The mental health of Americans has deteriorated considerably during what has been labeled this “perpetual COVID-19 pandemic”. We examined the dimensions of and some of the reasons for that decline in our blog preceding this one citing “identity, individuality, and isolation” as mental health variants, which, in the long term, could have greater negative consequences for our country than the Delta and Omicron variants.
We concluded that piece by asserting that “it will be up to we Americans who know and understand our civic roles and responsibilities” to come together to find ways to address this problematic condition. In our opinion, central to that solution is the development of a community-centric mindset.
A community-centric mindset is one which embraces the importance of the American community and building the bonds and bridges necessary to engage its willing members in productive and collaborative problem-solving. Developing and utilizing that mindset requires understanding: America’s mental state; the “plandemic period”; our being human; 21st century citizenship, and; what to do to improve America’s mental health.
Our thoughts on each of those requirements follow.
America’s Mental State
America’s current mental state is a depressed and depressing one.
In its 2022 Report on The State of Mental Health in America, Mental Health America opened with the following statement, “In 2019, just prior to the COVID-19 pandemic, 19.86% of adults experienced a mental illness, equivalent to nearly 50 million Americans.”
Because Mental Health America had been unable to conduct meaningful research in 2021, it concluded its 2022 Report with a spotlight on its 2021 Report titled COVID-19 and Mental Health: A Growing Crisis. That report, based upon research conducted from January through September 2020, opened by declaring, “The number of people looking for help with anxiety and depression has skyrocketed.”
Through its research from March-April 2020 to March-April 2021, the Boston University School of Public Health found that depression rates tripled and symptoms worsened during the first year of COVID-19. In a press release, the study’s authors stated, “Typically, we would expect depression to peak following the traumatic event and then lower over time. Instead, we found that 12 months into the pandemic, levels of depression remained high.”
The COVID-States Project, conducted by a consortium of universities (Harvard, Northeastern, Northwestern, and Rutgers) and funded by the National Science Foundation, had similar findings to the Boston University study. The Project looked at the impact of COVID through multiple waves of research beginning in April-May 2020 until April-May 2021.
The Project report released after the 2021 wave of research disclosed no evidence of an improvement in the prevalence of depression and other measures of mental health, despite marked improvement in the pandemic occurring in the United States after the winter months. The rate of depression was 28%, compared to a high of 30% and a low of 25% in all surveys.
As 2021 drew to a close, the American Psychiatric Association released the results of the Healthy Minds Monthly national poll conducted in early December by Morning Consult showing that “just over one third (37%)” of the respondents “say they are anxious about their mental health to start the new year.” In that same poll, 46% of young adults 18–34 and 42% of mothers graded their mental health as fair or poor in 2021.
The “Plandemic Period”
The COVID-19 pandemic has gone on much longer, and had much more serious physical, mental, and other consequences, than almost anyone expected or projected. The pandemic created — to coin a term — a “plandemic period.” A plandemic period is an interval of time in which it is impossible to analyze and predict how things will evolve, and to develop approaches that will control their evolution in order to conclude them positively on a date certain.
This inability, in conjunction with a desire to turn the clock back and to return to “normalcy,” has stressed all Americans to some degree. As we move further into this new year, it appears that while uncertainty prevails, healthcare professionals and average citizens alike have begun to adjust to this new ongoing reality.
From the healthcare side, in January experts at Harvard and the state of Massachusetts were saying that omicron appears to be shifting from the pandemic to endemic stage. This is good news, albeit with caveats. As Alvin Powell reports in his article for the Harvard Gazette,
Though some are anxiously awaiting this transition from pandemic to endemic, William Hanage, an epidemiologist at the Harvard T.H. Chan School of Public Health and associate professor of epidemiology, pointed out that labeling a virus “endemic” doesn’t mean “harmless.” It can still kill, as do endemic diseases such as tuberculosis and malaria.
