Coping with Grief and Loss During the COVID-19 Pandemic

Tens of thousands of Americans have died in the COVID-19 pandemic. This is by far one of the most significant disasters in U.S. history, and the loss of life is unprecedented; now exceeding over 100,000 deaths.

COVID-19 is rapidly changing our perception of the world, upending our feelings of predictability and security. More than that, we ache from loss – the loss of freedoms, the loss of livelihoods, the loss of connections, and most of all, the loss of human life. Many resources have been developed and made available for coping with the mental, educational, financial, and physical strain of this crisis, and that is to be applauded. Countless people across the country have found help, assistance, guidance, and even solace in the materials and support being provided.

What is lacking, from my perspective, is a similar level of support to the tens of thousands of families who have lost a loved one to this virus. These families are grieving from their losses and may also be dealing with the guilt that can accompany surviving something that others close to them have not. They may even feel guilty for not having sought treatment sooner, or from having passed the virus on, however unintentionally.

However, rather than a concerted effort to help families in their time of grief, we are instead seeing a new form of prejudice and discrimination – a “Coronavirus Stigma” that may have started with xenophobic overtones and has now extended to a sense of discrimination against almost anyone who has had the disease and their families. I know about this as people that I love and care about lost a loved one and are suffering. Suffering from sadness and heartbreak. Suffering from guilt. Suffering from this stigma.

Perhaps the most unfortunate way prejudice and discrimination are being manifested is the lack of resources being provided to the families who have lost a loved one. In the aftermath of 9/11, our country came together to care for our mourning families. We rallied around survivors, first responders and those who had lost husbands, wives, siblings, or children, and we made sure that programs were available to help in the months and years to come. It was a time of solidarity that changed the fabric of our nation. To date, even though COVID-19 has taken more than fifteen times the number of lives as 9/11, our response has been dampened by fear and avoidance.

In response to this pandemic, we must be prepared to support the survivors and those who are mourning. This grief is wide-reaching and inclusive, affecting people in every corner of the country.

Grief and mourning are social processes that brings people together to honor and celebrate the loved one who has passed, creating connections and supports that ultimately contribute to healing and closure.

Today, this honoring looks and feels quite different as we – by necessity – must maintain healthy space from each other. Saying goodbye is a luxury, making the closure process difficult, and we are compounding the problem by not focusing on a collective approach to support the families who have experienced the ultimate loss.

We need to validate and listen to every one of those who have lost a loved one as a result of this pandemic, and continue to do so in the days, months, and years to come. Every press conference and public event addressing COVID-19 should begin by thanking our first responders and those that risk their own health and lives by helping others. We should also express empathy to those who have suffered and sacrificed the most.

In our collective history we have always cared for those who were hurting. We now need to let survivors know that it is Okay to Say that you have been impacted by COVID-19, and in the case of people who have lost a loved one, we can start by simply acknowledging their tremendous loss and letting them know that we are here for them – today and always.

Gary M. Blau, Ph.D.
Dr. Blau is the Executive Director of The Hackett Center for Mental Health, a Regional Program of the Meadows Mental Health Policy Institute. Prior to this he was Chief of the Child, Adolescent and Family Branch at the federal Substance Abuse and Mental Health Services Administration. Follow him on Twitter @GaryBlauPhD

About The Hackett Center for Mental Health
Through the generosity of the Maureen and Jim Hackett Family, The Hackett Center for Mental Health was established in January 2018 as the inaugural regional program of the Meadows Mental Health Policy Institute (MMHPI) to serve the Greater Houston and Gulf Coast Region of Texas. Leveraging the participation of exceptionally skilled researchers, community leaders, and health care providers, The Hackett Center’s purpose is to transform systems and influence policy through unprecedented collaboration.

Mental Health Awareness Month: A Focus on Veterans and Their Families with Kyle Mitchell

Texas is proud to be home to the second largest population of veterans in the country, and we have an obligation to care for those who have served bravely, and the people whose support made that possible.

Five years ago this month, the Texas Legislature once again demonstrated our state’s commitment to Texas veterans and their families by creating and funding the Texas Veterans + Family Alliance (TV+FA) grant program to support community mental health programs for veterans and their families.

