic illness has historical precedents and can explain the wide variety of symptoms, lack of brain or ear damage and the subsequent spread around the world.

    [Understand new developments in science, health and technology, each week.Subscribe to The Conversation’s science newsletter.]The Conversation

    Robert Baloh, Professor of Neurology, University of California, Los Angeles

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

  • Kids Already Coping With Mental Disorders Spiral as Pandemic Topples Vital Support Systems

    When states and communities fail to provide children the services they need to live at home, kids can deteriorate and even wind up in jail.

    A bag of Doritos, that’s all Princess wanted.

    Her mom calls her Princess, but her real name is Lindsey. She’s 17 and lives with her mom, Sandra, a nurse, outside Atlanta. On May 17, 2020, a Sunday, Lindsey decided she didn’t want breakfast; she wanted Doritos. So she left home and walked to Family Dollar, taking her pants off on the way, while her mom followed on foot, talking to the police on her phone as they went.

    Lindsey has autism. It can be hard for her to communicate and navigate social situations. She thrives on routine and gets special help at school. Or got help, before the coronavirus pandemic closed schools and forced tens of millions of children to stay home. Sandra said that’s when their living hell started.

    “It’s like her brain was wired,” she said. “She’d just put on her jacket, and she’s out the door. And I’m chasing her.”

    On May 17, Sandra chased her all the way to Family Dollar. Hours later, Lindsey was in jail, charged with assaulting her mom. (KHN and NPR are not using the family’s last name.)

    Lindsey is one of almost 3 million children in the U.S. who have a serious emotional or behavioral health condition. When the pandemic forced schools and doctors’ offices to close last spring, it also cut children off from the trained teachers and therapists who understand their needs.

    As a result, many, like Lindsey, spiraled into emergency rooms and even police custody. Federal data shows a nationwide surge of kids in mental health crisis during the pandemic — a surge that’s further taxing an already overstretched safety net.

    ‘Take Her’

    Even after schools closed, Lindsey continued to wake up early, get dressed and wait for the bus. When she realized it had stopped coming, Sandra said, her daughter just started walking out of the house, wandering, a few times a week.

    In those situations, Sandra did what many families in crisis report they’ve had to do since the pandemic began: race through the short list of places she could call for help.

    First, her state’s mental health crisis hotline. But they often put Sandra on hold.

    “This is ridiculous,” she said of the wait. “It’s supposed to be a crisis team. But I’m on hold for 40, 50 minutes. And by the time you get on the phone, [the crisis] is done!”

    Then there’s the local hospital’s emergency room, but Sandra said she had taken Lindsey there for previous crises and been told there isn’t much they can do.

    That’s why, on May 17, when Lindsey walked to Family Dollar in just a red T-shirt and underwear to get that bag of Doritos, Sandra called the last option on her list: the police.

    Sandra arrived at the store before the police and paid for the chips. According to Sandra and police records, when an officer approached, Lindsey grew agitated and hit her mom on the back, hard.

    Sandra said she explained to the officer: “‘She’s autistic. You know, I’m OK. I’m a nurse. I just need to take her home and give her her medication.’”

    Lindsey takes a mood stabilizer, but because she left home before breakfast, she hadn’t taken it that morning. The officer asked if Sandra wanted to take her to the nearest hospital.

    The hospital wouldn’t be able to help Lindsey, Sandra said. It hadn’t before. “They already told me, ‘Ma’am, there’s nothing we can do.’ They just check her labs, it’s fine, and they ship her back home. There’s nothing [the hospital] can do,” she recalled telling the officer.

    Sandra asked if the police could drive her daughter home so the teen could take her medication, but the officer said no, they couldn’t. The only other thing they could do, the officer said, was take Lindsey to jail for hitting her mom.

    “I’ve tried everything,” Sandra said, exasperated. She paced the parking lot, feeling hopeless, sad and out of options. Finally, in tears, she told the officers, “Take her.”

    Lindsey does not like to be touched and fought back when authorities tried to handcuff her. Several officers wrestled her to the ground. At that point, Sandra protested and said an officer threatened to arrest her, too, if she didn’t back away. Lindsey was taken to jail, where she spent much of the night until Sandra was able to post bail.

