When President Joe Biden announced his high-profile COVID-19 task force in late 2020, the headlines focused on the big names: epidemiologists, infectious disease leaders, former FDA officials, and public health heavyweights. It looked, on paper, like a dream team for fighting a respiratory virus. But there was one very loud silence in that lineup no dedicated mental health expert at the table.

That may sound like a small technical oversight, but it happened during what many clinicians were already calling a “second pandemic”: a wave of anxiety, depression, substance use, burnout, and grief that touched nearly every household in the United States. By late 2020, U.S. surveys were already showing that roughly half of adults reported symptoms of anxiety or depression, several times higher than pre-pandemic baselines.

So yes, forgetting mental health in the earliest design of the Biden COVID-19 task force wasn’t just a minor omission. It was a strategic miss. And even though the administration later rolled out major mental health initiatives, starting with a national mental health strategy and big investments in crisis services, that early absence still matters for how we think about pandemic preparedness going forward.

The original Biden COVID-19 task force: who was in the room?

In November 2020, the Biden transition team unveiled a 13-member COVID-19 advisory board. It included infectious disease experts, former federal health leaders, and public health scholars. These were exactly the people you’d expect to direct vaccine distribution, testing, hospital capacity, and masking guidelines. But there was no psychiatrist, psychologist, social worker, or behavioral health researcher in the core group. Multiple commentators, including clinicians and public health researchers, called out this gap and argued that mental health needed a seat at the table from day one.

That doesn’t mean the administration didn’t care about mental health. In fact, Biden’s broader health platform had already emphasized protecting the Affordable Care Act, expanding coverage, and strengthening parity between physical and mental health benefits. But the optics and structure of the COVID-19 task force mattered: when you are crafting national strategy for a once-in-a-century crisis, whoever is in the room shapes what counts as “urgent.”

In those early months, the dominant narrative centered around ventilators, ICU beds, and vaccine timelines. The mental health fallout was often framed as a sad but secondary side effect. Without a dedicated behavioral health voice embedded in the task force, the risk was that psychological and social harms would be treated as downstream “cleanup” issues, not as core elements of the response.

The mental health toll of COVID-19 in America

A “shadow pandemic” of anxiety and depression

The data make it clear that mental health was not a side story. It was central to the COVID-19 experience. Early in the pandemic, screening data and large surveys showed sharp spikes in anxiety and depression among Americans. One analysis found that rates of depression and anxiety in 2020 were many times higher than in 2019. Globally, the World Health Organization estimated a 25% increase in the prevalence of anxiety and depression in the first year of the pandemic.

In the United States, experimental data from the Census Bureau’s Household Pulse Survey tracked this crisis in real time. Week after week, large shares of adults reported symptoms of anxiety, depression, difficulty sleeping, and stress about finances, health, and caregiving. Other research found that by late 2020 about half of Americans reported significant anxiety and nearly as many reported depression symptoms.

Youth mental health: the crisis within the crisis

Young people paid an especially steep price. School closures, social isolation, family stress, and uncertainty about the future all collided. The U.S. Surgeon General later issued a landmark advisory on youth mental health, warning that symptoms of depression and anxiety among children and adolescents had roughly doubled during the pandemic, with about one in four experiencing depressive symptoms and one in five experiencing anxiety.

Surveys of high school students told a similar story. Roughly one-third of U.S. teens reported poor mental health during the pandemic, and many described persistent sadness, hopelessness, and suicidal thoughts. Even as classrooms reopened, these emotional scars did not automatically fade.

Long COVID and the long tail of distress

Add long COVID to the picture and the mental health stakes rise even further. Research has shown that cognitive difficulties, fatigue, insomnia, anxiety, and depression can linger months after the acute infection. Some studies suggest that mental recovery from COVID often takes longer than physical healing, with a substantial portion of people still reporting poor overall health many months later.

Put simply: if you were designing a pandemic response in 2020 based on what we already knew and what early data clearly signaled you would not treat mental health as optional.

Why leaving mental health off the task force was a miss

1. Policy decisions had psychological side effects

Pandemic policies were not just about virology and hospital capacity; they were about people’s lives, routines, and social networks. School closures, stay-at-home orders, limits on gatherings, and business shutdowns all had emotional and social costs. A task force that foregrounded mental health could have:

• Built mental health impact assessments into major policy decisions, the way economic impact analyses are often required.
• Helped design school reopening plans that paired academic catch-up with robust emotional support for students and teachers.
• Elevated the needs of parents (especially mothers), caregivers, and essential workers who faced severe burnout and stress.

