What Mayors Need to Know about Stress and Mental Health

The Bloomberg Harvard City Leadership Initiative is collaborating with Bloomberg Philanthropies’ Coronavirus Local Response Initiative to support mayors as they manage COVID-19. This article covers key points from session four of the Coronavirus Local Response Initiative, drawing on the work of Kimberlyn Leary and Jorrit de Jong.

Photo by Kristina Tripkovic on Unsplash

Like physical health, mental health is complex and multifaceted, with effects along a broad continuum of wellbeing. Stress and anxiety are universal human experiences — normal and adaptive responses that evolved to keep us safe from threats of all kinds. Prolonged or severe stress, however, can become trauma. Stress is cumulative. For those already under various pressures, the addition of a new source of stress may exacerbate distress.

The most stressful events are those that are negative, uncontrollable, ambiguous, unpredictable, and require significant adaptation. Even for those of us not dealing with the acute stressors of illness, death, and/or loss of income, stay-at-home orders and social distancing disrupt the usual ways we orient and stabilize ourselves–our routines, social interaction, and sense of mastery.

You may already be seeing evidence of a surge in the demand for mental health care:

  • Among the general population, online resources like TalkSpace, BetterHelp, and the Crisis Text Line are seeing steep rises in new users, with people reporting feeling “terrified,” “overwhelmed,” “panicked,” and “paranoid.” A survey by McKinsey and Company during the last week of March showed a large majority of respondents feeling anxious and depressed and a significant uptick in substance abuse.
  • Healthcare workers are especially vulnerable to the mental effects of stress at this time. In a study out of China, half of healthcare providers involved in COVID-19 response reported depression and more than a third had trouble sleeping.
  • Social isolation and financial stress are also taking a toll on families, with parents reporting losing their tempers with their children frequently. Domestic violence is on the rise These stresses are heightened for parents of children with disabilities and those with health vulnerabilities.

Multiple studies show that the mental health effects of stress related to disasters can linger for months or years following the event. (See graphic below.) It may be decades before we fully understand the scope of the pandemic’s impact on mental and behavioral health.

The good news, however, is that stress-related mental health conditions are treatable — even under stay-at-home rules.

The WHO, CDC, and SAMHSA (Substance Abuse and Health Services Administration) offer the following guidance for positive coping:

  1. Adapt and use coping strategies that have helped you in the past.
  2. Create new routines and stick to the parts that work.
  3. Prioritize rest and nutrition.
  4. Stay in contact with family and friends (online and by phone).
  5. Look for opportunities to safely help others/neighbors.
  6. Minimize COVID-19-related media exposure. Look for media reports featuring practical steps to take.

↗️ Guidance from the National Alliance on Mental Illness (NAMI)

↗️ Guidance from the CDC

About the Bloomberg Harvard City Leadership Initiative

The Bloomberg Harvard City Leadership Initiative is a collaboration among Harvard Kennedy School, Harvard Business School, and Bloomberg Philanthropies. Its mission is to inspire and strengthen city leaders, as well as equip them with the tools to lead high-performing, innovative cities. Learn more on the Initiative’s website.




A resource center, curated by the Ash Center at Harvard Kennedy School, for public sector practitioners to highlight cases, teaching, policy solutions, and other examples of how governments are responding to the outbreak

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Harvard Ash Center

Harvard Ash Center

Research center and think tank at Harvard Kennedy School. Here to talk about democracy, government innovation, and Asia public policy.

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