    Clayton County Solicitor-General Charles Brooks denied that Sandra was threatened with arrest and said that while Lindsey’s case is still pending, his office “is working to ensure that the resolution in this matter involves a plan for medication compliance and not punitive action.”

    Sandra isn’t alone in her experience. Multiple families interviewed for this story reported similar experiences of calling in the police when a child was in crisis because caretakers didn’t feel they had any other option.

    ‘The Whole System Is Really Grinding to a Halt’

    Roughly 6% of U.S. children ages 6 through 17 are living with serious emotional or behavioral difficulties, including children with autism, severe anxiety, depression and trauma-related mental health conditions.

    Many of these children depend on schools for access to vital therapies. When schools and doctors’ offices stopped providing in-person services last spring, kids were untethered from the people and supports they rely on.

    “The lack of in-person services is really detrimental,” said Dr. Susan Duffy, a pediatrician and professor of emergency medicine at Brown University.

    Marjorie, a mother in Florida, said her 15-year-old son has suffered during these disruptions. He has attention deficit hyperactivity disorder and oppositional defiant disorder, a condition marked by frequent and persistent hostility. Little things — like being asked to do schoolwork — can send him into a rage, leading to holes punched in walls, broken doors and violent threats. (Marjorie asked that we not use the family’s last name or her son’s first name to protect her son’s privacy and future prospects.)

    The pandemic has shifted both school and her son’s therapy sessions online. But Marjorie said virtual therapy isn’t working because her son doesn’t focus well during sessions and tries to watch TV instead. Lately, she has simply been canceling them.

    “I was paying for appointments and there was no therapeutic value,” Marjorie said.

    The issues cut across socioeconomic lines — affecting families with private insurance, like Marjorie, as well as those who receive coverage through Medicaid, a federal-state program that provides health insurance to low-income people and those with disabilities.

    In the first few months of the pandemic, between March and May, children on Medicaid received 44% fewer outpatient mental health services — including therapy and in-home support — compared to the same time period in 2019, according to the Centers for Medicare & Medicaid Services. That’s even after accounting for increased telehealth appointments.

    And while the nation’s ERs have seen a decline in overall visits, there was a relative increase in mental health visits for kids in 2020 compared with 2019.

    The Centers for Disease Control and Prevention found that, from April to October last year, hospitals across the U.S. saw a 24% increase in the proportion of mental health emergency visits for children ages 5 to 11, and a 31% increase for children ages 12 to 17.

    “Proportionally, the number of mental health visits is far more significant than it has been in the past,” said Duffy. “Not only are we seeing more children, more children are being admitted” to inpatient care.

    That’s because there are fewer outpatient services now available to children, she said, and because the conditions of the children showing up at ERs “are more serious.”

    This crisis is not only making life harder for these kids and their families, but it’s also stressing the entire health care system.

    Child and adolescent psychiatrists working in hospitals around the country said children are increasingly “boarding” in emergency departments for days, waiting for inpatient admission to a regular hospital or psychiatric hospital.

    Before the pandemic, there was already a shortage of inpatient psychiatric beds for children, said Dr. Christopher Bellonci, a child psychiatrist at Judge Baker Children’s Center in Boston. That shortage has only gotten worse as hospitals cut capacity to allow for more physical distancing within psychiatric units.

    “The whole system is really grinding to a halt at a time when we have unprecedented need,” Bellonci said.

    ‘A Signal That the Rest of Your System Doesn’t Work’

    Psychiatrists on the front lines share the frustrations of parents struggling to find help for their children.

    Part of the problem is there have never been enough psychiatrists and therapists trained to work with children, intervening in the early stages of their illness, said Dr. Jennifer Havens, a child psychiatrist at New York University.

    “Tons of people showing up in emergency rooms in bad shape is a signal that the rest of your system doesn’t work,” she said.

    Too often, Havens said, services aren’t available until children are older — and in crisis. “Often for people who don’t have access to services, we wait until they’re too big to be managed.”

    While the pandemic has made life harder for Marjorie and her son in Florida, she said it has always been difficult to find the support and care he needs. Last fall, he needed a psychiatric evaluation, but the nearest specialist who would accept her commercial insurance was 100 miles away, in Alabama.

