Mental health

COVID-related depression and anxiety are improving, still higher than pre-pandemic

While Americans reported heightened symptoms of anxiety and depression during the pandemic peaking last winter, their symptoms had improved by this past June, according to a new CDC study (Source: “COVID nearly doubled self-reported anxiety symptoms,” Axios, Oct. 6).

Still, Americans reported their anxiety and depression symptoms are still higher than they were before the pandemic. The average anxiety severity score increased 13% from late August to December 2020 and then decreased nearly 27% from December to late May and early June this year.

About a fifth of U.S. adults still experience high levels of psychological distress, per the Pew Research Center, especially adults under 29, those with lower income or adults with a disability or health conditions.


Ohio study finds Black children twice as likely to die by suicide

Black children ages 5 to 12 are twice as likely to die by suicide as their white counterparts, a new study from Nationwide Children's Hospital in Columbus shows (Source: “Black children are twice as likely to die by suicide, Nationwide Children's study finds,” Columbus Dispatch, Sept. 9).

Research on suicide by Black youths is extremely limited and this study sought to identify the circumstances that arise when young Black people take their own lives.

"[W]e wanted to look specifically within Black youth only to get a clear understanding of what is happening within this population,” said Dr. Arielle Sheftall, principal investigator in the Center for Suicide Prevention and Research and the Abigail Wexner Research Institute at Nationwide Children’s.

Black girls, the study found, were more likely to experience a crisis with a boyfriend or girlfriend prior to death and died by suicide within 24 hours of an argument. Black boys were more likely to have experienced a recent legal problem and when compared with Black girls were less likely to have received prior mental health treatment, the study found.

Younger children who died by suicide, especially those 5 to 11 years of age, were more likely than older children to have experienced family and school problems. If Black children ages 5 to 11 were diagnosed with a mental health concern, it was more likely to be attention deficit disorder (ADD) or attention deficit hyperactive disorder (ADHD), according to Nationwide Children's.

“When implementing suicide prevention with Black youth, you have to start from ground zero," Sheftall said. "You have to figure out what the risk factors are for Black youth and then evaluate which prevention programs are beneficial or if adaptation of the prevention programs are needed."


Organizations aim to connect patients, therapists of color

A number of new organizations aim to digitally connect patients with mental health providers who value and understand different cultures (Source: “It’s Hard to Search for a Therapist of Color. These Websites Want to Change That.,” New York Times, July 16).

In recent years there has been an expanding number of digital companies and nonprofits created to help people of color find a therapist they can trust — someone who is not only skilled in the best evidence-based treatments but also culturally competent. In other words, a provider who is aware of their own world views, knowledgeable about diversity and trained to connect with different types of clients.

The founders of these organizations say there has always been a need for such services, and even more so now that people are coping with the stressors of the pandemic and the racial reckoning that followed the killing of George Floyd by the Minneapolis police.

Studies have shown that mental health treatments can be more effective when a client feels that their therapist values culture.

It can be difficult for people of color to locate a therapist with a shared cultural background.  An American Psychological Association report found that only 5% of psychologists are Hispanic and 4% are Black — 86% are white. A similar disparity exists among the country’s social workers and psychiatrists.


States not ready to meet mental health needs of students this fall, report finds

A report released this week from advocacy group Mental Health America found that a majority of states are not ready to address youth mental health as schools prepare to reopen for in-person learning in the fall (Source: “Analysis: Most states not ready to tackle youth mental health ahead of fall,” The Hill, July 20). 

The analysis reports that just 14 states have fully expanded Medicaid to cover mental health services in schools, and only a handful have legislation requiring mental health education. The lack of access and education make states unprepared to deal with mental health issues among children, which were exacerbated by the pandemic, the report said. 

Children of color are more likely to receive school-based mental health services than white children, so limited resources can also lead to disparities in who is getting care. And although Black and Latino children are less likely than white children to get mental health treatment for depression, they made up the largest increases in the proportion of youth experiencing suicidal ideation between 2019 and 2020, the report said.

Advocates say the coronavirus pandemic worsened an already existing mental health crisis devastating young people. The percentage of 12- to 17-year-olds who reported a past-year major depressive episode doubled over the past 10 years, according to the National Survey on Drug Use and Health. 


Feds consider adding text option to new 988 suicide hotline

Recognizing that many Americans rely on texting, U.S. regulators are weighing whether to require that phone companies allow people to text the new 988 suicide hotline (Source: “Texting option weighed for upcoming ’988′ suicide hotline,” Associated Press, April 22).

The Federal Communications Commission (FCC) last summer voted to require a new “988” number for people to call to reach a suicide-prevention hotline. Phone companies have until July 2022 to implement it. Once it’s in place, people will be able to dial 988 to seek help, similar to how 911 is used for emergencies. Currently, the National Suicide Prevention Lifeline uses a 10-digit number, 800-273-TALK (8255), which routes calls to about 170 crisis centers across the country.

Crisis counselors began responding to texts sent to the Lifeline last August, the FCC said. On Thursday, the agency voted unanimously to start a process that would also require phone companies to let people text 988. The agency noted the importance of texting for young people and those who are deaf, hard of hearing or have speech disabilities.

“While a voice hotline has its benefits, traditional telephone calls are no longer native communications for many young people. Texting is where they turn first,” said FCC Acting Chairwoman Jessica Rosenworcel in a statement. “So it’s time to make the suicide prevention hotline text accessible with 988.”


