THE HIDDEN CONSEQUENCES OF A GLOBAL PANDEMIC
COVID-19 has made a clear impact on nearly every aspect of daily life in Wichita and beyond, from obvious things like masks, social distancing and business closures to more inconspicuous effects like the toll on individuals’ mental health.
Adverse mental health outcomes — depression, anxiety, suicidal thoughts and harmful family dynamics — are likely to have a lasting impact on societies around the world in the wake of COVID-19.
In one survey conducted by the Kaiser Family Foundation, 45 percent of Americans reported that their mental health had already been negatively impacted by the pandemic. As the uncertainty and economic hardship continues, that number is likely to increase.
Michael "Mac" McKenzie, licensed clinical marriage and family therapist and owner of McKenzie & Associates, says this mental health impact is highly prevalent in Wichita.
"Things have been really tough for mental health professionals," he says. "We're all grief counselors now. Collectively, we are mourning."
As Wichita and the world go through the various stages of grief, the mental health impact of this pandemic will no doubt take a toll on the professionals helping our city process and the funds that provide help for the most vulnerable within our city.
FEAR OF CHANGE & UNCERTAINTY
Most of COVID-19's mental health impacts are coming from the sheer uncertainty of the situation. It seems most agree that this pandemic will be with us for a prolonged period of time, which is a stressor in and of itself.
According to a study from QJM, an international medical journal, COVID-19 has been linked with distress, anxiety, fear of contagion, depression, insomnia, chronic stress and economic difficulties that can exacerbate any pre-existing mental health problems.
"There's a lot of uncertainty, a lot of unpredictability, a lot of loss, a lot of sadness — and it's cumulative at this point," says Joan Tammany, executive director of COMCARE. "It's just a very difficult, painful time in our nation and particularly in our community, which has a very high unemployment rate."
McKenzie says it's the sheer pervasiveness that makes COVID-19 more impactful than other disasters with limited scope.
"We do natural disasters pretty good, and we do terrorist attacks fairly well," he says. "It's somewhat isolated. "And even if I knew people, ... we memorialize that and we move on. But this has affected the entire world and so there's going to be social change."
Social change has been a bed partner with world-shifting events like pandemics throughout history, McKenzie says.
The 1918 pandemic was the backdrop to the women's suffrage movement. Events from the bubonic plague to 9/11 have dramatically shifted how the world works. COVID-19 is already proving that it's no exception.
"When we talk about some of the other things that are happening politically and racially in this country, I don't necessarily think that they're all disconnected," McKenzie says. "I think our collective consciousness kind of understands that there's big change and change is scary. So we're mourning. We're mourning what was and mourning that we don't know what will be."
Just as when someone has lost a loved one, our collective society has to go through the five stages of grief. But the trickiest part of that is many of us find ourselves in different stages in different times.
THE STAGES OF GRIEF DURING COVID-19
The first stage of grief is denial, which can be seen from the Facebook timeline to the highest office in the United States.
"Some of us, we don't want to accept the fact that our normal is gone," McKenzie says. "And in a lot of ways, it's not going to come back."
Once we finally accept some of the impacts of this pandemic, anger — the second stage in the cycle — will likely set in. But McKenzie says the root of this anger is often fear.
"The basis of anger is fear," he says. "Your family member who will not wear a mask is not hateful. They are afraid. And so they're adopting a narrative that's more conducive to soothing their fear."
Next, we have bargaining — a stage many of us currently find ourselves in as we weigh options to re-open schools, restaurants and activities that were a part of the old normal.
"We have created impossible choices because we're not mourning together," McKenzie says. "I think there's been a lack of overall national leadership, so therefore, we kind of fill in the gaps. We go, 'Well, I don't like that. I don't like that life is going to be changed — and maybe irreparably in some ways — so I just choose the narrative that's best for me.'"
Following the bargaining stage, grief takes us through depression and, finally, acceptance. Depression is when the sense of loss truly sets in and we experience it inwardly. Acceptance is when we finally accept the situation. It's not that there's no more sadness or anger about COVID-19, but is that we're no longer using these tactics to defend ourselves from the reality of the situation.
