Mental Health and Substance Use Disorder Impacts of a COVID-19 Economic Recession

Meadows Mental Health Policy Institute (MMHPI) issued the first in a series of reports analyzing the mental health impacts of the COVID-19 pandemic. The first report focuses on how an economic recession could increase rates of mental health and substance use disorders (MHSUD) and result in deaths from suicide and substance overdoses.

“The COVID-19 pandemic has brought unprecedented change to the lives of people in every county across our state, and, sadly, the stress and pain for many Texans will not end when the immediate risk to life from the pandemic subsides,” said MMHPI President and CEO Andy Keller, PhD.

“Mitigating and treating the threat of this virus was the right immediate public health focus, and now we must prepare for a second wave of the pandemic involving ‘diseases of despair,’ especially depression and addiction.”

“Fortunately, these are very treatable diseases if we increase readiness now to detect and treat them, so we can care for the mental health of Texans in the months ahead, as well as through our long-term recovery efforts.”

In Texas, MMHPI’s models project that – absent an increase in preparedness to detect and treat depression and addiction – every five percentage point annual increase in the unemployment rate could result in 300 additional lives lost to suicide each year and 425 additional lives lost to drug overdoses. In 2018, over 3,800 Texans died from suicide and over 7,000 died from substance-related deaths.

Nationally, the MMHPI models project that for every five percent increase in the unemployment rate, an unemployment rate on par with the 2007-2009 recession, over a year we could lose 4,000 more Americans to suicide and 4,800 to overdose, as well as 600,000 more people who will suffer from addiction more broadly. A deeper economic recession similar in magnitude to the Great Depression could lead to 18,000 more lost to suicide and more than 22,000 to drug overdose.

The report also notes that rates of depression and addiction will be many times higher than the number of deaths. Furthermore, rates of mental illness more broadly are likely to increase over time, given that most mental health impacts of trauma manifest 60 to 90 days following exposure to traumatic events, though the sustained and unpredictable length of the COVID-19 pandemic stressors may change that pattern. These effects can continue to significantly manifest for years, as seen following Hurricane Harvey.

Andy Keller talks with KERA Radio about this white paper and how America can better prepare in the wake of these projections. Listen here: Charting the Mental Health Effects of the Coronavirus Pandemic

The entire report can be found at:

Organizations sharing data from this report should be mindful of the potential effects of misreporting information on suicide and overdose deaths on people at-risk for such outcomes and follow national guidelines on reporting published by the American Foundation for Suicide Prevention that can be found at:

Regarding the MMHPI models, Dr. Keller added: “All public health models over-simplify the world and are therefore inaccurate to some degree, but some models can have utility by helping us prepare for the types and potential magnitudes of risks we face. Hopefully this model will be wrong because we get people the help they need.

“We know that depression, addiction, and suicide are all treatable if we are ready to provide effective care to people when they seek it, particularly at the point in the system people tend most to ask for help: the family doctor.”

Additionally, steps taken now to practice self-care and care for others can help mitigate the impact of the pandemic on emotional health, such as establishing a new daily routine or staying connected with friends and family through technology. And those in need of more support should reach out to a primary care or mental health provider, community health program, online support organization, or peer network for help.

Resources for individuals in crisis or in need of support include:

  • National Suicide Prevention Lifeline 1-800-273-TALK (8255)
  • Crisis Text Line: Text “HELP” to 741741
  • Texas Health and Human Services Statewide COVID-19 Mental Health Support Line available 24 hours a day, 7 days a week toll-free: 833-986-1919
  • Disaster Distress Helpline 1-800-985-5990 or Text “TalkWithUs” to 66746

Rees-Jones System Assessment Focuses on Children’s Mental Health in Dallas County

Assessments are valuable tools for communities to help take stock of their resources, identify gaps in care, and understand how various systems work or, in some cases, don’t work together. MMHPI develops these assessments for communities seeking to close those gaps and ensure resources are being used to the maximum efficiency and effectiveness.

Recently, MMHPI and The Rees-Jones Foundation completed the Dallas County Mental Health Service Delivery Systems Assessment, which focused on the children’s mental health delivery system.

