Ohio Health Policy News

New research finds Black adults are more likely to visit emergency departments when experiencing a mental health problem than white adults but face longer delays, and are less likely to be admitted to a hospital for treatment (Source: “Study: Black People Visit ER for Mental Health at Highest Rates,” U.S. News, March 1).

A new analysis released Wednesday by the Centers for Disease Control and Prevention’s National Center for Health Statistics shows that from 2018 to 2020, non-Hispanic Black adults visited the emergency department for any mental health-related concern at an annual average rate of 97 visits per 1,000 adults, nearly double the rate of the national average. By comparison, the rate of mental health-related emergency department visits among non-Hispanic white adults was 53.4 per 1,000 from 2018 to 2020, while Hispanic adults had the lowest rate at 36 visits per 1,000.

The analysis did not examine contributing factors for the racial disparities found, but previous research has indicated people of color are routinely underdiagnosed and undertreated for mental illness, which has in part led to rising rates of drug overdose death and suicide.

New research from the American Psychological Association shows that state restrictions and lockdowns imposed during the first six months of the pandemic were not related to worsening mental health (Source: “Study: Early state lockdowns not tied to worse mental health,” CIDRAP News Scan, Oct. 18).

The study, published in Health Psychology, was based on data collected from a survey of more than 6,500 participants at the start of the pandemic from March 18 to April 18, 2020, and answers were compared with the same survey given to 5,600 of the same participants about 6 months later: from Sept. 26 to Oct. 16, 2020.

Though loneliness and symptoms of distress increased for participants during the first six months of the pandemic, those feelings were not related to state lockdowns, and instead were correlated with knowing someone who had the virus, and consuming pandemic-related media, researchers found.

"There were robust significant relationships between personal direct experiences with the pandemic—that is, knowing someone who got very sick or died or getting sick oneself—and increased global distress, loneliness, and traumatic stress symptoms," the authors concluded.

As the demand for mental health services grows — and with many psychologists aging and near retirement — Ohio lawmakers are sponsoring a bill aimed at increasing the number of mental health care providers (Source: “Ohio lawmakers propose a new way to increase the number of mental health providers,” Statehouse News Bureau, Oct. 13).

State Senator Theresa Gavarone (R-Bowling Green) said her bill would create more access to mental health professionals by allowing colleges to offer specialized master's degrees.

"It creates a new licensed professional in the state of Ohio who has the ability to prescribe and work under the supervision of a medical professional and just creates greater access for individuals in need of mental health services," Gavarone said.

The National Alliance on Mental Illness in Ohio estimates one in five people experience mental illness each year. Many times, people who need help for a mental health problem cannot get in to see a provider because there aren’t enough of them. The Ohio Department of Mental Health and Addiction Services shows between 2013 and 2019, there was a 353% increase in demand for mental health services.

Gavarone said she doesn’t expect this bill to be taken up before the end of this year but added she wants lawmakers to start considering the proposal soon.

A new report estimates that racial mental health disparities cost the United States around $278 billion between 2016 and 2020, putting a price tag on a health equity issue that’s long plagued the nation (Source: “Racial Mental Health Disparities Cost US $278B in 4 Years,” Patient Engagement, HIT, Sept. 14).

According to the report from Satcher Health Leadership Institute at Morehouse School of Medicine, between 2016 and 2020, the U.S. saw an excess of 117,000 premature deaths among indigenous and racial or ethnic minorities due to mental health needs, adding $278 billion in excess costs.

“Investing in mental healthcare saves lives and dollars — we have known this for decades, but until now did not fully understand the monumental impacts of neglecting to act,” Daniel E. Dawes, a professor and the executive director of the Satcher Health Leadership Institute, said in a statement.

At the conclusion of Suicide Prevention Awareness Month, new analysis from the Health Policy Institute of Ohio details the changing demographic trends in suicide deaths in Ohio (as illustrated in the graphic above).

According to data from the Ohio Public Health Data Warehouse, between 2007 and 2021 (the most-recent year in which data is available), suicide deaths increased for both male and female Ohioans, with a greater increase among males. Suicides among Black Ohioans have increased 56% over the past 14 years, compared to a 34% increase for white Ohioans. In terms of age groups, Ohioans ages 25-64 remain the most likely to die by suicide, although rates have increased for all ages since 2007.

Earlier this month, HPIO released a graphic illustrating how, between 2007 and 2021, the rate of suicide deaths in Ohio that involved a firearm increased by more than 50% and how, in 2021, suicides involving a firearm accounted for more than all other methods combined.

Suicide is preventable and the state’s 2020-2022 Suicide Prevention Plan includes evidence-informed strategies that both public- and private-sector leaders can implement to address the issue.

If you or someone you know is experiencing emotional distress or a suicidal crisis, please call the 988 Suicide and Crisis Lifeline, the Trans Lifeline at 877-565-8860 or the Trevor Project at 866-488-7386. If you don’t like talking on the phone, consider using the Crisis Text Line at www.crisistextline.org or text “4HOPE” to 741-741.

