THE PSYCHOLOGICAL EFFECTS OF THE COVID-19 PANDEMIC ON CHILDREN AND ADULTS
By David Thomas & Christine A. McCallister
The impacts of COVID-19 worldwide have been tremendous, therefore, an overview of what has been taking place in 2021 across the world and in the United States of America is in order. As of August 20th, 2021, there have been 38,231,972 million confirmed cases of COVID-19 and 643,113 deaths in the United States. There have been 211 million confirmed cases of COVID-19, and 4,421, 876 deaths worldwide. The top 10 countries with leading death tolls are as follows (ELFLEIN, 2021).
- USA — 643,113
2. BRAZIL — 572,733
3. INDIA — 433,622
4. MEXICO — 251,319
5. RUSSIA — 174,485
6. UNITED KINGDOM — 131,373
7. ITALY — 128,634
8. INDONESIA — 123,981
9. COLOMBIA — 123,901
10. FRANCE — 113,103
SOCIAL IMPACTS OF COVID-19
Economic Impacts of COVID-19
Economically speaking in America, the U.S. Travel and Tourism Industry lost 51.5 billion dollars (Duffin, 2020). 50 million people are out of work due to business closure. Consumer spending was down by 12.6 percent in April, which would have been drastically worse if not for the Cares Act that passed and provided unemployed Americans with $600 a week (Ghosh, 2020). In May, the Bureau of Labor statistics reported that 20.5 million non-farm jobs were lost. The Congressional Budget office reported that unemployment claims were 49 billion in April of 2020. In April 2019, the output for unemployment was $3 billion. Due to the economic impact of COVID-19 and mass unemployment, 19 to 23 million renters or 1 in 5 are at risk for eviction (Benfer, 2020). Another project estimates that 16 million households are unable to pay rent and are at risk of eviction as of July of 2020 (Abruzzese, 2020). The unemployment rate in America reached an all-time high of 14.7 percent (Trading Economics, 2020). Additionally, the unemployment rate in 2020 rose from 4.8 percent to 8.3 percent worldwide (International Monetary Fund, 2020).
These numbers have been given to set the stage not only in America for the devastating effects of COVID-19 but worldwide as well. It is likely that these effects will cause and have caused catastrophic mental health issues in America and worldwide and have greatly affected people of all ages and backgrounds in negative ways. The contention is that on the world stage, a push for mental health services to be in place and accessible to all is needed. The hope is that the mental health services will combat the forthcoming tsunami of issues that are taking place and will take place not only in America but globally as well.
Crime and COVID-19
Due to the COVID-19 pandemic and movement restriction, there has been a decrease in organized crime (Muggah, 2020). The associated press reports that Chicago drug arrests have fallen 42%. Overall crime in Chicago has fallen 10%. Additionally, there is a decrease in street crime globally. In contrast, there has been an increase in looting, arson, vandalism, and assaults as a result of the protests taking place. There has also been an increase in counterfeiting and fraud. For example, counterfeit surgical masks are being sold. Cybercrime has also increased due to the increase of many people being online due to the lock down and movement restrictions. (Sheng, 2020). The United Nations has reported an increase in domestic violence globally (The Department of Global Communications, 2020). Peru has reported more than 5 missing women per day. During 3 months of lockdown in Peru, 915 women have been reported missing (Craig, 2020). Additionally, the FBI has reported an increase in hate crimes towards Asians stemming from the belief that the virus origin is Chinese (Margolin, 2020). Terrorist attacks are reported on the rise as terrorists are taking advantage of the shut downs to carry out attacks. In May 2020, a series of attacks in Afghanistan killed 56 people, Terrorists targeted a hospital’s maternity ward and a funeral causing the deaths of babies, hospital staff, and funeral participants (Mukhutar, 2020)
THE MENTAL HEALTH CRISIS NO ONE IS FOCUSED ON
The COVID-19 pandemic as well as the violence and unrest expressed through the protests and the relationship to media has led to an increase in isolation, the witnessing of violence and destruction on a daily basis, and the economical collapse of individual’s financial stability and wellbeing, which is being experienced by children as well as adults. An unfortunate side effect of all of this is a surge in the suicide rates among adults and teens.
