Marking a year since COVID-19 was declared a worldwide emergency, Utah health experts are warning of what one called “a second pandemic within that pandemic.”

The impact of the COVID-19 pandemic on mental health has likely not been fully realized yet, but studies are already showing concerning trends, including increases of anxiety, depression and substance abuse in the state and nationwide, local mental health experts said in a virtual news conference hosted by the University of Utah’s Huntsman Mental Health Institute.

“A year ago today, we began to go into a circumstance that we’ve never had before in our lifetimes,” Dr. Mark Rapaport, CEO of the Huntsman Mental Institute, said Thursday.

“All of a sudden it was a sense of helplessness. All of a sudden there was a change in agency — a change in our belief that somehow we controlled our lives and controlled our fates. We began a journey that has allowed us to unfortunately experience loneliness and experience a sense of helplessness in ways that we never imagined we would do in our lifetime.”

Rapaport said “all of a sudden the definition of what an essential worker” changed radically, and Utahns and people worldwide all experienced “remarkable changes.”

With all those changes, evidence is mounting that more Americans are experiencing problems with anxiety and depression, Rapaport said. Plus, “the amount of sales of alcohol has skyrocketed, as has problems with substance-use disorders,” he said.

“We have a second pandemic within that pandemic right now,” Rapaport said.

Research by Dr. Andrew Smith, a clinical psychologist at the Huntsman Mental Health Institute, found more than half of teachers, medical workers and emergency responders at risk for mental health problems, most notably alcohol use, insomnia and depression.

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Last year, the Huntsman Mental Health Institute also received more than 105,000 calls for help. Total calls to the institute’s Statewide CrisisLine and Statewide WarmLine — phone lines meant to provide mental health help — combined trended up 48% from March 2021 compared to March 2020, according to the institute. Those calls were up 42% year over year for the Utah CrisisLine, and 68% for the Utah WarmLine.

Additionally, the Huntsman Mental Health Institute is seeing “increased levels of stress and emotional crisis” from callers since the beginning of the pandemic. The institute reported it’s taking certified crisis workers 41% longer to support callers this March compared to March 2020.

“This is a time of tremendous change and tremendous opportunity,” Rapaport said.

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He urged Utahns to be “very vigilant” and to watch for red flags from their loved ones and others, warning the impacts of the pandemic on mental health likely hasn’t been fully realized yet.

“We don’t know the impact of all of these changes on children of different ages,” he said. “We’re going to have to work very, very hard and devote a lot of time and attention to care of children, of first responders, and to each other in a way that’s both empathetic and respectful.”

Rachel Lucynski, crisis services business operations manager at the Huntsman Mental Health Institute, told of a woman who recently called a crisis line “stating that she wanted to die. She had intent, and she did have a plan and access to lethal means.”

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“She was in the basement of her home trying to not disrupt her husband who was working from home,” Lucynski said.

Crisis line workers kept the woman on the phone for 30 minutes, Lucynski said, and helped support her through one of three panic attacks she had had in the last 12 hours. A mobile crisis outreach team then went to her home and met with her. Ultimately the woman was taken to the institute and health workers set her up for follow-up care.

“She left feeling hopeful and was thankful for the support and collaborative intervention from our team,” Lucynski said. “Ultimately it saved her the cost of an emergency department visit, and it certainly saved her family from a very devastating and traumatic experience.”

Citing survey data from the Centers for Disease Control and PreventionKFF polling and data from the Huntsman Mental Health Institute, Rapaport and other health experts who joined him Thursday listed off a slew of statistics causing them concern. They included:

  • 4 in 10 adults have reported new symptoms of anxiety and depressive disorder, a four-fold increase since last year.
  • Young adults between the ages of 18 to 24 are twice as likely as all adults to report new or increased substance use (25% compared to 13%) and recent suicidal thoughts (26% compared to 11%).
  • More women than men are facing mental health challenges. During the pandemic, women have reported more symptoms of anxiety and/or depressive disorder (47% compared to 38%).
  • Between March and October 2020, the number of emergency department visits nationwide by children under 18 for mental health reasons increased 44% over the previous year, according to the CDC. For children between the ages of 5 and 11, it was up 24%.
  • People experiencing job loss are at higher risk for mental health problems. Adults in households that experienced job losses or reduced incomes report higher rates of mental health symptoms than other households (53% compared to 32%).
  • Essential workers face more significant challenges than other workers. Essential workers are more likely to report symptoms of anxiety or depressive disorder (42% compared to 30%), increased substance use (25% compared to 11%), or recent suicidal thoughts (22% compared to 8%).
  • Communities of color are disproportionately affected. Non-Hispanic Black adults (48%) and Hispanic or Latino adults (46%) are more likely to report symptoms of anxiety or depressive disorder than white adults (40%).

Asked about a study the Utah Department of Health released in late January that found no significant increases in suicides, mental distress or drug overdoses, Rapaport said that data “is not consistent with what we’re seeing on a national level.”

“What happens with studies so often is that they’re snapshots in time of what people perceive,” he said. “We know well from the CDC, we know well from published research not only in this country but other countries, that unfortunately the rates of depression, the rates of suicide and suicide attempts, of substance-use disorders and overdose deaths as well as anxiety disorders and PTSD have all increased dramatically.”

Rapaport said looking at the “weight of scientific evidence” across studies internationally, “all of them point to the fact that we’re in a mental health pandemic.”

Lucynski said mental health experts are “waiting with bated breath to see the delayed effects” of the pandemic.

“So we are encouraged, and crisis services in particular, we do feel proud of the services that we offer the state of Utah and do hope and feel that those are contributing to mitigating some of the increased stressors and making sure that folks have no cost to access to life saving services,” Lucynski said. “We definitely know that while it is a preliminary and encouraging result, there is still a lot of work to be done.”

One suicide is still too many, Lucynski added.

Dr. Kristin Francis, assistant clinical professor specializing in adult, child and adolescent psychiatry at the Huntsman Mental Health Institute, said “there is some really good evidence that there is about a two-year lag time after a big crisis where suicides then increase.”

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So there may be a delay or “buffer” between the pandemic and when the gravity of its impacts on mental health will fully present themselves, Francis said.

“Suicide rates can increase by as much as 6%, which has been seen in other big disasters before,” she said. “So I think it’s really important that we’re being aware and vigilant of this time frame, right? We’re just in our first year of the pandemic.”

Anecdotally, Francis said, she’s seeing more people seek support for “pretty intense suicidal thoughts.”

For help, Utahns can call the Utah CrisisLine, which is available 24/7 and can be reached at 1-800-273-8255 (toll free) or 801-587-3000 (local). The Utah WarmLine is available seven days a week from 8 a.m. to 11 p.m. by calling 833-SPEAKUT.

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