A panel of medical experts on Tuesday recommended for the first time that doctors screen all adult patients under 65 for anxiety, guidance that highlights the extraordinary stress levels that have plagued the United States since the start of the pandemic (Source: “Health Panel Recommends Anxiety Screening for All Adults Under 65,” New York Times, Sept. 20).

The advisory group, called the U.S. Preventive Services Task Force, said the guidance was intended to help prevent mental health disorders from going undetected and untreated for years or even decades. It made a similar recommendation for children and teenagers earlier this year.

The panel, appointed by an arm of the federal Department of Health and Human Services, has been preparing the guidance since before the pandemic. The recommendations come at a time of “critical need,” said Lori Pbert, a clinical psychologist and professor at the University of Massachusetts Chan Medical School, who serves on the task force. Americans have been reporting outsize anxiety levels in response to a confluence of stressors, including inflation and crime rates, fear of illness and loss of loved ones from Covid-19.

The new 988 Suicide and Crisis Lifeline is already reaching more Americans in distress – and connecting them to help faster — than the old 10-digit suicide prevention line it replaced July 16 (Source: “New 988 mental health crisis line sees jump in calls and texts during first month,” NPR, Sept. 10).

New data released last week by the U.S. Department of Health and Human Services show that in August – the first full month that 988 was operational — the Lifeline saw a 45% increase in overall volume of calls, texts and chats compared to August 2021.
 
The number of calls answered went up from 141,400 to 216,000 – a more than 50% increase, according to HHS officials. And texts answered went up by a whopping 1000% – from 3,400 in August, 2021, to 39,900 in August of this year. The number of chats on the Lifeline's website that were answered saw a 195% increase.
 
While the 988 Lifeline is accessible nationally, with a national network of call centers, it essentially functions as a state-run system. And states vary vastly in how much they have invested in the former 10-digit Lifeline and associated services. According to a recent analysis by the National Institute of Mental Illness, very few states have passed legislation to supplement the recent federal funds into 988 (Ohio has partial 988 implementation legislation pending).

As national and state organizations mark September as Suicide Prevention Awareness Month, data show that while suicide deaths among young Ohioans have risen overall in Ohio over the past two decades, the increase has been sharpest among Black Ohioans.

In 1999, the suicide rates for both white Ohioans and Black Ohioans ages 10 to 24 were the same: 6.8 per 100,000 people. By 2020 (the most recent year for which data is available), the rate for white Ohioans had risen to 11.2 (an increase of 64%) and the rate for Black Ohioans had risen to 12.8 (an increase of 88%).

More-recent national research indicates that the disparity in suicide rates may have increased during the COVID-19 pandemic.

Reducing suicide and eliminating disparities are priorities of the Ohio Department of Health’s 2020-2022 State Health Improvement Plan (SHIP). Public- and private-sector leaders can implement strategies identified in the SHIP and Ohio’s 2020-2022 Suicide Prevention Plan, including suicide fatality review boards, behavioral health integration with primary care and education on safe storage of lethal means (i.e., firearms and medications).

If you or someone you know is experiencing emotional distress or a suicidal crisis, please call the 988 Suicide and Crisis Lifeline; the Trans Lifeline at 877-565-8860 or the Trevor Project at 866-488-7386. If you don’t like talking on the phone, consider using the Crisis Text Line at www.crisistextline.org or text “4HOPE” to 741-741.

A new study has found that suicide attempts by ingesting toxic substances or overdosing on medications soared by 26% over the past five years among people ages 6 to 19 (Source: “A Growing Number of Young People Are Attempting Suicide by Self-Poisoning,” Time, June 1).
 
The study published in the journal Clinical Toxicology found that the number of self-poisoning attempts increased in each of the five consecutive years, from 75,000 in 2015 to 93,500 in 2020. During that same time period, there were a total of 514,350 calls to poison control centers involving children ages 6-19 who, according to the control centers’ guidelines for suspected suicide attempts, had “an exposure resulting from the inappropriate use of a substance for self-harm or self-destructive” reasons.
 
“We began to notice an increase in younger aged children attempting suicide by acute overdoses in our clinical practice at [the University of Virginia Health System],” said Dr. Christopher Holstege, chief of the division of medical toxicology at the University of Virginia School of Medicine and a co-author of the paper, in a statement. “We were disturbed at our institutional numbers and decided to perform research on the national numbers which confirmed that this increase was not just a local issue, but a national issue.”
 
Immediate help and resources are available for anyone who is in crisis. You can call the Suicide Prevention Lifeline 24/7 at 1-800-273-TALK (1-800-273-8255), or text the Crisis Text Line at 741741.

More than 4 in 10 U.S. high school students said they felt persistently sad or hopeless during the pandemic, according to government findings released Thursday (Source: “Pandemic took a toll on teen mental health, US study says,” Associated Press, March 31).
 
Several medical groups have warned that pandemic isolation from school closures and lack of social gatherings has taken a toll on young people’s mental health.
 
The Centers for Disease Control and Prevention study found that the pandemic did not affect teens equally. LGBT youth reported poorer mental health and more suicide attempts than others. About 75% said they suffered emotional abuse in the home and 20% reported physical abuse. By comparison, half of heterosexual students reported emotional abuse and 10% reported physical abuse, the CDC said.