There has been a tremendous increase in drug use as well as substance abuse relapse during the COVID-19 pandemic. I, David, can tell you first hand that many of the clients that I serve as a case manager have relapsed due to the overwhelming stressors that they are presented with as well as the extreme isolation. According to an interview with a spokesperson from OhioCan, which is an organization that works with the families and loved ones of people who have overdosed, during the first half of the year in Ohio, 2600 individuals have overdosed and died (B. R. Hamiton, personal communication, August 14, 2020).
Children who depend on school for a safe haven away from an abusive homelife as well as a steady meal do not have that with the initial forced shut down of the schools. For many children, this is where they have access to a counselor who will hear them out about what is going on at home and support them. Taking this away has increased hopelessness in children and caused a surge in the suicide rate.
Depression, anxiety, and stress are on the rise in children and adults (Liu et al., 2020). There is a steady threat which is COVID-19 looming over our heads, which has forced isolation and loss. This has created a sense of hopelessness and a steady unknowing about the future. COVID-19 has stripped Maslows hierarchy of needs completely away and put many individuals in fight or flight mode, exhausting their nervous systems with stress and creating self medicators who have searched for some relief. There is also a potential increase for mass violence worldwide.
COVID-19 creates the following issues:
1. Trauma from widespread disease
2. Grief over losses of life
3. Fear of getting sick
4. Unprecedented physical distancing
5. Financial concerns, including unemployment and housing insecurity
6. Loss of community
7. Reduced access to caregiver
Mental Health Impacts from COVID-19 Pandemic
The COVID-19 pandemic has led to tremendous psychological impacts among individuals of all ages. Research suggests that mental health concerns such as depression, anxiety, and trauma-related disorders have increased. The mental health impacts stem from a variety of sources, such as COVID-19 stressors, secondary impacts such as loss of resources or finances, and vulnerability among individuals with chronic illnesses (Pfefferbaum & North, 2020). Specifically, fear related to contracting the virus and grief and trauma related to loved ones dying from the virus has increased. The fear that people experience related to the virus itself can lead to cognitive impacts, such as “I will die if I contract the virus,” or “I cannot go out of my home or see anyone because I don’t want to contract the virus.” Stress from worrying about the virus can also lead to physical impacts such as somatic symptoms (i.e., headaches, stomachaches) and physiological symptoms (i.e., shortness of breath, heart palpitations, sweating). The fear related to the virus can also lead to emotional impacts such as depression, grief, loss, anxiety, panic attacks, anger, and agoraphobia. For people with chronic illnesses, who are at a greater risk, this fear may be heightened and come with a wide variety of other concerns, such as increased isolation, feelings of loneliness, and lack of medical care.
Impact of COVID-19 Pandemic on People with Eating Disorders
People with eating disorders are at increased risk as a result of the COVID-19 pandemic due to various factors such as isolation, staying at home for longer periods of time, food insecurity, and interpersonal distress (Touyz et al., 2020). Specifically, the negative emotional impacts of the pandemic, such as anxiety, sadness, and loneliness, may exacerbate physical and isolation among people with anorexia nervosa, which may increase symptoms of disordered eating (Brooks et al., 2020). Additionally, individuals with physical health concerns, such as cardiovasculor and gastrointestinal concerns, due to disordered eating may be at greater risk of health complications from COVID-19 (Touyz et al., 2020). People with bulimia nervosa or binge-eating disorder may experience increased difficulties due to triggers such as staying at home, food insecurity, panic buying, and constant exposure to food. Binge-eating has also been shown to increase familial conflict and suicidality. Treatment for individuals with eating disorders tends to be long-term and intensive, therefore, in person day treatment programs that have transitioned to telehealth may exacerbate concerns and symptoms among this population (Barakat et al., 2017).
