WASHINGTON -- As the number of COVID-19 deaths in the U.S. exceeds 100,000 and people continue to take precautions, military medical experts expect the need for mental health care to increase because of stress, anxiety and other psychological symptoms.
During the COVID-19 emergency and the existing phase in which some communities are starting to emerge from restrictions, the psychological impact can affect health care workers, service members, veterans, civilians and their families. Four medical specialists of the Military Health System agreed Wednesday in a media telephone roundtable.
The panelists were Dr. Nicholas Polizzi, action officer for the inTransition Program and the Real Warriors Campaign, Psychological Health Center of Excellence; Dr. Holly O'Reilly, clinical psychologist with the Defense Health Agency; Army Col. (Dr.) David Benedek, chief of psychiatry at the Uniformed Services University of the Health Sciences; and Dr. Stephen Cozza, associate director of the Center for the Study of Traumatic Stress at the USUHS.
May is Mental Health Month, but the Defense Department focuses on the health of its people year-round, O'Reilly said, adding that this month's theme is "Need a Little Help."
"[S]ometimes a little bit of help is all we need to improve our mental health and [be] mission ready; taking small steps to address problems early on makes a big difference, especially during the pandemic," she explained.
"During the COVID-19 pandemic, people can experience stress, anxiety, fear, sadness and loneliness. It's changed how we live and … how we interact," O'Reilly said.
DOD has many resources for mental health help, she said, adding that service members and veterans are encouraged to ask for help and recognize that seeking help is a sign of strength.
While many facets of society are affected in different ways by the pandemic, in the health care realm, it's not just doctors and nurses who are overwhelmed, Benedek said.
Other front-line workers — such as hospital administrators, janitorial workers and other hospital employees — have been exposed to a lot more sickness, severe illness, surges and greater numbers of deaths, he said.
While most people will be resilient and recover from exposures and experiences, stress and anxiety can be side effects of working in a COVID-19 environment, Benedek noted.
The effects on health care workers can also affect their family members when they are faced with long and extended absences from their loved ones, while they work under varying circumstances and put themselves at risk by having close exposure to the virus, Cozza said.
The invisible nature of the war on COVID-19 can also escalate from stress and anxiety to post-traumatic stress disorder, Benedek said.
"In terms of the challenges confronting health care workers, I think it's important to know that, to some degree, we are in uncharted territory, so it's hard to know how many will develop post-traumatic stress disorder or depression," he said.
If someone has thoughts of suicide, that's a big red flag, and certainly should be taken seriously, Benedek said. The National Suicide Prevention Lifeline and Military OneSource offer the phone line 1-800-273-8255 for crisis intervention.
"Concerns about decreases in levels of function, the inability to concentrate, or the inability to interact as normal with other people should prompt concerns about seeking additional help," he emphasized.
"In terms of resources, I think it's important to emphasize that DOD has both Real Warriors Campaign and inTransition that [are] able to work with National Guard and reserve leaders … to help support not just individual people… but to help create a whole culture at the installation that supports psychological health … and to normalize psychological health care as just health care," Polizzi said.
According to their websites the Real Warriors Campaign encourages help-seeking behavior among service members, veterans and military families coping with invisible wounds. The second mental health care resource, inTransition, is a free, confidential program that offers specialized coaching and assistance for active-duty service members, National Guard members, reservists, veterans and retirees who need access to mental health care during relocation, returning from deployment and other life changes.
Mental health experts anticipate a rise in demand for seeking care, Benedek said, and they are taking steps to be ready for that surge whether it's in a hospital environment or a behavioral health or telehealth capacity.
"[We] think we're a little bit in unchartered waters," Benedek said. "It's hard to have a crystal ball, but we believe that because the concerns are higher across society, the demand will be higher, and we're prepared and ready to address those demands as they declare themselves."