• Tami D. Benton, MD, Psychiatrist-in-Chief & Executive Director and Chair of the Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia
• Sara Goldsby, MSW, MPH, Director of the South Carolina Department of Alcohol and Other Drug Abuse Services
• Andy Keller, PhD, President and CEO & Linda Perryman Evans Presidential Chair, Meadows Mental Health Policy Institute
• Jonathan Muther, PhD, Vice President of Medical Services-Behavioral Health, Salud Family Health Centers & Clinical Integration Advisor, Eugene S. Farley, Jr. Health Policy Center

The health officials testifying before the committee shared a unified message of concern over the mental health and substance use crises, noting that the global pandemic has led to a marked increase in overdoses and mental health disorders.

Dr. Benton testified that mental health had been an issue for children prior to the pandemic and issues have increased exponentially over the past year. She referred to a November 2020 CDC report that found the number of mental health visits for children ages 12 to 17 was 31% higher between March and October of 2020 than that of the prior year. Dr. Benton added that more children between the ages of 6 and 12 are experiencing depression, suicidal ideation, and severe anxiety. Dr. Benton recommended bolstering care services provided through schools and community health centers as a method to prevent and protect against the mental health crisis. Dr. Benton also emphasized the importance of telehealth flexibility during the pandemic, recommending it become a mainstay in health care delivery—particularly to allow providers to care for patients across state lines.

Dr. Keller testified to lawmakers that the rate of overdose deaths skyrocketed by 33% over a 12-month period ending in September 2020, attributing the deaths to the increasingly ubiquitous methamphetamine and fentanyl. Dr. Keller also emphasized the pandemic’s disproportionate impact on communities of color, noting that Black and Latino adults were more likely to report symptoms of anxiety and depression than White adults— ascribing this to the financial strains that disparately burdened people of color during the pandemic. Dr. Keller also pointed to the co-morbidities between mental illness and COVID-19, noting that individuals with mental health disorders were 65% more likely to contract the virus.

Ms. Goldsby echoed the other health officials, testifying that the COVID-19 pandemic has exacerbated substance use disorders, referencing a 27% increase in alcohol sales, a 25 to 35% increase in mental health calls, and a 45% increase in drug overdose deaths in South Carolina. Dr. Goldsby recommended a transition to more flexibility in block grants to address all substances, including opioids, as well as increased resources for recovery housing.

Dr. Muther testified that community health centers played an integral role during the pandemic, noting that services otherwise unaffordable and unattainable were provided to disadvantaged communities. Dr. Muther emphasized that mental illnesses and substance use disorders increased by four-fold during the pandemic, overwhelming an “already overburdened mental health system.” Dr. Keller made several recommendations to committee members, most notably reinforcing primary care and increasing workforce capacity, noting that a strong investment in “a robust pipeline that supports recruitment and retention of individuals of diverse backgrounds into mental health training programs through loan forgiveness programs” would assist in preventing and treating the mental health and substance abuse crises. NACCHO has been working with Members of Congress throughout the pandemic to establish a public health loan repayment program that would help to shore up a waning public health workforce.