The American Psychiatric Association (APA) defines Post Traumatic Stress Disorder (PTSD) as a disorder that “may result when an individual lives through or witnesses an event in which he or she believes that there is a threat to life or physical integrity and safety and experiences fear, terror, or helplessness”. The question we ask ourselves in this era of the COVID-19 pandemic is if we all, to a lesser or greater extent, are victims of PTSD?
Taking these clinical diagnoses and applying them to the lives we have lived over the last year, we could make a layman’s clinical diagnosis that American society is certainly in the throes of what we at Curus have defined as Post COVID Stress Disorder (PCSD). With more than 25 million Americans having been diagnosed with Covid-19 and many experts asserting that the number could be easily tripled we as a society are facing a PCSD tsunami.
Think about how our lives have changed from what we considered normal in our society over the last 12 months:
- Isolation, particularly of our senior citizens. We have asked our senior citizens to stay at home while we recognize the increasing trauma of enforced loneliness.
- Remote and socially distanced learning. We have asked our children to learn from home utilizing all of the distance-learning techniques that used to be a value add. Think about the dislocation of our children not interacting physically either with their teachers or their classmates. We have no comprehension yet of the emotional cost this remote learning will have on the lives of this learning generation.
- Businesses struggling without patrons. Think about those of us that have built businesses such as restaurants, entertainment, travel and leisure that have come to a virtual halt.
- Sport/entertainment virtually closed down. Think about sporting events being delayed and now viewed on television in empty stadiums.
- Healthcare and first responders personal sacrifices. Think about our healthcare workers who face the trauma of the lives lost to this pandemic while having the responsibility to be the last person those individuals see as their families are prohibited from the hospital.
We are asked to wear masks and stand a minimum of 6 feet apart as we go about our daily lives outside of our homes. As we shop for essentials in the grocery store we have one Way Isles, and markers on the floor where we should stand awaiting check out. We interact with people through plastic barriers. If these experiences we are having on a daily basis do not qualify for PCSD then the ASA definition of PTSD will have to be revised in new literature..
There is one silver lining I have thought about as a result of this pandemic. Finally, America will understand that we are all suffering from this shock and our changed lives. We are all feeling anxious with varying mood changes. The implications from the perspective of our mental health, I believe, are profound. We are finally as a society going to recognize that mental illness is no different than physical illness. We have a society that is either crying out for help or isolated and distraught. We can do something to recognize the problem and begin to treat it. We must prepare ourselves in our schools, our offices, our factories, and in our communities of the elderly to address this issue head-on.
We have an opportunity to develop creative programs to ameliorate the PCSD symptoms. We need to be creative because the resources are going to be far outstripped by the demand for services. An example of what we are thinking about at Curus – Developing group programs structured for the age cohorts and the likely symptomatology within that age cohort. Utilizing this methodology the members of our society will understand that their feelings of anxiety, isolation and disorientation are the norm not the exception.
There is a unique opportunity here to reform the licensing requirements for healthcare providers, particularly mental health care providers to create the national interstate physician licensing compact. This should also apply to psychologists and social workers. This would enable the use of telehealth on an expansive basis across state boundaries ensuring the best qualified providers could be available without regard to their state boundaries. Each of us with a driver’s license from one state is presumed qualified as we can drive the entire expanse of the United States. Yet, highly educated and highly trained professionals are restricted to providing their services within the geographic boundaries of their licensure.
With the geometric increase in telehealth, the rules and licensure around the delivery of these services will have to be revised if we are going to keep up with the demand for the services we will require in our society. We are now seeing numerous studies emerging regarding patient satisfaction with telemedicine. There is no healthcare service more uniquely qualified to take advantage of telehealth then is the area of tele-mental health.
We are at a unique inflection point in healthcare delivery. If we seize the moment and adjust our delivery systems to take advantage of the technologies available, we can significantly improve both our physical and our mental health. If we revert to our old ways of delivering healthcare services, the system will continue to fail us and diminish the quality of our care.
I believe there is no going back. Healthcare, particularly mental health care, will accept the new normal. The healthcare system in all of its facets has proven to have great adaptability during this crisis. This momentum for change is now irreversible. The pandemic has created an opportunity to accelerate dramatic changes in our healthcare delivery system that would ordinarily have taken decades to achieve. Let’s take advantage of this crisis to improve our lives.