In May 2023, the federal Public health emergency COVID-19 ended – reflecting a long-awaited return to normalcy across the United States. However, this is not the case for millions of Americans who continue to struggle with the economic and social impacts of the pandemic, including disruptions to daily life, loss and grief. For some, the physical and mental health effects of the virus continue to persist long after the period of initial infection. These lingering effects of a previous COVID-19 infection are better known as Long COVID.
Symptoms of Long COVID are numerous and varied. Common symptoms include fatigue, difficulty concentrating or “brain fog,” shortness of breath or difficulty breathing, chest pain, palpitations, cough, joint or muscle pain, depression, anxiety, and many other side effects. About a quarter of people with Long COVID face significant activity limitations.
Early population estimates from the Centers for Disease Control and Prevention (CDC) show that in 2022, about 7 percent of the total US adult population reported having long-term COVID. According to the US Government Accountability Office calculates, there are probably between 7.7 and 23 million people living with Long COVID in the United States. CDC data also reflect that Long COVID cases are reported in children, although less often than adult cases. A assessment suggests that about 1.3 percent of children age 17 and younger have experienced long-term COVID.
The impact of long-term COVID on mental health
The impact of the COVID-19 pandemic on our nation’s well-being is well-documented, with people of all ages and backgrounds reporting increased stress and behavioral health challenges for a variety of reasons, including physical and behavioral health symptoms from the effects of the virus, social isolation, financial insecurity, caregiver burnout and grief. The Substance Abuse and Mental Health Services Administration (SAMHSA), CDC and others have noted that during the pandemic, those who have mental health conditions and substance use disorders faced higher risks of complications.
For long-term COVID-19 sufferers who are dealing with lingering effects of a COVID-19 infection, the impact on both physical and mental health can be especially challenging, especially when there are no immediate answers or solutions.
Some of the more common mental health conditions associated with Long COVID include fatigue, sleep disturbances, depression, anxiety, psychosis, cognitive impairment, obsessive-compulsive disorder, and post-traumatic stress disorder. Both COVID-19 and Long COVID can leads to new onset of behavioral health conditions in those who have not previously reported these conditions and exacerbate complications for those with pre-existing mental health conditions; and substance use disorders.
SAMHSA’s work during and after the Public Health Emergency illustrates the significant effects that COVID-19 has had on behavioral health for both adults and children.
SAMHSA’s commitment to helping those affected by the prolonged COVID
Because of the burden Long COVID can have on behavioral health, SAMHSA and its federal partners are committed to helping individuals, families and caregivers, health professionals and others identify and manage this condition. Accordingly, SAMHSA has been involved in a number of efforts, including participating in the federal response to Long COVID, hosting technical expert meetings, and producing publications on effects of Long COVID on behavioral healthas guidance for primary care physicians on identifying and managing patients’ behavioral health symptoms. SAMHSA also works closely with key partners, including newly established ones HHS Office of Longitudinal Research and Practice. The federal government, researchers, clinicians, advocates, and policymakers have laid the groundwork to advance advances in prevention, diagnosis, treatment, and provision of services (PDF | 1.5 MB) for people dealing with long-term COVID.
SAMHSA Policy for Action Initiative
Recognizing concerns about Long COVID’s behavioral health impacts, SAMHSA hosted its first Long COVID Action Policy Initiative meeting in mid-May. This meeting brought together a group of researchers, clinicians, representatives from national organizations, people with lived experience of Long COVID, and federal agency colleagues. The Policy for Action Initiative was designed to create a unique partnership to transform behavioral health policies and conversations into concrete commitments and action on the ground. During this two-day meeting, participants discussed challenges related to the behavioral health effects of Long COVID and worked to identify key messages and strategies to raise awareness among public health professionals, behavioral health professionals, researchers, policymakers policy-making and the public. During the meeting, participants discussed and/or committed to the following:
- The importance of ensuring that mental health and substance use disorders receive the same attention and priority as other long-term effects of COVID.
- Communication materials and strategies for health care providers and patients, continuing education materials for health professionals, and ensuring adequate compensation of providers who diagnose and treat long-term COVID.
- Commit to steps such as highlighting long-term COVID and behavioral health in social media and agency and organization newsletters, and working together to support research, communication and policy action, educate respective members and stakeholders about with how long-term COVID affects patients and how best to help them and empower patients’ voices to destigmatize and humanize the condition. and
- Coordination and expansion among the network of actors and organizations focused on carrying out work to influence the landscape of Long COVID behavior-related services and advocates.
We recognize that much remains to be done to help the millions of Americans who are struggling to recover from Long COVID and who are feeling isolated, depressed, or dealing with other mental health or substance use conditions as a result. We want you to know that you are not forgotten. SAMHSA leadership is committed to continuing its work to support and strengthen efforts to address this issue. Long COVID is a complex set of conditions. Only through transparency and collaboration can we work to make a difference for those in need.
SAMHSA is committed to providing support and resources to those who need them. Visit the SAMHSA website to find resources such as FindSupport.gov, the 988 Suicide & Crisis Lifelineand more.