A ‘Category 5’ mental health crisis is coming | COMMENTARY

Research suggests the pandemic is having a negative effect on children and teenagers' mental health.

Whenever a hurricane nears our shores, the government implements a system to track the disaster, including assigning a score on a scale of one to five to assess its severity and to guide disaster preparedness efforts. A storm reaching a magnitude of 3 or higher has the potential for devastating damage and loss of life.

No such scale exists to warn us of the psychological dangers of our current crisis. While the invisible COVID-19 virus devastates our nation, we are simultaneously bombarded by gale-force winds of financial hardship, racial and political tensions, and a polarizing election, where the loser refuses to concede.


As a psychotherapist, I have witnessed firsthand the anxiety, fear and depression that have resulted from the confluence of these once-in-a-century emotional storms. A Category 4 mental health storm of incalculable proportions has reached landfall across our entire nation, and a Level 5 disaster may make landfall this winter.

None of us are immune. Nor are we adequately prepared for this unprecedented emergency.


Alcohol and drug use are rising at an alarming rate (a RAND study found that heavy drinking by women is up 41% compared to 2019). Many people report feeling helpless, unable to sleep, plan or imagine a future. By midsummer 2020, a majority of U.S. adults reported that the worry and stress of the pandemic had negatively affected their mental health. We have sadly watched our virtual “consulting rooms” reach capacity. The demand for psychiatric hospital beds has outpaced their availability, with people in need stranded for days in emergency rooms, while potentially being exposed to COVID-19.

Until the new vaccines reach more people, our primary protections from COVID-19 remain social distancing and masks to shield ourselves. Paradoxically, these safety precautions exacerbate psychological trauma, most importantly the loneliness and isolation that ensue. More than 35 million Americans live alone, and we know that loneliness weakens the immune system. A data analysis from 2018 covering more than 580,000 adults found that social isolation increases the risk of premature death across gender and race.

But statistics tell us nothing about the individuals my colleagues and I are seeing each day — mothers overwhelmed by trying to work as they oversee their children’s online learning, marriages on the brink of divorce. Last month a colleague told me of a patient whose husband, depressed after losing his job, stepped in front of a train.

Adolescents are at particularly high risk. At a time when teens are developmentally wired to fall out of love with their parents and fall into love with their peers, they find themselves trapped at home. In teletherapy sessions with teens, I hear the psychological impact of living a virtual life, doing school online without the social and developmental benefits of contact with peers. Young people may be less at risk for the serious physical health consequences of the virus, but their mental health immune systems, not as robust as adults’, leave them at greater psychological risk, including death by suicide.

While we can physically distance from one another and don masks, we can’t cover our emotional windows in plexiglass to guard against the loneliness, anxiety and depression that engulf us. We cannot prepare as we do when a hurricane is approaching: Know our risk, know our plan. And nothing raises anxiety in a crisis like the unpredictable and the inability to protect oneself.

Medical experts on President-elect Biden’s COVID-19 Task Force can ramp up testing, track the available ICU beds and push mask mandates. Epidemiologists will trace new cases and the number of deaths. The military will assist in handling the complicated job of distributing the vaccine. Congress has reached an agreement on a stimulus package to help those in need. What is missing, though, is the ramping up of mental health care to manage this psychological crisis — the social workers, psychologists and psychiatrists whose expertise is needed to manage the “clean up” of this psychological trauma, which will remain long after the virus is gone.

Mr. Biden’s commitment and reliance on medical expertise, in contrast to his predecessor, offers us hope, as does the distribution of vaccines. But no vaccine can inoculate us from the grief, pain and anxiety wreaked by the pandemic. Mental health symptoms, after all, do not respond to vaccines. Behavioral health professionals are urgently needed on the COVID-19 Task Force to tackle the psychological devastation and debris that will be left behind from this Category 5 mental health storm.

Kerry Malawista ( is a writer and psychotherapist practicing in the Washington, D.C., metropolitan area.