Whether it is a pandemic or an endemic, citizens are saying its time to move on. A Monmouth University poll conducted in January revealed that “fully 7 in 10 Americans (70%) agree with the sentiment that ‘it’s time we accept that COVID is here to stay and we just need to get on with our lives.’”
Other healthcare experts are encouraging this acceptance and adaptive attitude of the citizenry:
- Robert Frenck, professor of pediatrics and director of the Vaccine Research Center at the Cincinnati Children’s Hospital, is quoted in a Washington Post article saying “You know what? You’re probably going to get COVID,” but went on to observe, “if you have been vaccinated you are unlikely to become seriously ill.” The article goes on to report that, “Instead of thinking they lost the race against the virus, Frenck encouraged people to redefine their concept of winning. “It’s not that you failed,” he said. “You actually succeeded. You dodged the bullet…”
- In his Elemental article, Dr. Tom Frieden, former CDC director, advises, “Omicron is a serious threat but we’re not back to square one. We’ve got vaccine, masks, tests, treatment, and ventilation….Do what matters most to you as safely as possible.” Frieden closes his article by observing, “If anyone insists they know what’s coming next with COVID, they don’t know what they’re talking about. To blunt the spread of disease and death, we need to learn quickly, adapt our response, communicate well, and act on what we know.”
- Richard Danzig, former Navy Secretary, Jeremy Farrar, director of the Wellcome Trust, and Richard Hatchett, chief executive of the Coalition for Epidemic Preparedness Innovations, sound a note similar to Frieden. They end their guest essay on the status of the pandemic for the Washington Post by observing:
We are now doing something very human: acting on the premise that what we hope is happening is indeed happening. We need to be more clear-eyed and candid: The virus’s persistence and the factors driving its evolution create a substantial chance that another wave of COVID-19 will again threaten our societies.
The virus is not disappearing. It is adapting. We must do the same.
On Being Human
Danzig, Farrar, and Hatchett make a critical point on who we are as humans and how we think and act. As human beings, we are rational. As human beings, we are emotional. As human beings, our decision-making can be rational, it can be emotional, or it can sometimes be a blend of both.
When it comes to our making decisions as humans related to promoting physical health and mental well-being during this time of COVID, it would seem that rationality should dominate. But it clearly does not always do so.
The refusal of tens of millions of anti-vaxxers to get inoculated, in spite of evidence that vaccines can significantly reduce illness and prevent death from COVID-19. is a well-known example of irrationality prevailing. In his January 25 Morning Newsletter for the New York Times, David Leonhardt cites two lesser known examples of “COVID irrationality” a poll done by Morning Consult for his newsletter highlighted.
They were: (1) The vaccinated with boosters were much more worried about getting sick from COVID than those unvaccinated. (2) Although Democrats and Republicans were equally concerned about the impact of COVID on children not being able to attend school in person, Democrats were much more likely to support transitioning students to online learning.
In this Newsletter on January 31, Leonhardt drew upon new research to show that comparable percentages of Democrat and Republicans (around 30%) had not gotten a booster shot. He observed, “Ideology tends to shape COVID views, for a complex mix of often irrational beliefs.”
From Leonhardt’s examples and discussion, it appears that in the political domain, irrationality may be an equal opportunity offender. That may be the truth. It is definitely true for all of us as human beings.
David Brooks focuses on the complexity and nature of our thinking and reasoning processes in a September 2, 2021 article, in which he states,
Over the centuries, humans have come up with all sorts of concepts to describe different thinking activities: memory, perception, emotion, attention, decision-making. But now as scientists develop greater abilities to look at the brain doing its thing, they often find the activity they observe does not fit in the neat categories our culture has created, and which we rely on to understand ourselves.
It’s not just those looking at the brain who are offering updated or new perspectives. There has been a swath of books and articles over the past few years focused on how we think, what influences our thoughts, and how we act because of our thinking process.
