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News & Events

Mental health issues, substance abuse escalate as access to vital care dwindles

Topic: News
By Susan Kozak
Special to the Detroit Free Press
Susan Kozak, LMSW, Executive Director, Community Care Services.

It should come as no surprise to anyone that mental health and substance abuse issues are escalating during the coronavirus pandemic.  What may come as a surprise is the extent of this problem and that we are likely to see the number of individuals with mental health and substance use problems reach epidemic levels. Compounding this growing problem is a lack of resources and a shortage of professionals who are needed to assist.

With unemployment up both in Michigan and nationally, along with reduced income, housing instability, accompanied by social isolation, fear, and loneliness, it is not difficult to understand why 1 in 3  Americans are reporting new or increased mental health symptoms and why alcohol sales are up 250%.  We all are likely to know someone who has experienced increased anxiety, depression, or increased use of substances over the past six months.

What is most alarming is the number of individuals needing mental health or substance abuse treatment who are delaying, postponing, avoiding, or unable to access care. During the pandemic — when we know that mental health and substance use issues are rising —  the community mental health system,  specifically,  has seen a significant decline in requests for services, with some providers reporting up to a 30% decline in new requests for services.  This decline in requests for services is compounded by the fact that many are unable to access services that now rely on technology.

With the onset of the pandemic, many outpatient providers rapidly moved treatment services to telehealth video or via phone, which was imperative to provide services safely.  What we have come to realize is that many with severe mental health and substance abuse issues are those with the fewest resources, such as internet service, a computer, or even a phone.  Pre-COVID-19, they may have accessed public internet in libraries or fast food restaurants. With COVID-19 came the closure of those public spaces with free internet.  Many professionals in the field report large numbers of clients having difficulty utilizing technology.  At a time when services are so greatly needed, we see that the resources and access to them are simply not available.

Compounding this crisis even further: Many providers within the community mental health system are experiencing significant professional staffing shortages. It seems that there has always been a shortage of individuals who choose to work in the mental health and substance abuse field, and that problem has only increased. These professionals, mostly social workers, psychologists, counselors, and peer support specialists, are the front-line workers and have been essential personnel throughout this pandemic.

This file photo, shows syringes of the opioid painkiller fentanyl in an inpatient pharmacy.

Adjustments of working remotely, fear of getting sick, and losing co-workers from COVID-19 has resulted in increased stress and anxiety for workers. Most professionals report that their clients’ symptoms are increasing, and relapse is a common occurrence.  Support systems have been disrupted for both staff and clients. Staff no longer have colleagues to collaborate and confer with quickly, and clients no longer have regular support groups to attend. Stress is taking its toll on these workers and many are choosing to work in other industries.

Before we can address this systemic crisis within the mental health and substance use fields, we must acknowledge that the crisis exists. The harsh reality is, if unresolved, we will collectively be facing increased drug overdoses, suicides, homelessness, and untreated cases of mental illness. And that devastating impact will be most felt within the same populations who were most at risk for COVID-19: people of color, elderly people, lower-income individuals, and health care workers.

It’s a complex problem that requires immediate attention and more funding to ensure access to services and to maintain a community mental health workforce. This impacts us all, directly, and as a society. You can help by contacting your state and federal elected officials and urging them to increase funding for mental health and substance abuse programs.

Susan Kozak has been a licensed social worker for the past 35 years and currently serves as the executive director of Lincoln Park-based Community Care Services, a non-profit agency that specializes in the treatment of mental health and substance use disorders.