By Bart Magee, Ph.D.
Now, almost two months into COVID-19 quarantine and lockdown, there’s still plenty of bad news to go around. With little in the way of a roadmap out of the crisis, the psychological toll grows by the day. More than half of Americans now say that the pandemic is negatively impacting their mental health. A new wave of mental illness is inevitable and we will need to muster tremendous resources, creativity, and leadership to confront it. So much to think about, but not my topic today. Rather, I’d like to focus on a related subject, one that I believe could help us in the coming struggle. I’m calling it “the lockdown teaching moment.”
Never before have we experienced such a massive interruption in social momentum, in our collective day-to-day experience. Never before has the vast majority of the human population, literally billions of people, stopped in their tracks and rapidly changed their behavior. When the “shelter” and “distancing” orders came in March, it was like watching a massive cloud of starlings shifting course at once, a murmuration it’s called. Working from home, distancing, hand washing, sanitizing everything, zoom happy-hour, masking in public, and a multitude of behaviors adopted almost instantly. From a psychological standpoint, one of the most dramatic effects we’ve witnessed in the last two months is how rapidly and totally behavior can change. While the media plays up the protests and outliers, the real news is that the vast majority of the country is in agreement on the stay at home and distancing measures, polling puts the number at 85%. Ask yourself, when was the last time 85% of people agreed on something so critical? Can we ever doubt that human beings are social creatures, intimately attuned and responsive to others around them? The pandemic response tells the story.
More importantly, we are seeing how changing behavior changes outcomes. Dramatically. Looking at the COVID-19 Pandemic, we watched as countries like South Korea adopted social distancing and contact tracing and avoided the worst of the outbreak. Even here in the US, where the response has been chaotic at best, the Bay Area was one of the first areas in the US to adopt “shelter” and consequently escape a spike in cases. The per capita case and death rate from COVID-19 in San Francisco is only a quarter of the rate in Los Angeles and tiny fraction of New York’s. As of mid-May, the City was seeing an average of only 25 new cases per day (out of a population of 900,000).
The emergence of a threat to health and safety clearly spurred the rapid response. Yes, fear does motivate. However, changes like these can have much broader meanings and impacts and even have implications for addressing mental illness. The very things we need to achieve as a society to end mental illness all involve social and behavioral changes of a similar scale. Changes like increased community involvement (think volunteering and community service as a social expectation); childrearing and teaching based in attachment, empathy, and mutual respect; rejection of perfectionism, the culture of acquisition, and embracing meaningful pursuits; and building connections to the natural world. All of these changes involve behavior and would have profoundly positive impacts on our collective mental and emotional well-being, yielding vast social benefits. The real question is how to make these behaviors into new and universal social norms. And the question is not whether, but how. It will take leadership – political, moral, spiritual – and will take a mass movement based in increased awareness of the fundamentals of psychological resilience and mental wellness.
Secondly, the pandemic is teaching us more about the reality and effects of social and economic inequality. We’ve known for a long time that inequality has been rising in our society. The top 1 percent now owns a greater share of wealth than at any time in the past 50 years. The pandemic has shone a spotlight on the terrible consequences. It’s become painfully clear how COVID-19 is disproportionately impacting low-income, Black, Latino, and Native Americans – who are more likely to get infected, become ill, and face dramatic economic impacts. While 32% of upper-income Americans report having lost a job or income due to the Pandemic, 52% of lower-income report job or income loss. Upper-income and white people are more able to work from home, protecting them from exposure to the virus. Nursing home attendants, grocery clerks, bus drivers, and other “essential workers” don’t have that luxury. Other workers employed in the hospitality, retail, and service sectors are laid off, many unsure they will ever return to their old jobs. Most Americans have less than $1000 in the bank.
What does inequality have to do with mental health? More than you might think. It’s not just that poverty is associated with poorer health and mental health outcomes, but relative poverty. It’s been well studied and documented that societies with a greater gap between the rich and the poor tend to have higher levels of depression and other forms of mental illness. How does this work? The reasons are complex, but one way to understand it is that in unequal societies, resources (economic, social, educational, health, environmental) are distributed upward, where relatively few people have an over-abundance of them and the rest of society makes due with the leftovers. That means that relatively few people are enjoying all the health and mental health supporting resources, where as those on the middle to lower rungs of the economic and social ladder have to make due with minimal and precarious supports. In more equal societies, even ones what are far poorer overall than the US, these resources are distributed more equally allowing them to benefit more people overall. We see this most dramatically in education and housing. In the US, which has about the highest rate of income inequality in the developed world, the kind of resources in housing and education available to the wealthy is boundless. Wealthy families invest vast sums in the education of their children, while poor families’ children go to schools that can barely attend to basic educational needs. The same for housing. Countries with low rates of inequality, like Japan and Finland also have low rates of homelessness. There are fewer unhoused people in all of Japan than in the city of San Francisco.
Will a lasting impact of the Pandemic refocus our attention on reducing inequality? There are signs that it may. Witnessing dramatic rates of unemployment, small business failure, and the inadequacy of our social safety nets has already focused attention and has the potential to create a movement for change. The national conversation seems to be shifting from the question of whether the system needs to be changed, to how we change it. We are noticing this shift most strikingly in the conversation around healthcare. With millions of unemployed people losing their health insurance, support for universal health coverage jumped dramatically in March. A similar movement is happening in other areas as well. Even those who advocate for free-markets and small government are advocating for additional government-financed payments to low-income families and Joe Biden’s campaign has now embraced the “big structural changes” once considered too radical for mainstream America.
From the highest levels of government to community organizers on the streets, everyone needs to be part of the push for changes – economic, governmental, and cultural – that move us from a model that relies on “you’re on your own” to “we are in it together.” The more we advance in that direction the more we will be creating an environment in which we can bend the curve on mental illness. That’s how we come out of the pandemic, not only averting a new mental health crisis, but creating a society where mental health is fully sustainable. That means a society that prioritizes mental wellness, where everyone has access to the social capital and basic supports that promote individual and community well-being, and where high-quality mental health care is fully accessible to all.