| America's mental health was in bad shape long before the coronavirus pandemic began. Princeton professors emeritus Anne Case and Angus Deaton coined the term "deaths of despair" in 2015 to describe a trend of middle-aged white men and women dying prematurely from suicides, overdoses and alcohol abuse dating back to the turn of the century. Now, mental health-focused researchers are finding that the isolation and economic pain caused by the Covid-19 crisis could lead America's long-running suicide and overdose crisis to get worse. A new paper, which wasn't peer-reviewed, found that over the next decade as many as 75,000 more people could die from suicides and substance-abuse-related deaths depending on the severity of the economic damage from the pandemic. The research was done by the Well Being Trust and researchers affiliated with the American Academy of Family Physicians. "I hope in 10 years people look back and say, 'Wow, they way overestimated it,'" said John Westfall, director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, who co-wrote the report.  Unemployment applications in Hialeah, Florida. Photographer: Joe Raedle/Getty Images North America It's not easy to build mental-health models for Covid-19: Nothing in history compares to it. The virus is one thing; then there's the isolation that comes with sheltering in place, the grief associated with losing loved ones and the economic fallout which is just starting to unfold. The unemployment rate has already soared to 14.7%, the highest since the government started collecting such data. The researchers looked at suicide rates in the last financial crisis to build models that could account for what's to come. "One of the main things people should take away from this paper is that employment matters," said Benjamin Miller, chief strategy officer at the Well Being Trust and a clinical psychologist who worked on the paper. "It matters for our economic livelihood, and for our mental and emotional health." So far, various U.S. pandemic-relief bills have allotted $425 million for mental health (by comparison, $25 billion has been set aside for a bailout of air carriers). There's still time to devise policies that prevent more pain. States that had more generous unemployment benefits during the last recession saw fewer suicides, said Julia Raifman, assistant professor of health law at Boston University School of Public Health. "That points the way to what we should be thinking about."—Cynthia Koons | 
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