    “Even when you have the money or you have the insurance, it is still a travesty,” Marjorie said. “You cannot get help for these kids.”

    Parents are frustrated, and so are psychiatrists on the front lines. Dr. C.J. Glawe, who leads the psychiatric crisis department at Nationwide Children’s Hospital in Columbus, Ohio, said that once a child is stabilized after a crisis it can be hard to explain to parents that they may not be able to find follow-up care anywhere near their home.

    “Especially when I can clearly tell you I know exactly what you need, I just can’t give it to you,” Glawe said. “It’s demoralizing.”

    When states and communities fail to provide children the services they need to live at home, kids can deteriorate and even wind up in jail, like Lindsey. At that point, Glawe said, the cost and level of care required will be even higher, whether that’s hospitalization or long stays in residential treatment facilities.

    That’s exactly the scenario Sandra, Lindsey’s mom, is hoping to avoid for her Princess.

    “For me, as a nurse and as a provider, that will be the last thing for my daughter,” she said. “It’s like [state and local leaders] leave it to the school and the parent to deal with, and they don’t care. And that’s the problem. It’s sad because, if I’m not here …”

    Her voice trailed off as tears welled.

    “She didn’t ask to have autism.”

    To help families like Sandra’s and Marjorie’s, advocates said, all levels of government need to invest in creating a mental health system that’s accessible to anyone who needs it.

    But given that many states have seen their revenues drop due to the pandemic, there’s a concern services will instead be cut — at a time when the need has never been greater.

     

    This story is part of a reporting partnership that includes NPR, Illinois Public Media and Kaiser Health News.

    View the original article at thefix.com

  • In Hard-Hit Areas, COVID’s Ripple Effects Strain Mental Health Care Systems

    Although mental health services continued largely uninterrupted in areas with low levels of the coronavirus, behavioral health care workers in areas hit hard by COVID-19 were overburdened.

    In late March, Marcell’s girlfriend took him to the emergency room at Henry Ford Wyandotte Hospital, about 11 miles south of Detroit.

    “I had [acute] paranoia and depression off the roof,” said Marcell, 46, who asked to be identified only by his first name because he wanted to maintain confidentiality about some aspects of his illness.

    Marcell’s depression was so profound, he said, he didn’t want to move and was considering suicide.

    “Things were getting overwhelming and really rough. I wanted to end it,” he said.

    Marcell, diagnosed with schizoaffective disorder seven years ago, had been this route before but never during a pandemic. The Detroit area was a coronavirus hot spot, slamming hospitals, attracting concerns from federal public health officials and recording more than 1,000 deaths in Wayne County as of May 28. Michigan ranks fourth among states for deaths from COVID-19.

    The crisis enveloping the hospitals had a ripple effect on mental health programs and facilities. The emergency room was trying to get non-COVID patients out as soon as possible because the risk of infection in the hospital was high, said Jaime White, director of clinical development and crisis services for Hegira Health, a nonprofit group offering mental health and substance abuse treatment programs. But the options were limited.

    Still, the number of people waiting for beds at Detroit’s crisis centers swelled. Twenty-three people in crisis had to instead be cared for in a hospital.

    This situation was hardly unique. Although mental health services continued largely uninterrupted in areas with low levels of the coronavirus, behavioral health care workers in areas hit hard by COVID-19 were overburdened. Mobile crisis teams, residential programs and call centers, especially in pandemic hot spots, had to reduce or close services. Some programs were plagued by shortages of staff and protective supplies for workers.

    At the same time, people battling mental health disorders became more stressed and anxious.

    “For people with preexisting mental health conditions, their routines and ability to access support is super important. Whenever additional barriers are placed on them, it could be challenging and can contribute to an increase in symptoms,” said White.

    After eight hours in the emergency room, Marcell was transferred to COPE, a community outreach program for psychiatric emergencies for Wayne County Medicaid patients.

    “We try to get patients like him into the lowest care possible with the least restrictive environment,” White said. “The quicker we could get him out, the better.”

    Marcell was stabilized at COPE over the next three days, but his behavioral health care team couldn’t get him a bed in one of two local residential crisis centers operated by Hegira. Social distancing orders had reduced the beds from 20 to 14, so Marcell was discharged home with a series of scheduled services and assigned a service provider to check on him.