Instead, mental health supports often arrived later, in separate initiatives and advisories, rather than being baked into the earliest rounds of decision-making.

2. Communication focused on case counts, not coping

Daily briefings and news cycles revolved around case curves, R-values, and vaccine rollouts. Those are crucial metrics, but they were only half the story. A behavioral health expert on the task force could have:

• Helped craft messages about managing anxiety, grief, and uncertainty alongside messages about masking and vaccination.
• Normalized seeking mental health care and using crisis services, making it clear that emotional distress was an expected response, not a personal failing.
• Ensured that campaigns about “flattening the curve” also highlighted ways to “protect your mind,” not just your lungs.

In fairness, many public health leaders and advocates did their best to talk about mental health, but a dedicated voice within the COVID-19 brain trust would have made those efforts more central and consistent.

3. Access gaps and equity issues needed earlier attention

The pandemic didn’t create mental health inequities, but it magnified them. Communities of color, low-income families, rural residents, and essential workers often had less access to affordable, culturally responsive mental health care. A task force that fully integrated mental health could have elevated:

• Telehealth policies that made it easier for people to see therapists and psychiatrists from home, and sustained those flexibilities long term.
• Workforce investments to address shortages of mental health professionals in underserved areas.
• Community-based approaches that funded local organizations, faith communities, and peer support networks as part of the national response.

Instead, many of these issues were tackled later, through a patchwork of stimulus funds, state initiatives, and separate federal strategies.

To be fair: the Biden administration did move on mental health

Calling the initial omission a “miss” doesn’t mean nothing happened. In fact, by 2022 and 2023 the administration was explicitly talking about a “national mental health crisis” and rolling out a multi-pillar strategy to address it.

Key actions included:

• A comprehensive national mental health strategy that aimed to strengthen system capacity, connect people to care, and build healthier environments.
• Nearly $4 billion from the American Rescue Plan to expand mental health and substance use services across the country.
• Major investments to scale up the 988 Suicide & Crisis Lifeline, making it easier for people in crisis to reach trained counselors by phone or text.
• A federal mental health research action plan, meant to prioritize brain and behavioral health across agencies and improve long-term understanding of mental illness.

Professional organizations praised many of these moves, and they marked a clear recognition that mental health is core public health, not an optional add-on.

Still, those policies came after the crucial early phase of the COVID-19 response. The question this article raises isn’t whether the Biden administration ever took mental health seriously clearly, it did. The question is whether the absence of dedicated mental health leadership in the original COVID-19 task force limited how fully and how early the nation responded to the psychological fallout.

What was lost by not embedding mental health from day one?

Slower integration of mental health into COVID metrics

Imagine if pandemic dashboards had, from early 2020 onward, displayed mental health metrics alongside hospitalizations and deaths: rates of serious psychological distress, crisis line call volumes, suicide attempts, and substance-related overdoses. We had data sources capable of informing those trends from rapid surveys to health system data but mental health indicators rarely shared the same spotlight as viral ones.

A task force member with behavioral science expertise could have pushed for those metrics to be integrated into dashboards and briefings, making it harder for policymakers and the public to ignore the “invisible” damage.

Fewer built-in supports for frontline workers and families

Frontline health care workers, teachers, grocery clerks, delivery drivers, and caregivers experienced immense stress and trauma. Programs to support them from peer support to trauma-informed supervision to dedicated counseling often emerged in a patchy way, funded by individual hospitals, unions, or local grants.

With mental health directly represented on the task force, we might have seen:

• National frameworks for protecting the mental health of essential workers.
• Specific funding streams tied directly to workforce well-being.
• Guidance for employers on realistic schedules, mental health days, and burnout prevention.

Missed opportunity to normalize mental health care

Public briefings were powerful cultural moments. The experts who stood behind the podium became symbols of scientific authority. Including mental health leaders in those settings more consistently could have helped normalize therapy, medication, and crisis support as ordinary tools for surviving an extraordinary situation.

Instead, many people turned to informal coping strategies: social media, doomscrolling, comfort eating, or quietly burning out. While self-care trends took off, access to structured mental health care lagged behind need, especially for marginalized communities.

Lessons for the next pandemic (because there will be one)

1. Put mental health experts on every major public health task force

If there is one clear takeaway, it is this: any national task force responding to a large-scale health emergency should have mental and behavioral health experts at the table from day one. Not as informal advisors, not as a separate working group, but as full members shaping the agenda, the data, and the public messaging.

