The next Covid crisis could be a wave of suicides
Mental health experts worry that the economic uncertainty and social isolation of the pandemic will make things worse at a time when the health care system is already overwhelmed.
CYNTHIA KOONS, RILEY GRIFFIN and EMMA COURT 9 May, 2020 9:01 am IST
Representational image of suicide. Photo| Pixabay
Representational image of suicide. | Pixabay
Text Size: A- A+
New York: The isolation, grief and economic hardship related to Covid-19 are creating a mental health crisis in the U.S. that researchers warn could make the already-rising suicide rate worse.
A study released Friday tried to quantify the toll. The paper, which was not peer-reviewed, found that over the next decade as many as 75,000 additional people could die from “deaths of despair” as a result of the coronavirus crisis, a term that refers to suicides and substance-abuse-related deaths. The research was done by the Well Being Trust and researchers affiliated with the American Academy of Family Physicians.
“I hope in 10 years people look back and say, ‘Wow, they way overestimated it,’” said John Westfall, director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, who co-wrote the report.
Even as the American economy rebounded after the last recession, suicides and overdoses cut into Americans’ life expectancy. Mental health experts worry that the economic uncertainty and social isolation of the pandemic will make things worse at a time when the health care system is already overwhelmed. The suicide rate in the U.S. has been rising for two decades, and in 2018 hit its highest level since 1941, according to a viewpoint piece in JAMA Psychiatry in April called “Suicide Mortality and Coronavirus Disease 2019 – A Perfect Storm?” Author Mark Reger argued social distancing could hamper suicide prevention efforts and said ensuring that doesn’t happen is a “national public health priority.”
“There’s a paradox,” said Jeffrey Reynolds, president of a Long Island-based nonprofit social services agency, the Family and Children’s Association. “Social isolation protects us from a contagious, life-threatening virus, but at the same time it puts people at risk for things that are the biggest killers in the United States: suicide, overdose and diseases related to alcohol abuse.”
Advertisement: 6:42
VDO.AI
Also read: Indians talking mental health aren’t ‘millennial snowflakes’. Time for bosses to catch up
Since the middle of March, the number of people filing for unemployment benefits has reached around 33 million. Americans’ life satisfaction has eroded rapidly throughout that same period, according to a poll released Friday by Gallup. The percentage of U.S. adults who are very content with their current lives and optimistic about their future outlook has dropped to a low not seen since November 2008 during the Great Recession, showed the analysis of more than 4,000 surveys.
“One of the main things people should take away from this paper is that employment matters,” said Benjamin Miller, chief strategy officer at the Well Being Trust and a clinical psychologist who worked on the paper. “It matters for our economic livelihood, and for our mental and emotional health.”
The financial uncertainty caused by the coronavirus pandemic, coupled with the pervasive sense of isolation exacerbated by stay-at-home orders, makes this moment unprecedented—different from any other economic downturn in recent history—and thus, potentially difficult to model based on past events.
“It’s useful to have a wake-up call,” said Ken Duckworth, chief medical officer at the National Alliance on Mental Illness. “Unemployment is going to have a very important impact on deaths of despair.”
Already data is showing lower-income Americans are more impacted by coronavirus-related stress than their wealthier counterparts: A Kaiser Family Foundation study that showed 26% of people making less than $40,000 a year said the virus had a “major negative impact” on their mental health; only 14% of people making $90,000 or more a year said the same held true for them.
Johns Hopkins Bloomberg School of Public Health started measuring “mental distress” starting in March drawing on studies from the SARS epidemic of 2003. Early in the month, hotspots like California, Washington, New York and Massachusetts reported mental distress “significantly increased” — even when adjusting for variables like age and income. Distress was higher among people who used alcohol or marijuana more frequently in the past week or who’d consumed more media or social media. It was also higher in younger people, perhaps surprising given that Covid-19 is more lethal for older people.
Also read: Locked down and anxious, more and more Indians are making panic calls, seeking therapy
New York Governor Andrew Cuomo said his state is seeing a rise in drug use, alcohol consumption and domestic violence. “It has caused serious mental health issues,” he said in a public briefing last week. He encouraged New Yorkers to take advantage of a hotline set up for those in emotional distress. Meanwhile, on the national level, the Substance Abuse and Mental Health Services Administration reported an 891% increase in calls to its Disaster Distress Hotline in March compared with a year earlier.
