Policy Solutions for COVID-19 Related Mental Health Crises in Vulnerable Populations

Abstract

Mental health is a segment of public health under-addressed by health policy, and as such, presents an opportunity for cost-effective improvement of outcomes through the implementation of simple, decisive policy actions. During moments of complex crisis such as the COVID-19 pandemic, the mental health of the global population is detrimentally affected, with effects insufficiently addressed by policymakers. Pandemics and their associated policy exacerbate mental health problems for the entire population, with disparities in mental health outcomes particularly prevalent within vulnerable populations. To emphasize the importance of mental health for policymakers, this thesis first seeks to contextualize how mental health deteriorates during moments of complex crisis as well as the importance of the prioritization of mental health for policymakers. Mental health during times of complex crisis is often impacted by the breakdown of infrastructure around socialization, health, and economics. Individuals lose their conventional coping mechanisms and the fundamental necessities they require for feelings of safety and security. The removal of these comforts in turn leads to damage to self-perception, anxiety levels, self-esteem, and overall mental health. These findings are corroborated in theory by psychological literature and in practice through the tracking of mental health data in moments of complex crisis. Mental health represents a serious problem for policymakers due to its huge potential costs to society. Mental health conditions cripple society, cost billions in lost productivity, and interact with other diseases to create dangerous comorbidities, even aiding in the spread of viruses. This thesis then seeks to show the ways in which COVID-19 in particular poses a threat to mental health. COVID-19 and its associated public policy threaten mental health in several ways. COVID-19 disrupts conventional means of socialization and in turn is isolating for individuals experiencing mandatory quarantines and losing access to family and friends. Looking at evidence from previous public health crises, isolation is shown to have detrimental effects on mental health. COVID-19 also introduces uncertainty to the population which in turn leads to elevated levels of anxiety and increased incidence of mental health problems. This is particularly apparent in certain vulnerable populations as economic downturn leads to income uncertainty and associated mental distress. This thesis then analyzes existing COVID-19 policy in the United States, the United Kingdom, and France to assess the actions taken by the government to address COVID-19 and how these actions might impact the mental health of the population. These actions include policies around quarantine that introduce isolation to the population, policies around other health goods like vaccines and mandates that can introduce uncertainty, and finally economic policies that address the economic impacts of COVID-19, paying attention to how these policies address economic uncertainty. This thesis then conducts original analysis of longitudinal mental health data from New York in the United States and compares the findings of this analysis to studies of mental health in the United Kingdom and France to provide insight into how the pandemic affected the mental health of each of the various populations, with sub-analysis done on the ways in which the pandemic particularly affected different groups within the population. Based on this analysis, this thesis then compares lessons from each of these areas to make assertions about what policy could be undertaken to improve mental health outcomes during COVID-19, including actions such as increased mental health screening, mental health outreach programs, and job placement programs.