TV+FA provides $20 million from the state budget that is matched by another $20 million in local and in-kind funds to provide a wide range of services including: evidence-based therapies and treatment; individual, group, and family and couples peer support services; individual and family counseling; suicide prevention initiatives; support services essential to mental health services, such as child care, emergency financial support, transportation and housing assistance; and navigation services such as case management and referral services.

To date, this critical program has provided a total $114 million in funding across 74 grants and that will have helped more than 67,000 veterans and family members.

In addition to their other grant programs, the Texas Veterans Commission also provides Veteran Mental Health Grants to organizations to address the mental health needs of veterans and their families through direct services such as clinical counseling, peer delivered services, and non-clinical support services.

In the time of COVID-19, these programs for veterans and their families have never been more important. As the Bob Woodruff Foundation noted in a discussion on their recent research paper: “emergent trauma, loneliness due to social isolation, and unplanned wage loss or job termination can create or exacerbate mental health challenges for veterans … accessing mental health services was already an area of concern for the veteran population, and now, there may be a surge in demand for these resources.”

If you know a veteran or family member that needs help now, please direct them to one of the grantees in their area so they can get the help they need.

MMHPI Statement on Leadership’s Preservation of Behavioral Health Funding Amidst Budget Reductions

Today Meadows Mental Health Policy Institute (MMHPI) President and CEO Andy Keller issued the following statement regarding the preservation of behavioral health funding levels amidst agency budget reductions:

“Gov. Abbott, Lt. Gov. Patrick, and Speaker Bonnen have wisely preserved funding for behavioral health in Texas.”

“Amidst a crisis that has significant mental health implications, this action will help ensure Texans have access to care they need as they seek treatment for anxiety, depression, addiction, and other needs brought on by COVID-19 and the economic stress it has caused in their lives.”

“As we detailed in a recent report, the consequences of the pandemic hold the potential of leading to thousands more deaths from diseases of despair if we do not act to identify needs and provide necessary support early. Today, Texas is much more aware of the importance of behavioral health care and helping people as soon as possible, before their issues they require much more intensive, and costly, intervention and treatment, or worse, reach a tragic crisis point.”

In April, MMHPI released a report analyzing how an economic recession could increase rates of mental health and substance use disorders and result in deaths from suicide and substance overdoses. 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. The report can be found here: https://www.texasstateofmind.org/uploads/whitepapers/COVID-MHSUDImpacts.pdf

Mental Health Awareness Month – A Focus on Children and Families with Gary Blau, PhD

Mental Health Awareness Month is a good time to remember that mental illness is actually a pediatric disease. That’s because half of all mental illnesses emerge by the time a child turns 14, and 75% by the time a person is 24.

Even before the COVID-19 pandemic, studies indicated that 1 in 5 of our nation’s young people will experience a mental health challenge, and that 1 in 10 will have a serious mental health condition that will impact their ability to function at home, in school, and in the community.

And while these numbers were staggering prior to the pandemic, we can expect that issues such as depression, anxiety, and post-traumatic stress disorder will persist for weeks, months, and even years to come.

The good news is that we are talking more about mental health than ever before and we are slowly chipping away at the stigma that often comes with mental health conditions.

We understand the importance of engaging youth and families in their own care, and in working to improve services and systems. We understand the importance of working with schools, so staff can identify problems and begin working with parents as quickly as possible. We understand the importance of working with pediatricians and primary care providers who are often the first place families turn to when they are concerned about the mental health of a child. And we understand the importance of working with child welfare and juvenile justice professionals as so many of the youth involved in these systems have mental health conditions;

During the COVID-19 pandemic, we are seeing an expansion of telehealth, which is effective and efficient, and has been shown to improve mental health care access, capacity, and outcomes.

During the 86th Legislature, Texas invested in improving children’s mental health in a host of ways. From the formation of the Texas Child Mental Health Consortium, to the adoption of programs like Child Psychiatry Access Network (CPAN), Texas has made significant strides to ensure that every child who needs care is able to receive that care when and where they need.

The advances made in the last legislative session will make mental health care far more accessible, providing resources to primary care physicians – like CPAN – to help them identify and treat many mental health conditions, including depression and anxiety, conditions the COVID-19 pandemic will likely exacerbate. In addition, schools now have the Texas Child Health Access Through Telemedicine (TCHATT) program, which, at the direction of parents, allows access to health providers via telemedicine and telehealth to help meet the mental health needs of at-risk children and youth. Maintaining these advances will go a long way towards improving the emotional wellness of our youth and families.

