Apparently the pandemic made things much worse.
-a plague of abuse of mind-altering drugs including prescription ones
-the ability for those who've gone down that road to share their lifestyle with others that don't require them to physically meet. They can validate and reinforce their mental issues meeting others online.
-the migration of intelligent capable people away from dead and dying areas (including across oceans and continents), leaving behind a condensed number people who are "missing something"
-the multi-generational consequence of closing mental institutions where insane people have been breeding with others who belong in an institution.