Returning to resilience: The impact of COVID-19 on mental health and substance use

McKinsey 02 Apr 2020 12:00

The COVID-19 pandemic is a threat to our population, not only for its risk to human life and ensuing economic distress, but also for its invisible emotional strain. Recent days have seen the sharpest economic pullback in modern history and a record-breaking spike in unemployment. It is inevitable that the global pandemic, compounded by financial crisis, will have a material impact on the behavioral health of society. Following the global financial crisis in 2007–08, for example, many countries saw higher rates of depression, anxiety, and alcohol and drug use. In 2008, the Great Recession ushered in a 13 percent increase in suicides attributable to unemployment with over 46,000 lives lost due to unemployment and income inequality in that year alone. 1 1. Classen TJ and Dunn RA, “The effect of job loss and unemployment duration on suicide risk in the United States: a new look using mass-layoffs and unemployment duration,” Health Econ, 2012, Volume 21, Number 3, pp. 338–50, 2 2. Milner A, Page A, and LaMontagne AD, “Cause and effect in studies on unemployment, mental health and suicide: a meta-analytic and conceptual review,” Psychological Medicine, 2014, Volume 44, Number 5, pp. 909–17, 3 3. Nordt C et al., “Modelling suicide and unemployment: a longitudinal analysis covering 63 countries, 2000–11,” Lancet Psychiatry, 2015, Volume 2, Number 3, pp. 239–45,

Theodore Roosevelt once said, “The more you know about the past, the better prepared you are for the future.” By examining the behavioral health impact of the Great Recession and other large-scale disasters, we can mitigate the negative impact to society from further economic loss and human suffering. Extensive research has documented the association of recessions, mass layoffs, and prolonged periods of unemployment with an increase in income inequality and devastating impact on health and life expectancy in the United States. 6 6. Forbes MK and Krueger RF, “The Great Recession and Mental Health in the United States,” Clinical Psychological Science, 2019, Volume 7, Number 5, pp. 900–13, 7 7. Witters D, Americans Less Happy, More Stressed in 2009, GALLUP, January 1, 2010, 8 8. Case A and Deaton A, Deaths of Despair and the Future of Capitalism, first edition, Princeton, NJ: Princeton University Press, 2020. An examination of these data show income inequality maps closely to the rate of suicides among working age adults (Exhibit 2). These effects may deepen through the course of the COVID-19 pandemic.

Not only do mental and substance use disorders stem from economic hardship, they also are known drivers of lower productivity, increased healthcare costs, and higher mortality. 9 9. Davenport S et al., Potential economic impact of integrated medical-behavioral healthcare: Updated projections for 2017, Milliman, February 12, 2018, The World Health Organization has noted that depression and anxiety have an estimated cost to the global economy of $1 trillion per year in lost productivity. 10 10. Mental health in the workplace, World Health Organization, May 2019, A likely surge of people experiencing acute behavioral health problems—both those with new symptoms and those with existing conditions—has potential to further strain the healthcare system and add cost to an already unprecedented economic downturn.

In the turmoil around the economy and the coronavirus itself, society should be mindful of its collective resilience. The anxiety, stress, financial strife, grief, and general uncertainty of this time will undoubtedly lead to behavioral health crises. It is therefore important that communities seeking a “next normal” can draw from their inherent strength and compassion to recognize, treat, and support those experiencing this human toll of the COVID-19 pandemic.

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depressionMcKinsey Global Instituteanxiety
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