“We’ve seen from past work that policies play a really important role in shaping people’s experience and well-being,” Julia Raifman, assistant professor of health law at Boston University School of Public Health, said. New York, for example, asked psychologists and psychiatrists to volunteer to provide some free mental health care, which she said was a positive step. “I hope we’ll see other states start to do that. I think there’s a lot of room for innovation here.” States that had more generous unemployment benefits during the last recession saw fewer suicides, Raifman said.
Miller’s paper this week proposes long-term solutions like helping unemployed people find meaningful work or training the armies of contact tracers who will be sent out into communities to identify people at risk of a mental health crisis. He sees building up community-based mental health care services as a way to serve more people in need. Congress granted $425 million for mental health and substance use disorder initiatives in the Coronavirus Aid, Relief and Economic Security Act, or CARES, but Miller called that “almost an embarrassment” considering airlines got $25 billion in aid. “We are not taking this seriously as a nation,” he said.
The Crisis in Youth Suicide
Too often, suicide attempts and deaths by suicide, especially among the young, become family secrets that are not investigated and dealt with in ways that might protect others from a similar fate.
Credit...Gracia Lam
Jane E. Brody
By Jane E. Brody
Dec. 2, 2019
76
The death of a child is most parents’ worst nightmare, one made even worse when it is self-inflicted. This very tragedy has become increasingly common among young people in recent years. And adults — parents, teachers, clinicians and politicians — should be asking why and what they can do to prevent it.
In October, the Centers for Disease Control and Prevention reported that after a stable period from 2000 to 2007, the rate of suicide among those aged 10 to 24 increased dramatically — by 56 percent — between 2007 and 2017, making suicide the second leading cause of death in this age group, following accidents like car crashes.
“We’re in the middle of a full-blown mental health crisis for adolescents and young adults,” said Jean M. Twenge, research psychologist at San Diego State University and author of the book “iGen,” about mental health trends among those born since 1995. “The evidence is strong and consistent both for symptoms and behavior.”
Along with suicides, since 2011, there’s been nearly a 400 percent increase nationally in suicide attempts by self-poisoning among young people. “Suicide attempts by the young have quadrupled over six years, and that is likely an undercount,” said Henry A. Spiller, director of the Central Ohio Poison Center, who called the trend “devastating.” “These are just the ones that show up in the E.R.”
ADVERTISEMENT
Continue reading the main story
Had any other fatal or potentially fatal condition leapfrogged like this, the resulting alarm would surely have initiated a frantic search for its cause and cure. But too often suicide attempts and deaths by suicide, especially among the young, become family secrets that are not investigated and dealt with in ways that might protect others from a similar fate.
“We’re at a point now where this issue really can’t be ignored,” said John P. Ackerman, clinical psychologist and coordinator of suicide prevention at Nationwide Children’s Hospital in Columbus, Ohio. “We invest heavily in crisis care, which is the most expensive and least effective means of preventing suicide.”
Unlock more free articles.
Create an account or log in
He proposed instead that more time and money be spent “on identifying kids who are most vulnerable, helping them respond effectively to stress, and teaching them what they can do in a crisis. And we need to start early, in the elementary grades. We haven’t even begun to use the resources that we know work. We have to be proactive.”
In Ohio, he said, “about 40,000 students have been screened for depression and suicide risk, and hundreds of kids have been linked to services. It’s not putting ideas in their heads to ask directly whether they’ve had thoughts of suicide or dying. That doesn’t increase their risk. Rather, it’s relieving. You actually reduce the risk if you help kids talk through these difficult feelings.”
Although no one can say with certainty why suicide has become such a crisis among the young, experts cite several factors that parents, schools and others might be able to modify or control. Dr. Spiller, for example, attributes the rise in suicide attempts largely to the effects of social media and how teens and young adults communicate with their peers.
Editors’ Picks
I’m a U.S. Citizen. Where in the World Can I Go?
The Chicks Are Done Caring What People Think
‘Hamilton’ and the Historical Record: Frequently Asked Questions
ADVERTISEMENT
Continue reading the main story
“Kids now never disconnect,” he said. “They’re connected 24/7. They go to bed with their smartphones. It may be cyberbullying. It may be envy. Maybe many things are going on here.”
One thing the research didn’t find was a link of teen suicides to the opioid crisis. Instead, in school-age adolescents, it found a rise in suicide attempts during school months — September until December, then again January through May — that doesn’t happen in adults.