Impact of COVID-19 Pandemic on Anxiety
There has been a tremendous increase in anxiety as a result of the COVID-19 pandemic, for people with existing anxiety and for those who have not experienced anxiety previously. In fact, a survey among Chinese medical workers indicated that traumatic stress had a prevalence of 73.4%, depression had a prevalence of 50.7%, generalized anxiety had a prevalence of 44.7%, and insomnia had a prevalence of 36.1% (Liu et al., 2020). Additionally, a meta-analysis indicates that stress had a prevalence of 29.6% and anxiety had a prevalence of 31.9% (Salari et al., 2020). Panic attacks have also been shown to increase as a result of pandemics (Taylor et al., 2008). This suggests a high occurrence of anxiety as a result of the COVID-19 pandemic.
Due to the high rates of anxiety, the Coronavirus Anxiety Scale (CAS), a 5-item mental health scale, was developed to assess for dysfunctional anxiety, specifically related to the pandemic (Lee, 2020). Among participants who completed the CAS, 23.4% of participants indicated that they are spending 5–7 hours over the past two weeks preoccupied with the coronavirus and 19.7% indicated that they are spending 7 hours or more (Lee, 2020). This suggests that people with anxiety due to the pandemic are spending a great deal of time thinking about the virus, exposing themselves to media about the virus, and experiencing anxiety about the virus. Results from the CAS indicated that anxiety related to the pandemic is associated with contracting the coronavirus, using substances to cope, experiencing a sense of hopelessness, negative religious coping, suicidal tendencies, and attitudes towards President Trump and Chinese products (Lee, 2020). The CAS measures anxiety symptoms such as dizziness, sleep disturbance, motor inhibition, appetite loss, and abdominal distress. Results indicated that these symptoms were elevated as a result of pandemic-related concerns.
Anxiety as a result of the pandemic can occur for a variety of reasons. For example, the high mortality rate, uncertainty about the present and future, unemployment, financial concerns, false or rumored information, and high exposure to media related to the pandemic can increase anxiety (Salari, 2020). It is recommended that individuals decrease exposure to media related to the coronavirus, engage in health-promoting behaviors, and stay connected to loved ones as ways to decrease and cope with pandemic-related anxiety. This is particularly important because anxiety can lead to a decrease in immune functioning, which can increase the probability of contracting the coronavirus (WHO, 2020).
People with chronic illnesses may also be more likely to experience anxiety due to their increased vulnerability to the coronavirus (Salari, 2020). Additionally, women who are pregnant or who gave birth to a baby within one year may be more at risk for developing anxiety symptoms due to the pandemic. In one survey, moderate to high anxiety increased from 29% pre-pandemic to 72% during the pandemic (Davenport et al., 2020). Mothers may be more at risk for developing anxiety symptoms due to various pandemic-related factors such as fear of the virus, financial stressors, and household and caregiver demands (Davenport et al., 2020).
Impact of COVID-19 Pandemic on Psychosis
Individuals with psychosis have an increased risk of aversive effects from the COVID-19 pandemic and an increase in psychotic symptoms (Brown et al., 2020). This population may experience an increase in symptoms for a variety of reasons. For example, people with psychosis may experience greater stress due to social distancing and isolation. Due to social distancing regulations, the use of technology as a ways to communicate has increased. However, individuals with psychosis are less likely to use technology to communicate with others (Firth et al., 2015). Therefore, increased isolation may exacerbate depressive symptoms and psychotic symptoms. Additionally, paranoia about contracting the virus may be exacerbated due to health anxiety. Stressors, such as the pandemic, have been shown to be associated with the onset of psychotic symptoms (Fusar-Poli et al., 2017). Stressors specifically related to the pandemic, such as social isolation, relationship ending, domestic violence, unemployment, homelessness, and physical health issues are potential risk factors for people with psychosis (Anglin et al., 2020). Therefore, the stress of the pandemic can increase psychotic symptoms, along with paranoia about contracting the virus. Additionally, steroids may be used to treat COVID-19, which has been associated with psychotic symptoms (Wada et al., 2001).
Impact of COVID-19 Pandemic on Depression
Depression due to COVID-19 is also on the rise. Mothers may be a particular population that are at risk for developing depressive symptoms due to the pandemic. In one survey, 15% of participants reported a score not indicative of depression before the pandemic, whereas 40.7% of women were experiencing depression during the pandemic (Davenport et al., 2020). Mothers may be more at risk for developing depression symptoms due to various pandemic-related factors such as isolation and perceived lack of support (Davenport et al., 2020). To combat and prevent depression, it is recommended to engage in physical activity, as mothers who exercised more frequently experienced less depression (Davenport et al., 2020).
