COVID-19, Mental Health & Substance Abuse

SARS-CoV-2, the novel coronavirus that causes the COVID-19 illness, has infected at least 325,000 Missourians and led to over 4,500 deaths in the state as of December 2020. Social isolation and economic insecurity, both of which have increased during the pandemic, are known to exacerbate (and even cause) psychiatric disorders. Mental disorders such as depression, anxiety, schizophrenia, and substance abuse disorder are estimated to affect approximately 20% of the US population, so the COVID-19 pandemic poses increased risks to a significant portion of the community even if they are not directly infected with SARS-CoV-2. Research on mental health outcomes during the COVID-19 pandemic indicates that substance abuse, including the use of opioids such as fentanyl, has increased, illustrating how the current crisis may trigger new mental disorders even in those without a previous diagnosis. Moreover, populations with pre-existing mental health conditions have proven to be more susceptible to COVID-19 and subsequent health complications, including death, highlighting the complex interactions between mental health and population health outcomes. Finally, several demographic groups, including youth populations and racial/ethnic minorities, have been disproportionately affected by the dual COVID-19/mental health epidemic, pointing to a need for increased attention and resources for vulnerable populations to reduce further harm.

Highlights

• COVID 19-related social conditions have increased substance abuse, overdoses, and self reports of negative mental and behavioral health conditions.
• Individuals who contract COVID-19 are at increased risk of developing a psychiatric disorder following their illness.
• Individuals with pre-existing psychiatric disorders, including substance use disorders, are at significantly increased risk of contracting COVID-19 and experiencing serious negative health outcomes, such as hospitalization and death.

Limitations

• COVID 19-related data are often not disaggregated by demographic characteristics such as race/ethnicity, making it difficult at present to identify and understand disparities in health outcomes.
• Health records often lack info about housing density, family size, current employment status, and immigration status, making it difficult to identify other potential drivers of observed health outcomes.
• So far, it is unclear how particular policy responses to the COVID-19 pandemic are associated with mental health outcomes.