It feels all too surreal, this world we find ourselves in. A year ago, I remember being excited to work from home and save money on gas, all thanks to COVID-19. Now I find excuses to leave my house for regular walks and feel odd when a television show does not depict characters in masks. The world has changed, but so have I. We all have. 

Perhaps we are unaware of the ways in which we have changed. For some, like my fiancee’s father who lost 60 pounds through exercise and meal planning, the change is positive. However, for many, the change is neither physical nor positive. Mental illness and substance abuse has skyrocketed. The Kaiser Family Foundation reports that, compared to 2019, when 11 percent of adults reported symptoms for anxiety or depressive disorders, there are now approximately 41 percent (nearly a 300 percent increase from 2019) Americans reporting symptoms of anxiety and depressive disorders in 2021. The cause is multivariable: social isolation, financial hardship, unemployment, illness.

Increases in stress and anxiety and depression is not evenly distributed. 74.9 percent of respondents to a CDC report between 18 and 24 years of age report a minimum of one mental or behavioral symptom. 18- to 24 year-olds are disproportionately more likely to cope with substance use, and a quarter of those who had considered suicide within 30 days of the CDC report were within this same age range.

As I think back on the waxing and waning of COVID-19 infections, racial unrest and hate crimes this past year, I find myself shaking my head in disbelief. Something is very much not OK. I think that we can all agree that something is wrong and, at a minimum, the way that mental health has been handled in America is lacking.

Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, states that “Good mental health is absolutely fundamental to overall health and well-being. … COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programs — during the pandemic and beyond.”

As Ghebreyesus discussed, a focus on mental health is vital for healthy recovery from the pandemic. Reflecting on my experience over the past year, I have found that substantial focus at the local, state and federal level has focused almost exclusively on the physical dangers of the pandemic without giving due regard for the mental.

When I look around my community here at Yale and my family’s community back in Massachusetts, I do not see or hear any substantive mention of mental health, at least nothing worth remembering. Even ads on Spotify have been encouraging vaccination, mask wearing and social distancing; I have yet to hear an ad mentioning the importance of protecting mental health.

The CDC has put together “Healthy Ways to Cope with Stress,” but they seem to neglect metaphysical needs of social creatures during a pandemic. For instance, two of the top five recommendations are to “Continue with routine preventive measures (such as vaccinations, cancer screenings, etc.) as recommended by your health care provider” and to “Get vaccinated with a COVID-19 vaccine when available.” They also mention the importance of getting plenty of sleep, eating healthily and avoiding substances.

These measures and suggestions seem insufficient and inadequately address the gravity of the mental health epidemic that the country is heading towards.

Even before the pandemic, the U.S. struggled to provide sufficient mental health services for our population, and this has only gotten worse over the past year. Therefore, there needs to be an increase in mental health capacity. However, the answer is not just building more mental health clinics — the problem is lack of access that spurs from high costs and insufficient insurance coverage. One-quarter of Americans reported having to choose between mental health treatment and paying for daily necessities. There is also a lack of awareness and social stigma at play that prevent Americans from accessing resources.

My MPH work has, in part, focused on global health, specifically the ethics of global health work. In this field of study, mental health is also sorely neglected in part to cultural barriers and stigma. We polarize the global south from the global north, but I think that some of the interventions to address mental health in global health settings are quite effective. Researchers from Columbia University suggest the following: diminishing pervasive stigma, building mental health system treatment and research capacity, implementing prevention programs to decrease the incidence of mental disorders and establishing sustainable scale up of public health systems to improve access to mental health treatment. The common thread: prioritization.

Mental health has not been prioritized by leaders nor by community members and organizations. In 2016 the World Bank and World Health Organization made a call to action to “find solutions to a rising global mental health problem.” By 2030, mental health related disorders are expected to cost $6 trillion globally. Even after the end of COVID-19 there will be long-term residual damage within the social fabric of all American communities.

In light of this evidence and stark reality, the American public and leaders need to acknowledge the importance of mental health not only for our children but for our working class and elderly, as well. Funds need to be allocated to mental health sustenance and businesses must engage in prevention initiatives to support their employees. 

This pandemic has changed each and every one of us. Therefore, we must do what humanity has done for millions of years to survive: adapt and overcome. In the modern age, this is through a restructuring of priorities towards uplifting and engaging in mental health programming more than ever before.

Joseph Williams is a first-year MPH candidate in the Yale School of Public Health. His column 'Contemplating health' runs on alternate Thursdays.