A Nation in Pain
Our entire nation is embroiled in a mental health and addiction crisis that is spiraling further and further out of control. Deaths of despair — those involving alcohol, substance misuse, and suicide — have reached their highest levels on record. It’s a quiet epidemic festering just beneath the visible surface of everyday life, and it's wreaking havoc on American families.
This is the mental health equivalent of a five-alarm fire, and policymakers must urgently respond to the flames that threaten to engulf those closest to us. While this mass loss of life is senseless and tragic, policymakers, families, schools, and others should know that with adequate investment in prevention, timely access, and intervention, many of these deaths could have been avoided.
This year’s comprehensive Pain in the Nation report, compiled and released jointly by Well Being Trust and Trust for America’s Health, shows in stark detail that this grim and rising trend of deaths has no signs of abating. The report also exposes the insidious impact of the stress, loneliness and isolation, fear, and grief felt by many due to the social and economic disruptions in the first year of the COVID-19 pandemic.
In 2020, we lost a total of 186,763 of our fellow citizens to preventable drug, alcohol, or suicide deaths, with death rates rising in nearly every state in the country. The needless loss of these mothers, fathers, children, coworkers, neighbors, and loved ones should sicken every single one of us — whether you personally experienced a loss or not.
Concurrent with an increase in alcohol sales, alcohol-induced deaths numbered nearly 50,000 in 2020. Americans may have consumed more alcohol to deal with heightened stress levels during the pandemic, and drastic shifts in many people’s work schedules, including full-time remote work, creating more time alone at home, more isolation, time away from their support networks of friends and family, and more opportunities to drink in order to cope. Deaths due to alcohol consumption, like alcohol poisoning and liver disease, were up 27 percent from 2019, and increased across all age groups except children.
At the same time, the opioid crisis — officially declared a public health emergency in 2017 — continues to devastate the nation, affecting rural and urban communities from Maine to New Mexico and causing anguish for families of all sizes and socio-economic backgrounds. Americans died from drug use at a 30 percent higher rate in 2020 than in 2019. This was driven largely by a frightening spike in deaths from synthetic opioids such as fentanyl. Overdoses involving synthetic opioids increased a staggering 56 percent in 2020. All age groups, save for those 75 and older, saw increases in drug use, while Black communities saw the highest increase of 41 percent, underscoring a widening disparity in the ability to access effective treatments.
And while we saw a slight decrease in the nation’s overall suicide rate, suicide deaths among youth increased dramatically, and deaths in certain communities of color grew as well.
The time for debates and discussion has long passed. It is critical that policymakers at all levels prioritize passage, implementation, and funding of a broad range of transformative policies that focus on addressing the social and economic conditions that can lead to addiction and despair, as well as firmly establishing a continuum of care that can provide preventive treatment and meet people where they are.
We need to pay more attention to the next generation — our children and youth are our future, and investment in their mental health and well-being should be paramount among lawmakers. Abruptly transitioning to remote learning environments due to the pandemic has taken its toll on the social and emotional development of many school-aged children, and the psychological consequences may not yet be fully apparent to parents or even students themselves. School- and community-based mental health services should be expanded, with increased funding for onsite school counselors and mental health providers and training for teachers to recognize symptoms among their students.
We must also prioritize reducing substance misuse amongst our youth and increasing funding for national and community-based drug-free initiatives and education campaigns. Recognizing that drug use is a complex and pervasive reality in our country, efforts focused on saving lives and lowering incidents of overdoses should involve methods of harm reduction. Harm-reduction services might include ensuring access to overdose reversal medications and providing tools for the testing of drugs for fentanyl to reduce the consumption of laced substances.
Perhaps most importantly, our communities must expand their efforts to combat the myriad harmful forms of stigma surrounding mental health and addiction. The messaging that comes from all federal, state, and community leaders - from governors, to teachers, to parents of children of all ages — should be that of support, empathy, and understanding. No one asks to struggle with mental health, and no one chooses the severity of his or her condition. We must all be willing to lend an ear, or extend a hand, to help those who are in need. This is an issue that impacts us all and so we must all be involved in its solution.
We hope this report serves as a wake-up call to our leaders to help save the millions who are still alive and struggling. It is only through a proactive response and necessary investments in prevention methods and quality mental health care systems that we can hope to start to see an improvement in these numbers. Until then, millions of our friends, neighbors, and family will struggle to get the treatment and support they need for existing and newly developed mental health conditions, and overall mental health and well-being in our nation will continue to get worse, not better.
Dr. Benjamin F. Miller, PsyD, is president of Well Being Trust and chair of the advisory board of Inseparable, two leading mental health organizations. Dr. J. Nadine Gracia is the President and CEO of Trust for America’s Health (TFAH), a nonprofit, nonpartisan public health policy, research and advocacy organization that promotes optimal health for every person and community.
