To Heal From COVID, America Must Fix Its Psychological Infrastructure

 


Photo by Marco Bianchetti | Unsplash

Photo by Marco Bianchetti | Unsplash

As we continue in the fourth surge of COVID-19 across the country, millions of Americans are still grieving and attempting to heal from the emotional trauma of the pandemic. At the same time, the President and Congress are attempting to rebuild America’s long-neglected physical infrastructure. We have learned that roads, bridges, airports, and railroad tracks break down unless we tend to their foundations. The human mind is no different; we must attend to America’s psychological infrastructure especially after the pandemic has taken such a toll on health care workers and grieving family members, as well as on janitors, retail clerks, restaurant staff, flight attendants, school teachers, and other essential workers who have risked infection to do their jobs.

As President Joe Biden so eloquently put it in his inaugural address in January: “To heal, we must remember. It’s hard sometimes to remember. That’s how we heal. It’s important to do that as a nation.” These are the words of a man who personally knows grief and how emotional healing takes place. For him, this knowledge comes, not from a book, not from science, but from his own painful lived experience. For this reason, his words touched many who also know grief.

His words to America are an important and necessary beginning, but “to heal as a nation” we need to go far beyond a sound bite in a speech. To recover from the many losses and psychological traumas of the pandemic – and to more effectively address future COVID-related challenges – we need trained psychologists on the White House COVID-19 Response Team.  

In March 2020, a group of trauma-informed psychologists (myself included) gathered to prepare to address what we knew to be the inevitable psychological toll of this worldwide health crisis. Within the American Psychological Association’s Trauma Division, we formed a Psychology Task Force on the Pandemic.

The traumas of the pandemic are evident everywhere– from suddenly losing a loved one to the overwork and burnout of our frontline workers. There is also economic trauma. When the pandemic began, the economy took a nosedive and many businesses shut down. If the breadwinner of the family loses their job, they not only cannot pay their bills, but also deal with feelings of humiliation and fear. Scenarios like this one have become all too common.

The pandemic begins and businesses shut down. One father loses his job. A proud man, he has always been able to care for his family, but now he cannot pay his bills and is stuck at home all day. At the same time the corner bar now offers drinks to take out, and unemployed workers have nothing better to do. A few drinks lead to a few more, and soon, unemployed workers are also struggling with an addiction. A regular blue-collar husband can lose his self-respect and loathes himself for his “weakness.” He no longer recognizes himself – and neither does his family.

 

Many workers acknowledge they need psychological help, but there is no place to get it. Mental health and addictions facilities have closed, and many do not know what offerings are available online – like Zoom 12-Step Recovery Meetings or video therapy appointments.

 

Substance abuse increased dramatically during the pandemic. So did domestic violence and child abuse. Reports of child maltreatment declined in number only because children were no longer under the watchful eye of teachers, who are required by law to report suspicions that a child is being abused at home.

 

Tragically, healthcare workers have become the new lookouts for child abuse. Bone-chilling descriptions by medical practitioners in emergency rooms reveal that the severity of physical abuse of children far exceeded pre-pandemic levels. The pain no one sees, though, is that of the parent so overwhelmed by emotions that they, much to their horror, have taken it out on their child.

Dr. Patricia O’Gorman, an addiction and trauma specialist, and I co-chair the Medical and Addictions working group of the Task Force. The force’s mission is to reduce or prevent COVID-related psychological trauma and support resilience and growth within the medical and addictions communities. Seventeen months of observations lead us to recommend that psychologists –– along with other mental health professionals-be integrated into Biden’s COVID-19 Response Team.

In December 2020, Drs. Sema Sgaier and Neela Saldanha, accurately predicting that large numbers of Americans would refuse to be vaccinated, called for behavioral scientists to be part of Biden’s COVID Response Team to address the issue. Seven months later, Dr. Anthony Fauci, Chief Medical Advisor of the COVID Response Team stated, “It is almost inexplicable why people, when they see data in front of them, don’t get vaccinated.” 

While not a unified group, those reluctant to be vaccinated may have something in common. Questions arise. What experiences have people had with modern medicine? What authorities do they trust? Whose words have they learned to mistrust?

Consider the man who as a child watched his mother suffer through chemotherapy treatments that sickened and distressed her. After months of this, he still lost her to cancer the chemotherapy was supposed to cure. Now he is terrified to have medicine injected into his body. He wonders why the FDA is being so slow to approve the vaccines if they really are safe.

Or take an African American woman who has had many upsetting encounters with the medical world. As a black woman, she has often felt misunderstood or condescended by medical practitioners – including when she recently expressed reluctance to be vaccinated. While knowledgeable about the history of her own people who in the past were exploited by medical scientists in the interest of research, she has also educated herself about COVID vaccines and wants to believe what she is being told. But when her doctor responds dismissively to her questions, she wonders whether she can trust him to tell her the whole truth.

In a hopeful move, the world of psychology is finally being incorporated into the fight against vaccine hesitancy. Dr. Bechara Choucair, the Team’s National Vaccinations Coordinator, has already taken a very important step in recognizing the value of psychology in the pandemic fight by partnering with the American Psychological Association to help mental health clinicians reduce vaccine hesitancy in their patients.

However, we propose the even more powerful step of including trauma-informed psychologists and mental health professionals who understand the effects of psychological trauma on emotions, behavior, relationships, bodies, and medical conditions. They need to be included as part of the White House COVID-19 Response Team, who would:

  1. Educate the public to recognize the effects of grief and traumatic stress, and how to access mental health and addiction services. We suggest ways to reduce stigma that will encourage peop
    le to seek help earlier when problems are more easily treated.

  2. Educate about ways to enable coping and resilience in groups such as medical first responders, essential workers, people with COVID and their families, older adults, children, people with pre-existing medical conditions or psychological trauma, and others at greatest risk.

  3. Devise ways to effectively reach those suffering from addictions, with particular attention to the alcohol and opioid epidemic within the pandemic.

  4. Help people suffering from COVID and its aftereffects (including “Long COVID”) using the rapidly growing body of scientific knowledge regarding the complex interactions between the biological, psychological and social aspects of medical illness.

  5. Promote and fund research on the impact of pandemic trauma, and ways to address it.

  6. Devise effective ways to address vaccine hesitancy and refusal, and combat vaccine disinformation, by analyzing their complex social, psychological, cultural, and historical dynamics.

Our group joins others in advocating for psychological expertise to be part of the government. Antonio Gutierrez, Secretary-General of the United Nations, wrote: “Mental health services are an essential part of all government responses to COVID-19.” In May 2021, our nation’s grief experts called for the President to assemble a panel to address the anticipated pandemic of complicated grief.

Dr. Kirk Schneider, a current candidate for President-elect of the American Psychological Association, has long advocated for an Office of Psychologist Consultants, akin to the Surgeon General. This Office would work in coordination with organizations such as APA to amplify and increase the availability of psychological knowledge to the government and the public.

As with President Biden’s understanding of grief, our lived experiences inform our behavior and decisions. Physicians, who have an extremely high vaccination rate, witness the wonders of modern medicine daily, but there is clearly a disconnect that psychologists can help bridge.

President Biden would leave a powerful legacy if he were to weave an emotional understanding of human beings into the infrastructure of our nation.


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