Through this crisis and beyond, we must continue to focus our attention on our children and the importance of caring for every child’s mental health. We want to strengthen the ability of all of us to talk about mental health freely and openly and ensure that it is Okay to Say if you’re not okay.

Now, more than ever, we need to work together to do everything we can to raise happy, healthy, children. Supporting children’s mental health now and in the future is paramount to that make that happen.

Mental Health Awareness Month: A Focus on First Responders

In addition to May being Mental Health Awareness Month, May 11-15 is Police Week, with May 15 designated as Peace Officers’ Memorial Day. This coincidence of the calendar illustrates a real fact: the first responders we all trust and depend on also have mental health care needs that deserve to be met.

We know a number of factors contribute to mental health issues among police officers. One study found that on average, police officers witness 188 traumatic and critical incidents during their careers. This repeated exposure to trauma can lead to several forms of distress such as anxiety, insomnia, post traumatic symptoms, and depression.

First responders are more likely to die by suicide than in the line of duty.

Industry leaders are becoming increasingly aware of the link between behavioral wellness, physical wellness, and overall officer performance and retention and are calling for action.

For action, we must first have understanding. Research frequently describes shame and stigma surrounding mental health care needs within a profession that prioritizes bravery and toughness. While this culture is perhaps necessary to survive the dangers of the job, it also contributes to the phenomenon of officers not seeking help to manage chronic stress or trauma injury, or even recognizing the need before it becomes critical.

With no statewide coordinated effort to end police suicides in Texas (or in any other state), MMHPI and The University of North Texas-Dallas Caruth Police Institute (UNTD-CPI) are working to establish the Texas First Responder Peer Network. The network will be grounded with regional law enforcement agency hubs serving as network drivers, collaborating with law enforcement agencies in their region to recruit and train peers in trauma-informed, culturally competent, peer-to-peer response techniques. These confidential peer services will be available to any first responder within the region at no cost.

We also must recognize that the COVID-19 pandemic represents one of the biggest policing challenges in modern times. First responders are facing increased workloads as they adapt to policing and emergency response models in a pandemic, compounding the dynamic nature of first responder stress and fatigue at a time health, wellness, and resiliency are more critical than ever.

To help provide assistance, MMHPI and CPI recently presented the Policing in Pandemic Virtual Peer Networking Series, bringing together nationally recognized peer specialists, experts, and first responder wellness providers in a digital platform that provided anonymity to officers joining online to share experiences, hear from their peers, and get real time resources to address the impact of the daily stress and uncertainty that has become the new normal.

We owe a great debt to our first responders and will continue to work to improve their mental health care, their lives, and the lives of their families, no matter the week or month.

Mental Health Awareness Month 2020

Every May is designated as Mental Health Awareness Month, but like everything else, this year is far different. Events surrounding the COVID-19 pandemic have, justifiably, taken center stage in a world that is no longer too sure where to focus its attention next.

If nothing else, however, the pandemic has shined a light on just how important it is to maintain a focus on mental health care. Stories about people dealing with heightened anxiety and loneliness as a result of quarantine have also been widespread.

Further, an MMHPI report released in April demonstrated how diseases of despair, such as depression, substance use and addiction, and suicide all increase significantly during times of economic strife. The effects of this pandemic will be felt long after the virus is brought to bear.  The good news is that this report has gained both national and statewide attention, so we hope it adds clarity to the mission ahead.

If there is anything positive to this situation, Texas leaders have taken significant steps forward in improving the state’s mental health care, and as a result, we are better situated to deal with the emotional impact of the pandemic and its related economic slowdown than we would have been just a few short years ago.

But make no mistake, we are in this for the long haul.

This Mental Health Awareness Month we must rededicate ourselves to recognizing and addressing the overwhelming need to maintain and build upon the momentum we’ve created in mental health care, and to apply the lessons we’ve learned in helping people overcome the challenges unleashed by the COVID-19 pandemic and those that lie ahead.

Over the next several weeks, we will explore mental health from a variety of angles: children and family issues; COVID front-line workers and first responders; and veterans’ issues. We hope this will help us underscore how important mental health care is.

This Mental Health Awareness Month represents both a milestone marking how far we’ve come, and a somber reminder of how far we have yet to go.