Research findings spur US mental health action during pandemic

A program of research seeking to assess the public impact of the coronavirus pandemic is making a significant impact in the US, with findings prompting government officials and policymakers to expand access to mental and behavioural health services.

Mark CzeislerLed by Fulbright Scholar and Monash student Mark Czeisler, the COVID-19 Outbreak Public Evaluation (COPE) Initiative aims to assess public attitudes, behaviors, and beliefs related to the COVID-19 pandemic, and to evaluate the mental and physical health consequences of the pandemic. The project is a collaboration between researchers at the Turner Institute for Brain and Mental Health, Austin Health, Brigham and Women’s Hospital, and Harvard Medical School.

Having graduated from Harvard College in 2019, Mark first arrived in Australia in January of this year as a 2020 Fulbright Future Scholar. Under the supervision of Associate Professor Mark Howard at Austin Health and Professor Shantha Rajaratnam of the Turner Institute, he began work on what they planned to be a 10-month research project evaluating sleep and circadian rhythms as mediators of patient outcomes in the intensive care unit.

The universe had another plan. By March, COVID-19 was having a significant impact on Melbourne, his research had halted, and the Fulbright program was suspended globally, forcing Mark to return to the United States.

“I was keen to maintain the relationship between Australia and the US that is central to the Fulbright’s mission, so I proposed a collaborative initiative to develop and launch a transnational survey-based study of Australians and Americans amidst the COVID-19 pandemic,” Mark said.

“The aim of the ongoing study is to assess changes due to COVID-19 and mitigation strategies alongside associated mental and physical health outcomes, and to identify predictive factors that may be used to reduce potential negative consequences of the pandemic.”

Since the commencement of The COPE Initiative, Mark and the research team have published a number of reports. However, it is the findings from the third survey, conducted in June that has had the biggest impact so far.

Published in the US Centers for Disease Control and Prevention in the Morbidity and Mortality Weekly Reports in mid-August, the research revealed the growing mental health impact of the pandemic on US adults, with 40% reporting that they were struggling with mental health or substance use, and rates of anxiety and depression 3-4 times higher than in 2019.

The report has been used to support a public health plea for increased prevention and intervention efforts to address associated mental health conditions during the pandemic.

“Findings from the report have been referenced by government officials and policymakers in the US to expand mental and behavioural health services, including through an executive order issued by President Trump, a letter from mental health organisations to California Governor Gavin Newsom regarding a proposed Senate Bill, a proposal to from the National Safety Council both presidential candidates Trump and Biden regarding a National Plan to Address Opioid Misuse, and in a letter from Senators Elizabeth Warren and Bill Cassidy to Secretary of Education Betsy DeVos and Secretary of the Department of Health and Human Services Alex Azar advocating for guidance addressing the mental health needs of students with school re-openings,” Mark said.

The report was also cited twice in the Lancet COVID-19 Commission Statement from a recent session of the UN General Assembly.

According to Professor Shantha Rajaratnam, Deputy Director of the Turner Institute, the impact of Mark's work is significant.

“To have a series of papers published in the MMWR, the premier journal of the CDC, is in itself an extraordinary achievement. But to have the findings of the research be subsequently considered by the leading policymakers in the US is an outstanding example of research impact. The research has clearly demonstrated importance of mental health research during the pandemic.”