Stephen Pinker, Harvard psychologist, in his book Rationality: What it is, Why It Seems Scarce, Why It Matters comes out as a full-throated advocate for embracing, elevating, and educating for rationality. Anthony Gottlieb, in his New York Times review of Pinker’s book, says that it is “in large part a primer on how to reason well.” There is no doubt a need for a primer — but most likely only those who are already the most rational will read and use it.
Leonard Mlodinow’s Emotional: How Feelings Shape Our Thinking provides a counterpoint to the rationality perspective. Mlodinow is a theoretical physicist and mathematician. Given that professional background, one would not expect him to focus on the importance of emotions in reasoning and decision-making. But, he does — and does so well. As Frans de Waal comments in her New York Times review of Emotional, “Those interested in how feelings unconsciously steer thought…are in for a stimulating read.”
Another stimulating read on what shapes our thinking — although not directedly focused on emotion or rationality — is Noise: A Flaw in Human Judgment, written by professors Daniel Kahneman, Olivier Sibony, and Cass R. Sunstein. They define noise as “unwanted variability in judgments.”
This can be seen when individuals such as doctors, judges, and underwriters look at the same set of data and come to highly different conclusions. In a May 17.2021 New York Times article, Kahneman, Sibony, and Sunstein identify three major sources of “noise:” irrelevant circumstances such as mood and fatigue affecting judgment; people having different general tendencies such as being easy or tough graders, and; people having different patterns of assessment in the manner in which they examine the facts.
We would add a fourth source to the “noise” category, and that is social media, which can be used to disseminate and accelerate mis- or disinformation. The Pew Research Center reported in January of 2021 that social media platforms had become a “regular source of news for about a third of Americans.” In August 2021, Pew also reported social media had become an important way for regular users to get information on COVID-19 vaccines.
Given this, it is important to reflect on earlier research done by academics at the University of Florida and the University of Illinois, which found that many people do not even attempt to secure data if it does not agree with their viewpoints. And another study, which found that if some people were provided with accurate information on something, and then read a blog that provided incorrect information, they tended to believe the blog even if they were informed it was not true. (Think of the unwillingness to accept the results of the 2020 presidential election and resistance to getting vaccinated, in spite of overwhelming data to the contrary.)
In summary, we as human beings are flawed and imperfect vessels. We are definitely not of one mind.
What we have in common, however, is the fact that we all share certain common characteristics. These include: hardened beliefs; personal style preferences; selective reception of data; decision-making and thinking flaws; and a tendency toward irrationality.
That said, we leave this section with this thought to ponder. On October 20, 2021, Thomas B. Edsall’s guest essay for the New York Times was titled “Conservatives are Happier Than Liberals. Discuss.”
In his column, Edsall reported on two similarly titled academic papers that both found that conservatives are happier than liberals. One paper concluded this is because conservatives are able to rationalize inequality in society while liberals are not. The other concludes it’s because conservatives are more satisfied with their lives, report fewer mental/emotional problems, and emphasize the personal agency and responsibility of individuals to overcome inequality.
21st Century Citizenship
While conservatives may be happier than liberals, they are not necessarily making their fellow Americans any happier. In fact, they may very well be doing just the opposite.
That’s because they have an “essentialist mindset,” which, as David Brooks asserts in an October 2021 article, is tearing us apart. Those with an essentialist mindset see all those with opposite views or characteristics as the enemies who must be defeated. To be clear, there are essentialists on both the right and the left. Brooks concludes his article by stating “We’re a big diverse country; whether we see that diversity through a fixed mindset or a growth mindset makes all the difference.”
A community-centric mindset is a growth mindset that’s the exact opposite of essentialist. To develop the community-centric mindset requires having a civic mind and being a 21st century citizen. As we explained in our book, Working the Pivot Points: To Make America Work Again, such a citizen is:
- Interested: concerned about the common good and the American community as opposed to purely pecuniary or personal concerns
- Issues-oriented: focused on areas of civic and social concern as opposed to rigid ideologies
- Informed: dedicated to gathering and analyzing objective data as the basis for civic and social engagement
- Independent: committed to exercising personal judgment as opposed to taking totally partisan positions
- Involved: engaged actively in addressing those issues that are of paramount concern to our citizens, communities and the nation
The 21st century citizen is a good citizen. In his Politics, Aristotle stated, “The conclusion to which we are thus led is that excellence of the citizen must be excellence relative to the constitution.”
