Mr President, Vice President Pence, members of the Cabinet and colleagues,
As I have listened to states and communities struggle with mental health issues that have arisen due to the virus, I wanted to ensure that governors yesterday heard these concerns from a medical perspective. As my physician colleagues on the task force have been careful to rightly note, their perspective and advice centers on one aspect of the pandemic, virus containment. However, even medically it is not the sole perspective. I felt that it was important to offer the governors a different, albeit equally important medical perspective. As such - I made the following remarks:
It is my privilege to serve as the Assistant Secretary for Mental Health and Substance Use, but today I really speak to you more as a psychiatrist, who also happens to hold a PHD in infectious disease epidemiology. Never did I imagine the nation would be experiencing the coinciding of mental health issues and infectious disease that my training addressed.
The research literature is clear on the effects of quarantine and stay at home practices on mental health. We know that the longer the duration of these orders, the greater the intensity of the mental health problems experienced. We also know that these symptoms persist for years to come even once quarantine is lifted. The data tell us that when the lives of adults, children and families are drastically changed for extended lengths of time - for many, anxiety, depression and stress disorders will become manifest and will persist. These are real health conditions with potentially long lasting consequences.
To put all of this in perspective I believe it is important to point out that pre-pandemic we lose 120,000 lives per year to drug overdose and suicide. How many more lives are we willing to sacrifice in the name of containing the virus? When we look at strategies to reopen, I ask as a medical doctor that you take into account whole health, not just one narrow aspect of physical health. We continually ask ourselves what the risks might be of reopening, but I ask what they might be of not reopening - or of reopening in such a restrictive way that American lives are not restored.
Of course containing the effects of corona virus are critically important but so too is preventing suicide. So too is keeping a person from being so terrified to ever leave their home. So too is protecting the mental health of our nation's young people.
I ask you to remember that not every home is a safe home. Not every individual can withstand the trauma of not seeing or interacting physically with loved ones. Not every parent can survive the mental anguish of not being able to feed their children because of lost employment. Not every child can exist in a healthy way without the structure and support of school. We have to take a step back and recognize the other effects of our policies. While we contain the virus, are we increasing the risk of suicide and drug overdose? Are we creating a future of substance abuse and addiction for millions of additional Americans - and if we are doing these things, why have we decided collectively that this is OK? We have worked so hard in states and communities across this country to combat epidemics like the opioids crisis. Why are we willing to forget those efforts now, or deem them less important?
As a psychiatrist I would argue that a life lost to suicide is just as important as a life lost to corona virus. A family who loses someone to drug overdose experiences the same grief as a family who loses one to corona virus. Let us not forget that all American lives are precious. Our citizens count on us to remember their health and safety in all aspects of life. The preservation of America's health and the health of our citizens cannot be measured by only one metric. Virus containment cannot be our only goal, no matter the cost to Americans.
If we ignore the reality of the tremendous mental health strain we have put on our citizens - on the backdrop of an already over-burdened mental health care system, I am saddened but certain that the next major health crisis of our time will be that of mental and substance abuse disorders - and it is not far behind. I urge you to factor this reality into your planning - and I thank you for the work you have done thus far - on behalf of the millions of Americans with mental and substance abuse disorders
- Doctor Elinore McCance-Katz, Assistant HHS Secretary May 19, 2020
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