    However, Marcell’s symptoms ― suicidal thoughts, depression, anxiety, auditory hallucinations, poor impulse control and judgment ― persisted. He was not able to meet face-to-face with his scheduled psychiatrist due to the pandemic and lack of telehealth access. So, he returned to COPE three days later. This time, the staff was able to find him a bed immediately at a Hegira residential treatment program, Boulevard Crisis Residential in Detroit.

    Residents typically stay for six to eight days. Once they are stabilized, they are referred elsewhere for more treatment, if needed.

    Marcell ended up staying for more than 30 days. “He got caught in the pandemic here along with a few other people,” said Sherron Powers, program manager. “It was a huge problem. There was nowhere for him to go.”

    Marcell couldn’t live with his girlfriend anymore. Homeless shelters were closed and substance abuse programs had no available beds.

    “The big problem here is that all crisis services are connected to each other. If any part of that system is disrupted you can’t divert a patient properly,” said Travis Atkinson, a behavioral consultant with TBD Solutions, which collaborated on a survey of providers with the American Association of Suicidology, the Crisis Residential Association and the National Association of Crisis Organization Directors.

    White said the crisis took a big toll on her operations. She stopped her mobile crisis team on March 14 because, she said, “we wanted to make sure that we were keeping our staff safe and our community safe.”

    Her staff assessed hospital patients, including Marcell, by telephone with the help of a social worker from the emergency room.

    People like Marcell have struggled during the coronavirus crisis and continue to face hurdles because emergency preparedness measures didn’t provide enough training, funds or thought about the acute mental health issues that could develop during a pandemic and its aftermath, said experts.

    “The system isn’t set up to accommodate that kind of demand,” said Dr. Brian Hepburn, a psychiatrist and executive director of the National Association of State Mental Health Program Directors.

    “In Detroit and other hard-hit states, if you didn’t have enough protective equipment you can’t expect people to take a risk. People going to work can’t be thinking ‘I’m going to die,’” said Hepburn.

    For Marcell, “it was bad timing to have a mental health crisis,” said White, the director at Hegira.

    At one time Marcell, an African American man with a huge grin and a carefully trimmed goatee and mustache, had a family and a “pretty good job,” Marcell said. Then “it got rough.” He made some bad decisions and choices. He lost his job and got divorced. Then he began self-medicating with cocaine, marijuana and alcohol.

    By the time he reached the residential center in Detroit on April 1, he was at a low point. “Schizoaffective disorder comes out more when you’re kicked out of the house and it increases depression,” said Powers, the program manager who along with White was authorized by Marcell to talk about his care. Marcell didn’t always take his medications and his use of illicit drugs magnified his hallucinations, she said.

    While in the crisis center voluntarily, Marcell restarted his prescription medications and went to group and individual therapy. “It is a really good program,” he said while at the center in early May. “It’s been one of the best 30 days.”

    Hepburn said the best mental health programs are flexible, which allows them more opportunities to respond to problems such as the pandemic. Not all programs would have been able to authorize such a long stay in residential care.

    Marcell was finally discharged on May 8 to a substance abuse addiction program. “I felt good about having him do better and better. He had improved self-esteem to get the help he needed to get back to his regular life,” Powers said.

    But Marcell left the addiction program after only four days.

    “The [recovery] process is so individualized and, oftentimes, we only see them at one point in their journey. But, recovering from mental health and substance use disorders is possible. It can just be a winding and difficult path for some,” said White.

    Seeking Help

    If you or someone you know is in immediate danger, call 911. Below are other resources for those needing help:

    — National Helpline: 1-800-662-HELP (4357) or https://findtreatment.samhsa.gov.

    — National Suicide Prevention Lifeline: 1-800-273-TALK (8255).

    — Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746.

    View the original article at thefix.com

  • Flattening the mental health curve is the next big coronavirus challenge

    Some recent projections suggest that deaths stemming from mental health issues could rival deaths directly due to the virus itself.

    The mental health crisis triggered by COVID-19 is escalating rapidly. One example: When compared to a 2018 survey, U.S. adults are now eight times more likely to meet the criteria for serious mental distress. One-third of Americans report clinically significant symptoms of anxiety or clinical depression, according to a late May 2020 release of Census Bureau data.