2. Treat mental health metrics as key performance indicators

We track infections, hospital capacity, and vaccination coverage in real time. We should do the same for psychological distress, suicide attempts, overdose trends, and treatment access. With that information, leaders can adjust policies not just to flatten the viral curve, but to prevent a spike in despair.

3. Fund mental health infrastructure as core preparedness

You can’t surge a behavioral health workforce overnight. A resilient mental health system requires long-term investments in training, community programs, crisis services, and digital tools. That’s not glamorous, and it doesn’t fit neatly on a campaign poster, but it is essential if we want the next crisis to be less devastating.

4. Center equity from the start

Mental health inequities are not side issues; they are central to how communities experience and recover from crisis. Future task forces should partner early with community organizations, tribal nations, faith leaders, youth groups, and disability advocates to design responses that actually work for those most at risk.

5. Remember that recovery is not just physical

Even as hospitalizations fall and vaccines work, mental health recovery can lag. The long tail of COVID-19 grief, long COVID, financial strain, educational disruption will shape well-being for years. Preparedness plans must include long-term mental health recovery strategies, not just exit ramps for mask mandates and testing.

Experiences that show why forgetting mental health was a mistake

Statistics are important, but the impact of leaving mental health out of the early COVID-19 conversation shows up most clearly in lived experience in the stories people will tell years from now about this period.

Picture a nurse in a busy urban hospital in early 2021. She has watched entire families get admitted within days of each other. She has held a phone next to a patient’s bed so relatives can say goodbye over video. She goes home after 14-hour shifts, worries about bringing the virus back to her own family, and lies awake replaying the day in her head. For months, her hospital has been heroic about ventilators and PPE, but formal mental health support is thin. Maybe there’s a flyer about an employee assistance program tacked to a bulletin board in the break room, but it feels like an afterthought. A national task force with mental health baked in might have pushed for stronger, standardized systems to support her and her colleagues not just with applause at shift changes, but with trauma-informed care, schedule protections, and real time to recover.

Or think about a high school student who spent her sophomore and junior years toggling between remote classes and hybrid schedules. She watched her friendships drift into group chats and video calls. Her family struggled with job losses and illness. By the time school fully reopened, she felt behind academically and exhausted emotionally. Her school had a part-time counselor already overwhelmed before COVID-19; the waiting list for a private therapist in her town stretched for months. If mental health had been elevated earlier in federal pandemic planning, funding for school-based supports, tele-mental health, and youth-focused programs might have been more robust and more evenly distributed across districts, instead of depending so heavily on local resources.

Families also felt the gap in subtler ways. Parent groups traded advice on social media about handling kids’ anxiety, managing their own burnout, and navigating the blurred lines between home, office, and classroom. Some found creative solutions outdoor meetups, mutual aid networks, virtual support groups. Others felt isolated and ashamed, convinced they were the only ones not “using lockdown to learn a new skill.” A more visible federal emphasis on mental health could have normalized these struggles and encouraged families to see emotional well-being as part of the public health mission, not a private failing to hide.

Even people who never caught the virus often describe the pandemic as a before-and-after moment for their mental health. The constant uncertainty about jobs, rent, caregiving, and safety left a residue of hypervigilance that didn’t magically disappear once case counts dropped. Many report that their sense of time feels broken, their tolerance for stress is lower, and their patience is thinner. A task force that treated mental health as central might have led to more national campaigns about processing collective trauma, honoring grief, and rebuilding social connection, rather than quietly hoping everyone would “bounce back” once restrictions eased.

On the flip side, the past few years have also shown how resilient people can be when given even modest support. Communities that had access to culturally competent therapists, accessible telehealth, peer support, and reliable information about mental health fared better. That is exactly why the composition of a COVID-19 task force and how it thinks about mental health matters. When leaders send the signal that your emotional well-being is as important as your temperature or oxygen level, systems begin to organize around that principle.

In the end, forgetting mental health in the original design of the Biden COVID-19 task force didn’t doom the response but it did delay a more holistic one. The administration eventually invested heavily in mental health, and that deserves credit. The bigger lesson, though, is that in any future crisis, we cannot afford to treat the mind as an optional appendix to the body. Mental health belongs at the center of pandemic planning, not on the sidelines waiting to be invited in after the first wave has passed.

Next time we build a national response team, the question should not be, “Do we really need a mental health expert here?” It should be, “How many do we need, and how quickly can we get them to the table?”

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