And the reality of the situation will not be an easy one to face. For all of us, COVID-19 has proven difficult — even if it's as simple a difficulty as not going to our favorite restaurants or not being able to meet up with friends from other cities and states.
But for some, the reality of the situation is much worse. And even the silver linings of change won't immediately make it better.
Children, the uninsured, the unemployed and the mentally ill are all harder hit during any crisis, especially one as widely felt as the current pandemic.
COMCARE exists as Wichita's mental health safety net.
"There are very few of us that treat that population," Tammany says. "It's a mission-driven service. You've got to accept that you're not going to make a profit to treat the most vulnerable in our community. So COMCARE, as the community mental health center, is that safety net for behavioral health in our community."
But this safety net is often reliant on taxpayer support, which hasn't necessarily kept up with the growing need.
COSTS & OPPORTUNITIES
Apart from the nearly 180,000 deaths experienced so far in the U.S., COVID-19 has many other costs. For one, it takes a toll on the health workers and mental health workers who help us cope with the symptoms of this pandemic — both physical and mental.
McKenzie says he has seen a drastic up-tick in intake sessions, which has put a strain on himself and his therapists.
"From spring break in March, I worked every day until the end of June," McKenzie says. "It's hard. It is really, really hard. It's like we're mourning, but the death just continues on. The sorrow just continues on. The funeral's going to last for — we don't know how long. Maybe over a year, maybe more."
Tammany says COMCARE has also seen an uptick in services, often involving crisis. Shantel Westbrook, director of COMCARE's rehab services, which includes services involving children, compares it to people waiting to go to the doctor until they need to go to the hospital.
"They're not getting more of that ongoing help," she says. "Especially on the children's side, there's definitely an increase in where they're seeking higher levels of care because they were at home for three or four months and not really getting out and getting services or maybe just not connected."
Apart from the strain on people, there's also a strain on monetary resources, which were scarce even before the pandemic. Tammany says mental health coverage through Medicaid, which goes toward services like COMCARE, is still being funded at pre-2008 levels. Medicaid expansion would have helped boost funding for these services, but has come to a legislative impasse since the pandemic.
"Where it really hurts us is, we aren't competitive financially in supporting our clinical team and our providers or anybody in our organization," Tammany says. "We are way, way below market value for our positions."
This means even more uncertainty for people requiring services, as practitioners move away from underpaid COMCARE positions into areas like private practice.
This strain on services isn't necessarily felt equally. Children are one population particularly hurt by the current situation. Without school or social activities, children have no choice but to stay home — in some instances with an abuser. McKenzie says he has seen an up-tick in abuse cases in his office that is likely stemming from the pandemic.
He says going back to school may help get children out of the house, but it won't necessarily fix the problem if children start getting sick.
"On the other side of that, what happens if that child gets sick?" he says. "They wouldn't take care of the child when they were well. I think it's amazing that we're not addressing — we never have — the issue of child abuse."
Just like child abuse, COVID-19 has often acted as a magnifying glass for problems within our societies. From global warming to racism, the pandemic has given space for us to consider and address systemic problems that were here long before COVID-19.
"I think we've had to learn and relearn some things, and that is painful," McKenzie says. "We mourn for this world that we probably don't want to go back to. We really shouldn't want it back. 'The way things were' was not good."
In many ways, COVID-19 is offering an opportunity for change. We've now seen — far too often — the costs of not dealing with systemic racism in America. The pandemic helped to provide space for us to do something about it.
One rallying cry Black Lives Matter brought to bear is "defund the police." While most don't mean to completely get rid of police, it begs the question of where resources would be best spent.
McKenzie says mental health and policing cross paths at many points — and providing more resources to help those with mental health needs could help individuals as well as the police, who often are impacted by trauma themselves.
"I'm not just talking about let's allocate mental health resources to go along with the police," McKenzie says. "But let's utilize resources to help police officers themselves in their environment."
Fear, anxiety and depression are likely going to become more and more prevalent as we collectively move through the stages of grief in Wichita. But we should never give up hope or close our eyes to the opportunities this pandemic offers.
Change is scary, but it's often necessary. So what kind of world do we want to come back to in a post-pandemic Wichita?