Paying attention to the mental health effects of lockdown

The decision made by the leaders of many European countries and US states to implement social distancing requirements appears to be the right one. A recent study in Nature showed that the lockdowns in Europe had a “dramatic effect in reducing transmission” and saved millions of lives from Covid-19.

Preventing deaths of despair

But even though we have saved lives by locking down, we still have to address the health effects of this decision, including the impact on our country’s mental health. In a report published last month, leaders of the Well Being Trust warned that severe unemployment and social isolation due to the lockdown could lead to as many as 150,000 additional deaths from drugs, alcohol, and suicide.

We can reduce deaths of despair without putting more people’s health at risk from Covid-19.

Does this mean that “the solution is more harmful than the cure”? Not according to the report authors. They clarify that “this report is not a call to suddenly reopen the country,” and without taking the proper precautions, reopening prematurely will lead to even more needless death and suffering.

There are many actions we can take to reduce deaths of despair without putting more people’s health at risk from Covid-19:

  • Get as many people back to work as possible — but not necessarily in the same job they were in before. Create a Civilian Health Corps, reminiscent of the New Deal Era Civilian Conservation Corps, that puts millions of unemployed people to work as contact tracers or crisis counselors.
  • Provide better social connections by securing reliable internet everywhere in the country and funding community groups that are putting on virtual events to allow people to socialize remotely.
  • Bring mental health care to where people are, doing more telehealth visits and counseling via video. This is especially important for black Americans, who are weathering a double pandemic of Covid-19 and police violence.

Avoiding overprescribing

At the same time, we have to be careful to avoid treating every case of pandemic-induced anxiety with prescriptions. According to an analysis from pharmacy benefit manager Express Scripts, the number of weekly prescriptions for antidepressants, anti-anxiety medications, and sleep aids rose by about 19%, 15%, and 34%, respectively, between February 15 and March 15.

Doctors are worried about the long-term effects of increased prescribing, such as physical dependence, overdose, and withdrawal symptoms.

While prescribing for anxiety may seem like a “quick fix,” doctors are worried about the long-term effects of increased prescribing, including physical dependence, overdose, and withdrawal symptoms. Additionally, these medications can be dangerous for older Americans, who can suffer adverse events such as falls, dizziness, and cognitive decline.

One can imagine a situation in which bringing attention to the mental health crisis driven by Covid-19 and the lockdown leads to a dangerous increase in prescriptions of these medications. We cannot rely on medications alone to mitigate this crisis; we have to tackle the sources of anxiety such as unemployment and loneliness.