The report provides recommendations to enhance service delivery and emphasizes the utilization of the Child Psychiatry Access Network, telehealth and telemedicine, as well as the need for expansion of evidence-based strategies.

This was an exciting project for MMHPI because it focuses on specialty providers (i.e., those who offer more traditional office-based care) and enabled our team to expand and enhance our thinking and framework for what constitutes a successful system.

MMHPI and The Rees-Jones Foundation will continue to connect with the providers to better understand how the contents within the report are used at their agencies, as well as discuss any insights learned from the current crisis to further support the work providers do throughout the Dallas community.

Read the full report:

MMHPI Co-Hosts “Policing in a Pandemic” Series with Caruth Police Institute

The Meadows Mental Health Policy Institute (MMHPI) and Caruth Police Institute (CPI) recognize that the COVID-19 pandemic represents one of the biggest policing challenges in modern times.

At a time when people are taking measures to protect their family and loved ones from exposure to the coronavirus, first responders face the uncertainty of community exposure and in turn the fear of exposing their loved ones. In the midst of that, first responders are facing increased workloads and adapting to unique policing and emergency response models in a pandemic, something unprecedented in our state.

This can compound the dynamic nature of first responder stress and fatigue at a time when health, wellness, and resiliency are more critical than ever.

That’s why MMHPI and CPI have established the Policing in Pandemic Virtual Peer Networking Series, four weekly interactive online events featuring nationally recognized peer specialists, health and wellness experts, and first responder wellness providers. The digital platform provides an opportunity for officers to anonymously join online, share experiences, hear from their peers, and get real time resources to address the impact of the daily stress and uncertainty they are dealing with.

In this and other ways, MMHPI and CPI will continue working to help improve the lives of the brave men and women we all depend on to keep us safe during the midst of this unprecedented crisis.

Statement by MMHPI President and CEO Andy Keller on David Brown as Superintendent of the Chicago Police Department

Andy Keller, President and CEO of the Meadows Mental Health Policy Institute, issued the following statement upon the selection of former Dallas Police Chief David Brown, an MMHPI Board Member and Senior Fellow, as Superintendent of the Chicago Police Department:

Chief David Brown is an exceptional public safety executive, a bold leader, and the true embodiment of a public servant, dedicated to improving the lives of people everywhere he goes. As a board member of the Meadows Mental Health Policy Institute, Chief Brown has helped Texas transform criminal justice systems to address mental health issues, and health systems to better partner with law enforcement in response to mental health crises. The City of Chicago has made an excellent selection for Superintendent of the Chicago Police Department. We will miss Chief Brown’s visionary leadership in Texas, and we look forward to seeing the impact he will bring to the people of Chicago in this important new role.

Personal Protective Equipment and the Behavioral Health Workforce

The scarcity of coronavirus personal protective equipment (PPE) has been a concern for health care providers across the United States, and that definitely includes the many people who provide in-person services related to severe mental illness, substance use disorder, and the intellectual and developmental disabilities community.

That’s why MMHPI is working with The Hackett Center for Mental Health, our dedicated regional program for the Texas Gulf Coast, to develop a series of briefings for policymakers highlighting the PPE needs of these dedicated front-line personnel, whose work is crucial to keeping a large number of Texans with intensive needs from being forced into already-overburdened hospitals and institutions.

While an increasing number of services are being provided via telehealth or other telephone-based care, Texans with more serious conditions must still be treated in person. Currently, these services are being delivered with little to no PPE, potentially exposing these workers to illness. Texas needs to prioritize access to PPE for staff at community mental health centers, SUD provider agencies, child welfare contractors, and IDD services providers, just like hospital and first responder personnel.

This can help ensure that patients are protected, and that their vital caregivers do not get sick or resign out of concern for their personal safety. The crucial services they provide must continue to be delivered, safely and uninterrupted, throughout this crisis.

Our full briefing is available on our Policy Updates page and below:

Personal Protective Equipment and the Behavioral Health Workforce (March 2020)