MENTAL HEALTH TREATMENT
The increase of mental health symptoms among various populations calls for the need for access to mental health treatment (Roy et al., 2020). In fact, in one survey, 75% of participants reported that there is need for mental health treatment for individuals who experience anxiety and panic symptoms during the pandemic and over 80% of participants reported that there is a need for mental health treatment due to the increase in psychological and mental health symptoms due to the pandemic (Roy et al., 2020).
While there is a need for access to mental healthcare, research suggests that there are disparities related to accessing mental healthcare. There are a variety of factors that influence lack of access to mental healthcare. For example, stigma and shame associated with seeking counseling may reduce accessibility to mental health treatment (Cook et al., 2018). It is important for the general population and professionals to work towards reducing stigma associated with mental health treatment in order to increase access to care and encourage help-seeking behaviors. Additionally, access to mental health treatment may be lower depending on socioeconomic factors, demographics, mental illness diagnosis, and social determinants. For example, people with lower socioeconomic status may have greater difficulty obtaining access to mental health treatment.
To increase access to mental health treatment and reduce disparities, a variety of approaches may take place. For example, culturally-sensitive and trauma-informed care may improve access to mental health treatment (Cook et al., 2018). Additionally, utilizing a systems approach and using interventions that address the family dynamic may be useful. Increasing mental health provider availability and developing positive therapeutic alliances may also decrease disparities. Financial and socioeconomic factors play a significant role in access to mental health treatment (Cook et al., 2018). It is recommended that insurance coverage is expanded to increase access to mental health care.
The importance and use of tele-psychotherapy has increased during the COVID-19 pandemic and has been shown to be effective (Rosen et al., 2020). Mental health counselors have continued to provide services to clients through tele-health as a way to increase access to mental health care. The COVID-19 pandemic is considered a crisis, in which people may experience trauma-related symptoms. The purpose of counseling is to prevent and treat mental health symptoms and in this case of the pandemic, to increase coping during and after a crisis. A strengths-based framework may be vital during the use of counseling to instill hope and encourage the use of resources.
Overall, counseling has been shown to be effective both short-term and long-term (Erford et al., 2015). Additionally, research suggests that the benefits of counseling lasts. There are a wide variety of effective treatment modalities, such as Cognitive Behavioral Therapy and a wide variety of presenting concerns that improve with counseling, such as depression, anxiety, and trauma-related symptoms. Overall, there is a growing need for improved access to mental health treatment worldwide due to the increase in mental health symptoms among the pandemic.
Experiences with Protests
I, David, have covered several Protests beginning with May 29th in Canton Ohio over the murder of George Floyd by a police officer. The protests started out peaceful but an hour and a half into it, bottles began to be thrown at police and the swat team moved in with tear gas. There were young children at this protest as I have noted in protest footage. I have seen from other protests either 2nd amendment protests or Black Lives Matters protests children are present to see and experience the dangers present first hand. I covered a Black Lives Matters protest in Hartville Ohio June 14th , and once again children were present as well as counter protesters who would drive by the protesters yelling racial slurs. The first hand exposure of children to such a trauma inducing situation not only first hand but also the repeated viewing of these events on social media concerns me for our children and could have dramatic psychological effects for our children in the years to come.
IF IT BLEEDS IT LEADS
In relationship to COVID-19 and protests as governmental issues in America, as a Journalist I, David, can say that each day offers a new horror show of negative events for viewers to take in every aspect of news from printed media, television, to news on social media. Daily viewers are tuning in to witness people fighting over the reality of COVID-19, watching protests, that turn violent and viewing an almost civil war of ideologies in general.
Our Mission, Our Plea
The purpose of our paper is to plead with world leaders to see the damaging effects of everything that is going on surrounding the COVID-19 pandemic and to know that we must intervene and create programming to make mental health services accessible for all. We are focused on the tiger in the Jungle (COVID-19), but it is the lion behind us (Mental Health Crisis), that we are not talking about that is going to sneak up on us and cause devastating damage to our country and countries across the world.