    While all population groups are affected, this crisis is especially difficult for students, particularly those pushed off college campuses and now facing economic uncertainty; adults with children at home, struggling to juggle work and home-schooling; and front-line health care workers, risking their lives to save others.

    We know the virus has a deadly impact on the human body. But its impact on our mental health may be deadly too. Some recent projections suggest that deaths stemming from mental health issues could rival deaths directly due to the virus itself. The latest study from the Well Being Trust, a nonprofit foundation, estimates that COVID-19 may lead to anywhere from 27,644 to 154,037 additional U.S. deaths of despair, as mass unemployment, social isolation, depression and anxiety drive increases in suicides and drug overdoses.

    But there are ways to help flatten the rising mental health curve. Our experience as psychologists investigating the depression epidemic and the nature of positive emotions tells us we can. With a concerted effort, clinical psychology can meet this challenge.

    Reimagining mental health care

    Our field has accumulated long lists of evidence-based approaches to treat and prevent anxiety, depression and suicide. But these existing tools are inadequate for the task at hand. Our shining examples of successful in-person psychotherapies – such as cognitive behavioral therapy for depression, or dialectical behavioral therapy for suicidal patients – were already underserving the population before the pandemic.

    Now, these therapies are largely not available to patients in person, due to physical distancing mandates and continuing anxieties about virus exposure in public places. A further complication: Physical distancing interferes with support networks of friends and family. These networks ordinarily allow people to cope with major shocks. Now they are, if not completely severed, surely diminished.

    What will help patients now? Clinical scientists and mental health practitioners must reimagine our care. This includes action on four interconnected fronts.

    First, the traditional model of how and where a person receives mental health care must change. Clinicians and policymakers must deliver evidence-based care that clients can access remotely. Traditional “in-person” approaches – like individual or group face-to-face sessions with a mental health professional – will never be able to meet the current need.

    Telehealth therapy sessions can fill a small part of the remaining gap. Forms of nontraditional mental health care delivery must fill the rest. These alternatives do not require reinvention of the wheel; in fact, these resources are already readily accessible. Among available options: web-based courses on the science of happiness, open-source web-based tools and podcasts. There are also self-paced, web-based interventions – mindfulness-based cognitive therapy is one – which are accessible for free or at reduced rates.

    Democratizing mental health

    Second, mental health care must be democratized. That means abandoning the notion that the only path to treatment is through a therapist or psychiatrist who dispenses wisdom or medications. Instead, we need other kinds of collaborative and community-based partnerships.

    For example, given the known benefits of social support as a buffer against mental distress, we should enhance peer-delivered or peer-supported interventions – like peer-led mental health support groups, where information is communicated between people of similar social status or with common mental health problems. Peer programs have great flexibility; after orientation and training, peer leaders are capable of helping individual clients or groups, in person, online or via the phone. Initial data shows these approaches can successfully treat severe mental illness and depression. But they are not yet widely used.

    Taking a proactive approach

    Third, clinical scientists must promote mental health at the population level, with initiatives that try to benefit everyone rather than focusing exclusively on those who seek treatment. Some of these promotion strategies already have clear-cut scientific support. In fact, the best-supported population interventions, such as exercise, sleep hygiene and spending time outdoors, lend themselves perfectly to the needs of the moment: stress-relieving, mental illness-blocking and cost-free.

    Finally, we must track mental health on the population level, just as intensely as COVID-19 is tracked and modeled. We must collect much more mental health outcome data than we do now. This data should include evaluations from mental health professionals as well as reports from everyday citizens who share their daily experiences in real time via remote-based survey platforms.

    Monitoring population-level mental health requires a team effort. Data must be collected, then analyzed; findings must be shared across disciplines – psychiatry, psychology, epidemiology, sociology and public health, to name a few. Sustained funding from key institutions, like the NIH, are essential. To those who say this is too tall an order, we ask, “What’s the alternative?” Before flattening the mental health curve, the curve must be visible.

    COVID-19 has revealed the inadequacies of the old mental health order. A vaccine will not solve these problems. Changes to mental health paradigms are needed now. In fact, the revolution is overdue.
     

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    This article is republished from The Conversation under a Creative Commons license. Read the original article.