NIMH Director Highlights Institute’s Response to Joint Crises of COVID-19 and Systemic Racism

By Nick Zagorski

Similar to the long-term effects of previous traumatic events like natural disasters, mental distress has been rising during the COVID-19 pandemic, said National Institute of Mental Health (NIMH) Director Joshua Gordon, M.D., Ph.D., at APA’s online 2021 Annual Meeting. His presentation was titled “Mental Health Research in the Era of Competing Crises.”

The good news is that there is no indication yet that the increased burden of mental illness has led to a rise in suicidal ideation or self-harm, Gordon added. (In fact, in the time since Gordon’s lecture was recorded, newer data suggest that deaths by suicide dropped by nearly 6% from 2019 to 2020.)

Gordon noted that the drop in suicides may in part be due to the lessons learned by researchers and clinicians from previous natural disasters. “We know how to treat people during a crisis,” he said, indicating the four-pronged strategy of promoting a sense of safety, promoting calm, promoting a sense of efficacy (people can play an active role in their own safety), and promoting connectedness.

The role of efficacy has been particularly important during the pandemic; protective measures, including mask wearing and increased telework have given people a sense of control over their health. Tools such as social media and videoconferencing have also enabled people to maintain safe social connections—both with their loved ones and with their physicians.

Data from previous disasters indicate that with treatment, 90% of people who develop acute symptoms of mental distress will recover within a year. But given that COVID-19 has touched every corner of the United States, a significant number will develop chronic mental issues, Gordon warned, and minority populations are at particular risk.

“Social inequities and health disparities both predict and exacerbate vulnerability in marginalized populations,” Gordon said. “This is really important to underscore in this era of conjoining crises.”

Gordon was referring to another huge event that permeated 2020—the killing of George Floyd and subsequent awakening of some Americans to the deadly effects of racism, including the pandemic’s physical and economic toll on people of color.

The National Institutes of Health (NIH) is committed to addressing racial disparities, Gordon said. He discussed a large-scale project being led by NIMH known as the Social, Behavioral, and Economic (SBE) Impacts of COVID-19 initiative. This project brings together representatives from 21 NIH institutes and centers to study the impact of the pandemic and the public health mitigation measures (like shutdowns) on mental health and substance use outcomes.

“This effort specifically targets … older [U.S.] adults, frontline workers, children, racial and ethnic minorities, rural residents, and people of lower socioeconomic status.”

So far, the SBE has provided supplemental funding to 52 ongoing studies (28 longitudinal studies, 15 digital health studies, and nine community health studies) so they can incorporate COVID-19-related metrics in their data collection. For example, the Adolescent Brain Cognitive Development Study—which is tracking the brain development of more than 11,000 children over a decade—is now having a subset of children and their parents complete monthly questionnaires about their experiences during the pandemic.

Gordon added that the SBE is evaluating original research proposals on digital interventions and community health interventions aimed at improving the mental health of those whose communities were hit hard by the pandemic.

“We envision a world where mental illnesses are prevented and cured,” Gordon concluded. To reach that vision, Gordon acknowledged that NIMH needs to better understand the impacts of systemic racism and the lack of economic opportunity on the mental health of members of minorities, so that effective solutions can be found. ■