Ohio to create statewide support system for child and adolescent behavioral health

Ohio state agencies have announced plans to create a statewide center that will offer support to child and adolescent behavioral health programs and agencies, including providing services to keep children out of foster care (Source: “Ohio looks to form new statewide support system for child and adolescent behavioral health,” Cleveland Plain Dealer, March 12).

Ohio’s Child and Adolescent Behavioral Health “Center of Excellence” will offer training and technology and administrative services, including increased access to government support through telehealth. Multiple departments, including the Ohio Department of Job and Family Services and the Ohio Department of Mental Health and Addiction Services, created the request for qualified contractors to help develop the center.

Case Western Reserve University’s Center for Innovative Practices, through a two-year, $3.6 million contract, will organize the creation and operations.


Mental health demands rise as states face tighter budgets

States across the U.S., facing COVID-19 related budget shortfalls, are also contending with increased demand for mental health services as a result of the pandemic (Source: “As Demand for Mental Health Care Spikes, Budget Ax Set to Strike,” Kaiser Health News, Feb. 5).

A Kaiser Family Foundation poll found that demand for mental health services rose from 1 in 3 people in March to more than half of people surveyed in July.

The full extent of the mental health crisis and the demand for behavioral health services may not be known until after the pandemic is over, mental health experts said. That could add costs that budget writers have not anticipated.

“It usually takes a while before people feel comfortable seeking care from a specialty behavioral health organization,” said Chuck Ingoglia, president and CEO of the nonprofit National Council for Behavioral Health in Washington, D.C. “We are not likely to see the results of that either in terms of people seeking care — or suicide rates going up — until we’re on the other side of the pandemic.”


ACEs cost Ohio $10 billion a year in healthcare costs, new HPIO analysis finds

First-of-its kind analysis by the Health Policy Institute of Ohio has found that if adverse childhood experiences (ACEs) are eliminated, more than $10 billion in annual healthcare and related expenses could be avoided in Ohio.

The analysis is included in a new HPIO policy brief, Adverse Childhood Experiences (ACEs): Economic Impact of ACEs in Ohio. The study also found that focusing action on reducing ACEs, particularly those associated with behavioral health, can yield significant savings. For example, more than $4.5 billion in annual spending to treat depression in Ohio is attributable to ACEs.

“The research is clear that ACEs result in both significant health and economic impacts,” the brief states. “Economic costs from ACEs are incurred across the public and private sectors, including substantial costs to the healthcare system. The economic burden of ACEs also impacts the state child protection, behavioral health, criminal justice and education systems, as well as private sector businesses. By preventing and mitigating the impacts of ACEs, policymakers and others can put Ohio on a path towards improved health value.”

The brief is the second in three planned briefs as part of HPIO’s Ohio ACEs Impact Project. In August 2020, HPIO released the first brief, Adverse Childhood Experiences (ACEs): Health impact of ACEs in Ohio.


CDC: Teen mental-health emergency visits climb during pandemic

The proportion of mental health-related pediatric visits to hospitals are on the rise during the coronavirus pandemic, according to a new federal analysis (Source: “CDC: Proportion of pediatric emergency room visits for mental health increased sharply amid pandemic,” The Hill, Nov. 12).

According to analysis from Centers for Disease Control and Prevention, mental health-related emergency room visits increased 31% for children between the ages of 12 and 17 from March to October compared to the same period in 2019. There was also a 24 percent increase in emergency room visits for children between the ages of 5 and 11.

The increase comes as in-person school schedules have been dramatically reduced to stem the spread of COVID-19, limiting children's interactions with peers and teachers. In addition, sports and extracurricular activities have been limited or canceled — conditions that could isolate children at home causing anxiety, depression, lack of sleep and bad eating habits. 

The CDC analyzed hospital data from 47 states that comprised about 75% of nationwide emergency room visits. One in 85 pediatric visits were mental health-related from March to October in 2019, compared to one in 60 in 2020.


Study: Many children do not receive follow-up care for mental health conditions

A large new study finds that mental health care for many children in the U.S. falls far short, particularly when it comes to the follow-up treatment they receive (Source: “New research shows many children with mental health conditions don’t get follow-up care,” Stat News, Sept. 22).

The study, published Monday in Proceedings of the National Academy of Sciences, examined insurance claims from children between the ages of 10 and 17 covered by Blue Cross Blue Shield. Of the more than 2 million children included in the study, nearly one in 10 had a claim related to mental illness between 2012 and 2018.

The authors found that only 71% of the children received treatment in the 3 months that followed an initial insurance claim — but the study found that rate varied widely from one ZIP code to the next. In the best-performing ZIP codes, nearly 90% of children received follow-up care within three months of an initial insurance claim. In the worst-performing areas, only half of the children got that care.

In the past, some experts have suggested that shortages of qualified mental health providers are to blame for shortcomings in adolescent mental health care, with pediatricians often left to fill the gap. But the authors concluded that the disparities detailed in the study couldn’t be simply explained by staffing shortages.

The study found that the number of therapists in a given area is slightly associated with the chance that a child will receive follow-up treatment — but is far more closely correlated with the type of treatment a child receives. In communities where there are more psychiatrists, drug-only treatment and treatment with red flag drugs is more common. In communities with more of a supply of therapists, therapy-only treatment is more prevalent.