According to data from the World Health Organization, someone commits suicide every 40 seconds – 800,000 per year – and for every suicide, 20 more were attempted. That means 5-7 people will commit suicide during the time it takes you to read this article.
The CARE humanitarian organization recently issued a report focusing on women’s mental health, reporting that women were nearly three times more likely than men (27% vs. 10%) to report their mental health had been impacted by the pandemic, citing issues such as skyrocketing unpaid care burdens and worries about livelihoods, food, and health care. Women were also nearly twice as likely as men to report having trouble accessing health services, including access to maternal, sexual, and reproductive health. The report also noted a global rise in exposure to gender-based violence, with part of that due to COVID-19 lockdowns.
Many of my female friends share my concerns about the impact of COVID on their school-aged children for reasons ranging from:
· Social-media angst about the election since most of us rarely get off our devices.
· Lack of physical contact with friends at school and elsewhere
· Remote-learning challenges, including its impact on their grades and SAT scores as they decide which college they’ll (hopefully) attend next fall – with little ability to visit campuses.
· College students (particularly freshmen) studying in a converted bedroom or at the dinner table rather than enjoying on-campus activities and interactions.
We are understandably focusing on the importance of wearing masks and social distancing. But as I started doing the research for this column, I was surprised by some different trends:
· Symptoms of anxiety and depressive disorders have more than tripled among U.S. adults compared to this time last year – with women and Black and Latinax communities most acutely impacted.
· Calls into crisis hotlines normally decrease by 30% or more over the summer. Many saw increases this year, and a higher proportion came by text from teens stuck at home and not wanting to reach out with family members around. That reduces the ability to have a dialogue with the teen. I also saw an article that doctors in Maryland have seen an increase in specifically African-American suicides during the pandemic.
· The U.S Centers for Disease Control and Prevention says suicidal ideation is up among younger adults, while a Canadian study says the frequency of cannabis and alcohol use by teens has risen, with solitary substance use becoming more common.
· Mental health issues are the leading cause of disability and poor life outcomes in young people aged 10-24 years, contributing up to 45% of the overall burden of disease in this age-group.
· More than a third of youth receiving mental health services in the United States get them in an academic setting, which means that in many places that service has been disrupted.
· Prescriptions for antidepressants, anti-anxiety, and anti-insomnia medications shot up 21% between February and March, according to Elemental.
The IMD Exclusion
About one in eight visits to hospital emergency rooms involve a mental health or substance use condition. Very few of those people end up in beds because of a federal policy called the Institutions for Mental Disease Exclusion.
The IMD Exclusion was part of the 1965 law that established Medicaid. It prevents the program from funding care for mentally ill adults while they live in hospitals or even adult homes with more than 16 beds. It basically created a financial incentive for states to kick the mentally ill out of hospitals. As a result, the country has lost more than 450,000 beds since the 1950s.
COVID-19 has exacerbated the problem. Reports across the country are bubbling up about the closing of psychiatric beds, according to officials in New York, Illinois, Massachusetts, Texas, and here in Washington, D.C. In some cases, patients are being discharged even though many still showed signs of psychosis and mania. Those closures are forcing patients to turn to community organizations that help people outside of hospitals, but they’re struggling to meet that need.
The National Council for Behavior Health reports that in September nearly two-thirds of more than 300 of those community organizations had to cancel, reschedule, or turn away patients. These issues are rooted in poor reimbursement from insurers including Medicaid and because hospitals are preparing for a surge plan in the event of a second wave of Covid-19.
Rep. Brian Fitzpatrick (R-PA) and Rep. Eddie Bernice Johnson (D-Texas) have led bipartisan efforts to repeal the IMD Exclusion, with support from the White House. Fitzpatrick has said “the IMD exclusion has turned into federally mandate neglect of those suffering from mental illness. Repealing the exclusion will remove a major barrier to care for patients and make our communities healthier.” Readers should reach out to their representatives and candidates in your districts to support these efforts.
What Can We Do?
As the single mom of a middle-school child, I’m often asked by other mothers what we can do to help grow and nurture our children in this environment when we’re often not even nurturing ourselves. Here are a few thoughts:
· Keep it simple for you and your child: Get some fresh air one or more times a day, find ways to socialize at a distance or virtually, and take care of yourself through healthy eating, exercise, or sleep. Listen to relaxation recordings. Have conversations with co-workers while taking a walk outside, instead of in front of your computer.
· Control what you can control. Routines can beat back those feelings of uncertainty, including morning alarms, daily showers, and breaks from work and screen…and particularly social media. Part of this is about being a good role model for our children. I was also impressed by this editorial from the University of South Carolina student newspaper, where the staff realized it was time for a break after an exhausting semester filled with constant breaking news, the stress of COVID-19 and, full-time school.
· Follow your child’s lead. Just listen. Make sure they feel heard. They want to be able to talk about anything with no repercussions. I had a father tell me that his job is to offer solutions or play ‘devil’s advocate.’ That’s not the best approach right now. Ask them what they can control and what they can’t control and let them acknowledge those things out loud. That said, watch for signs of a ore serious issue, including bad moods they can’t seem to bounce back from.
· Pay attention to the narration in your head. Try to avoid agonizing about worst-case scenarios because that can quickly zap your mental reserves and feed your anxiety. Work on adjusting your inner monologue to something more patient and accepting. You need to embrace the uncertainty. Getting through this may take longer than we thought, but it’s not forever.
· Push for equity accountability. Global leaders need to put their money where their mouths are and provide funding that will support women and girls. Support the ones who support us.