How omicron changed mental health COVID challenges
Mental health systems across the United States were already struggling to care for a nation in crisis before China ever reported a new coronavirus outbreak in late 2019. There was an underbelly of despair across this country, reflected in the increasing deaths from opioids, methamphetamine use and homelessness. Working as a psychiatrist in a specialized emergency room for acute psychiatric emergencies, I saw this despair increasing year after year.
Then COVID-19 hit.
I was often asked last winter whether COVID-19 brought a flood of new patients to our door or whether our ability to care for patients with acute mental illness was impacted. The answer, by and large, was at that time no. It was true that there were occasional outbreaks in the community centers where we referred patients — our inpatient psychiatric unit was closed once, and a few of the staff caught COVID-19. Yet, we weathered last winter’s COVID-19 storm reasonably well.
Omicron and the current surge have made this variant of COVID-19 feel like a different illness entirely. So many more patients that arrive at our psychiatric emergency room are infected with omicron.
This increase in prevalence seems to be driven by various factors. The first is well known: omicron’s transmissibility. But there are other factors unique to the population of patients we care for. Those men and women who struggle with severe mental illness, drug addiction or both often have more difficulty protecting themselves from COVID-19.
If you are struggling to get to your community clinic to pick up your medications, social distancing and masking isn’t your first priority. As we know, those with severe mental illness or drug addiction are more often homeless. It’s far harder to protect yourself when you live in a tent encampment.
Last year, most patients with thoughts of hurting themselves or deemed dangerous to others were first brought to medical ERs to be medically assessed before coming to us. We knew if they had COVID-19 before they entered the doors of our psychiatric emergency room.
Today, the medical ERs are so inundated with omicron patients, and the ambulance wait times are so large at those emergency rooms, that patients are brought to us without first going to a medical emergency room. We must figure out ways to convince a patient who might be paranoid and violent to have a swab stuck up their nose so they can be tested for COVID-19. We never encountered this situation last year.
We’re trying to take care of this omicron surge while increasingly short-staffed. Three out of approximately 10 full-time physicians have caught COVID-19, and an unknown number of nurses have been infected. All of our information support staff got sick. We’ve just been trying to fill in the gaps, with everyone pitching in. I’m not sure I took stock of all the challenges that have been like dark clouds above our hospital until writing this.
This omicron variant has brought numbers of patients to our door that we didn’t see last year, brought more patients who are untested when they reach our door, and presented new challenges we didn’t have to face last year. Staffing shortages are increasingly common. It does drain you more and more.
But I don’t feel sorry for myself. I chose this profession. Those patients we care for, who remain more at risk for COVID-19, didn’t choose to be in their situation. Yet so often they are the ones truly suffering as omicron ravages this country.