The Psychological Fallout
On the afternoon of Friday, March 11th, the Fukushima Daiichi Nuclear Power Plant, located on Japan’s coast, was staffed by thousands of workers. Many of the plant’s workers grew up near the labyrinth of light boxy buildings, located a hundred and fifty miles north of Tokyo. At 2:46 P.M., on what had thus far been an ordinary day, a historic 9.1 magnitude earthquake off the coast began to violently shake the complex. Lights flickered and men fell to the ground unable to keep their balance on the unstable foundation. Ash filled much of the complex, with workers stuck inside. Emergency lights and alarms flickered to life. Sadly, the events and carnage that came down on much of Japan’s Pacific shore is ingrained in the public consciousness. The public recalls the failure of the plant’s sea walls and cooling systems as well as the horrendous casualty counts that followed. Although entire books could be dedicated to the tragedy that befell Japan that day, today we view the earthquake, tsunami, and the crisis that followed through the lens of hidden consequences.
Hidden consequences are by their very definition missed by the limits of our human perception and thinking. The COVID-19 crisis itself has had many hidden consequences of its own (in fact, the founding principle of this site was to bring attention to such issues). Today we focus on just one: while the spread of the novel COVID-19 virus could be analogous to the rushing high waves of water to hit Japan, the mental health toll the virus has had on so many is among the “hidden consequences” lurking in the shadow of the global pandemic.
But first we return to March 11th, and the (seemingly) sensible decision by Japanese leaders to evacuate hundreds of thousands within a dangerous distance of the Fukushima Daiichi nuclear power plant. The evacuation had to happen quickly — many were forced to flee their homes not to return for months or years. One elderly couple, Mikio and Hamako Watanabe, were (like so many) distressed by the orders to leave their home. In the end, the couple was able to return to their home for just a one-night visit. Mikio and Hamako clung to each other during the time they had back home. Hamako sobbed the entire night. In the morning, Hamako killed herself — refusing to live anywhere but her lifetime home. In what is a harrowing, incredibly personal, tragedy Japanese authorities found that at least several dozen others had killed themselves as a result of the evacuation orders. Hamako and the dozens of others who died by suicide are not considered to be among the casualty count of the Tōhoku earthquake or tsunami. Years after the tragedy, government decision making was assessed. The decision to evacuate is concluded to have caused a lot of human suffering while saving very few lives. Hamako and dozens of others deaths were among the “hidden deaths” caused by the crisis. Today we learn the very same toll could be happening as governments around the globe navigate responding to COVID-19.
Along with the symptoms those who contract COVID-19 have to battle, there has been a devastating adverse impact on mental health caused by the virus. Those who contracted the virus in this regard are not alone: those who have lost loved ones, their economic security, have sudden expanded child care responsibilities, experienced domestic violence, or have grown frustrated with strict lockdown measures have all experienced their own unique tolls of the COVID-19 pandemic on their mental health.
“Even more shocking, nearly 11 percent of those surveyed by the CDC said they had suicidal thoughts in the past month — with the sharpest increase being among people of color, essential workers, and those who have served as unpaid caregivers.”
A recent study released by the Centers for Disease Control and Prevention quantified those impacts. The impact of COVID-19 on mental health has been perhaps no more pronounced than among Black, Latino, and Young Americans. There has been a near universal increase in the levels of anxiety, depression, suicidal thoughts, and substance use among all demographics. According to one researcher, among 18 to 24 year olds alone nearly 63 percent reported symptoms of anxiety or depression attributed to the pandemic. Even more shocking, nearly 11 percent of those surveyed by the CDC said they had suicidal thoughts in the past month — with the sharpest increase being among people of color, essential workers, and those who have served as unpaid caregivers.
Further worsening the impact the virus is having on mental health has been strained outlets for coping with stressors and anxieties. Outings with friends, gyms, vacations, and regular sleep are among just a few outlets that have been significantly rolled back or eliminated entirely from the daily routines of many. “Social distancing” while good for mitigating the spread of airborne viruses has left many deprived of socializing — a behavior which could rival the harm to one’s physical health of obesity. Studies have shown that video calling can limit the impact of lockdown-imposed social isolation, though no means of digital communication could replace the connectivity of in-person interactions.
Though perhaps the most effective outlet for stressors and anxiety, mental health resources, have also been profoundly spread thin. Mental healthcare workers have begun to see both an increase in the number of cases and their severity. While telehealth and teletherapy may have helped dampen the impact of the pandemic on mental health, heightened workloads have fatigued mental health workers. Dr. Shabana Khan, the Director of Child and Adolescent Telepsychiatry at NYU Langone, also highlighted another factor that has been fatiguing mental healthcare workers: “show rates for appointments are a lot higher because telehealth visits decrease typical barriers such as travel time,” Khan explained. Though telehealth has not been alone in struggling to cope with the increased demand for resources in the middle of a pandemic: in-patient psychiatric units were forced to limit the number of their admitted patients to accommodate social distancing guidelines. The limit in supply of in-patient mental health resources has in-turn strained hospital emergency services, which now need to hold patients for longer periods of time before moving them to centers to receive the care they need.
As bad as the impact COVID-19 has had on mental health and the resources to treat it, it has been even worse for racial and ethnic minority communities. In Cook County, Illinois, deaths by suicide since the outbreak of the virus have overwhelmingly occurred in Chicago’s predominantly black neighborhoods. Cook County Medical examiner Toni Preckwinkle said “it is not surprising that the communities that have suffered the most are the ones who have the least. Disinvestment, red lining and systemic racism have culminated in a crisis that once again hits the African American community hardest.” Dr. Manuel Pacheco, the chief emergency service psychiatrist at Tufts Medical Center echoed a similar sentiment, “the cancellation of appointments and loss of access to clinicians or caseworkers because of social-distancing measures, particularly for those from underrepresented groups who don’t have access to phones that could be used for telehealth, has led to an increased number of suicide attempts.”
Bringing the happenings of today back to the lessons of the past: we are only at the beginning of learning the impacts the COVID-19 public health crisis is having on our lives. Just like Hamako Watanabe and the dozens who died by suicide long after the evacuations of those near the Fukushima Daiichi Nuclear Power Station — or the tens of thousands who are believed to have died by suicide in the aftermath of the 2007 economic crisis in North America and Europe — we can’t let these deaths and societal pain remain hidden. We must come together to learn where we thrived and where we failed in addressing this public health crisis — transforming hidden pain and deaths into future prosperity and lives.
Editors Note: If you or someone you know may be struggling with suicidal thoughts you can call the U.S. National Suicide Prevention Lifeline at 800–273-TALK (8255) any time of day or night or chat online.
Crisis Text Line provides free, 24/7, confidential support when you dial 741741.