Twenty-first century citizens understand that the Constitution is the starting line and not the finish line. They are problem solvers, not blame placers. They are future-focused and not fault-focused. They are proactive rather than reactive.
Citizenship, like patriotism, is not a partisan concept. The U.S. Constitution and our democracy belong to the people and not a party or a former president. The nation’s greatness and genius come from the many and not the few.
Senator Bill Bradley recognized and celebrated this at the end of his book We Can All Do Better when he wrote, “Wisdom is where you find it. . . . Wisdom acts for the long term. . . . It tells us that our great country needs to be revived and that its citizenry deep down wants to reclaim American democracy from the stranglehold of money and ideology. And it has faith in those citizens to succeed.”
Improving Mental Health
The COVID-19 pandemic has put a stranglehold on the mental health of tens of millions of Americans. In this final section of this blog, we provide our top-line thoughts on what a 21st century citizen with a community-centric mindset can do to help those whose mental health has been impacted by this most serious affliction.
The key components for contributing to improving the mental health of those in need are: Do your homework. Decide how to make your commitment. Make that commitment and follow-up.
The homework entails doing the following: First, think and assess your own mental health. The pandemic has had an effect on each and all of us. A number of organizations have developed self-tests to look at the stress and depression it may have induced on individuals. Here is a link to one used by the AARP. If you test well, proceed to determine how to help others. If you might need assistance yourself, seek and secure it and then return to this process.
Second, do your research to determine what national, state, regional, or local groups are assisting those persons in areas where you would like to get involved. The major national players include Mental Health America, the National Alliance on Mental Illness, and the government’s Substance Abuse and Mental Health Services Administration. In addition, there are numerous other national, state, regional, and local players that provide resources and contacts that can be levied to reach and assist those with mental health issues. Use your personal network of healthcare and other professionals to secure advice on where and how you might be most helpful.
After you have done the homework, decide how to commit. The way to do this, if the mentally ill person is someone close to you, is to discuss the situation with them, seek their agreement, and refer them to an appropriate resource.
The three broader methods are to contribute: dollars, time, and/or talent. The majority of mental health non-profits, religious, and NGO’s accept tax-deductible philanthropic donations. Many of these organizations also work with volunteers. And if you have the competencies to provide assistance to a mentally ill person, some also use volunteers as counselors and mentors.
In addition, there have been a number of high-tech digital mental health startups launched in response to COVID-related mental health issues. And in December 2021, the U.S. Department of Health and Human Services announced that 15 digital health startups are joining the 2022 PandemicX Accelerator cohort, specifically to address health inequities. If these are of interest to you, it would be worth investigating to determine whether one of them might be worthy of an investment.
Finally, make the level and type of commitment that is appropriate for you. If you have others in your personal network or community of relationships who you believe would be willing to join with you, reach out and ask for their participation.
Then, as your own resources allow, persist with patience and perseverance. As noted near the outset of his blog, COVID-19 is not going away and some new variants are inevitable. Because of this and their enduring nature, the mental health problems associated with COVID will continue and new ones will emerge.
In closing, we share these words of President Barack Obama from the National Mental Health Conference he convened in 2013:
We want to let people living with mental health challenges know that they are not alone, and we’ve got to be making sure that we’re committed to support those fellow Americans, because struggling with a mental illness or caring for someone who does can be isolating.
In 2022, many more of our fellow Americans need this support and will need it going forward.
The race to improve our American mental health will be a marathon and not a 100-yard dash. It will be a race that can never be completely won for all. But, those with a community-centric mindset can collaborate to ensure that there will be many more winners and many fewer losers in the race.