Some of the most vulnerable patients in the ER— those struggle with substance use disorders, mental health conditions or other challenges that require collaborative approaches to care—are having a particularly tough time during the COVID-19 pandemic.   

In June 2020, 40 percent of American adults reported struggling with mental health issues or substance abuse.  The pandemic has added new barriers to treatment and recovery for many of these patients who rely on friends, family and others in their support system, including therapists, social workers, or various community-based care programs. Emergency physicians encourage you to discuss how you feel with peers or professionals, schedule an appointment with a therapist, call a help line to speak with somebody who can help you, and/or find a support group.

Whether you are on the frontlines or a patient, the pandemic is clearly taking a toll on our nation’s mental health. An eye-opening CDC report recently found that nearly a quarter of young adults in the U.S. contemplated suicide in June 2020.  Among those struggling with mental health, the CDC noted that 13 percent have turned to using substances to cope during the pandemic.

That aligns with data showing that overdoses are increasing—incidents nationwide were up 18 percent in March, 29 percent in April and 42 percent in May compared to the same months in 2019, according to the Overdose Detection Mapping Application Program, a federal initiative that collects data from ambulance teams, hospitals and police. 

Unfortunately, many people lack a critical support system outside of the emergency department to begin with, whether due to limited local resources or other barriers to access. The reality is that an emergency physician could be providing the only medical attention that many vulnerable people receive during these challenging times.

If somebody goes to the emergency department for a mental health emergency, an emergency physician will make sure that the patient is not a danger to themselves or others. That patient will be safe for the time being, but the underlying cause of their mental health issue still needs to be addressed and it is likely that this requires longer term care more appropriate in a setting outside of the emergency department.