The rise in attempted and completed suicides by young people correlates directly with their access to smartphones, Dr. Twenge said. “Developmentally, these ages have always been difficult, but that’s been taken to the next level by smartphones, social media and the constant pressure to be online.”
“Eighty-five percent of teens are looking at social media,” she said. “There’s less face-to-face time spent with friends. It’s now the norm to sit home Saturday night on Instagram. Who’s popular and who’s not is now quantifiable by how many people are following you. Kids are spending as much as eight hours a day on social media, where there’s a lot of negativity, competition and jockeying for status and unfiltered access to sites that tell them how to harm themselves.”
Dr. Ackerman, who noted that “young brains are less adept at dealing with complex situations,” likewise believes social media plays an important role in the suicide crisis among the young. But he sees the problem more broadly and said there is a need for schools to help counter it. Staff can be trained and screening done within schools, he said.
“Ultimately it’s a combination of economic, social and technological factors that come together along with family and school issues, and kids are less equipped to tackle these problems,” he said.
Sleep, or rather, not enough of it, is another issue undermining the resilience of today’s teens.
Several studies have found a link between “problematic internet and social media use and sleep disturbance among youth,” and that “these associations contribute to depressive symptoms in this group,” Dr. Twenge and co-authors reported in the Journal of Abnormal Psychology.
ADVERTISEMENT
Continue reading the main story
“Two surveys have shown that teens are not sleeping enough, and having a smartphone in the bedroom results in less sleep and poorer quality sleep,” she said. “It’s too tempting to stay up late looking at the phone, and the blue light it emits keeps the brain thinking it’s daytime. Almost everything done on devices is psychologically stimulating. The brain can’t slow down and relax.”
Her advice: “Avoid looking at devices within an hour of bedtime, and buy an alarm clock. It’s not the technology itself that’s the problem — it’s how we use it. We have to use it more mindfully.”
She urges parents to set reasonable limits about kids’ use of technology. Setting such limits is “not only good for kids, but they appreciate it in the long run,” she said. She noted that modern smartphones have parental control systems built in and parents can set kids’ phones to shut down at 9 p.m.
Experts also urge parents to check in with their teenage children regularly, asking how they’re feeling and whether they ever think about dying. “As early as elementary school, children can have responsible conversations about suicide,” Dr. Ackerman said. “We need to prepare young people to talk about their emotions early in life.”
He and others also emphasized the importance of controlling access to possible means of suicide, which they note is most often an impulsive act. Youngsters should never have uncontrolled access to guns, drugs or other substances that can result in a fatal overdose.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
Mental health experts worry that the economic uncertainty and social isolation of the pandemic will make things worse at a time when the health care system is already overwhelmed.
CYNTHIA KOONS, RILEY GRIFFIN and EMMA COURT 9 May, 2020 9:01 am IST
Representational image of suicide. Photo| Pixabay
Representational image of suicide. | Pixabay
Text Size: A- A+
New York: The isolation, grief and economic hardship related to Covid-19 are creating a mental health crisis in the U.S. that researchers warn could make the already-rising suicide rate worse.
A study released Friday tried to quantify the toll. The paper, which was not peer-reviewed, found that over the next decade as many as 75,000 additional people could die from “deaths of despair” as a result of the coronavirus crisis, a term that refers to suicides and substance-abuse-related deaths. The research was done by the Well Being Trust and researchers affiliated with the American Academy of Family Physicians.
“I hope in 10 years people look back and say, ‘Wow, they way overestimated it,’” said John Westfall, director of the Robert Graham Center for Policy Studies in Family Medicine and Primary Care, who co-wrote the report.
Even as the American economy rebounded after the last recession, suicides and overdoses cut into Americans’ life expectancy. Mental health experts worry that the economic uncertainty and social isolation of the pandemic will make things worse at a time when the health care system is already overwhelmed. The suicide rate in the U.S. has been rising for two decades, and in 2018 hit its highest level since 1941, according to a viewpoint piece in JAMA Psychiatry in April called “Suicide Mortality and Coronavirus Disease 2019 – A Perfect Storm?” Author Mark Reger argued social distancing could hamper suicide prevention efforts and said ensuring that doesn’t happen is a “national public health priority.”
“There’s a paradox,” said Jeffrey Reynolds, president of a Long Island-based nonprofit social services agency, the Family and Children’s Association. “Social isolation protects us from a contagious, life-threatening virus, but at the same time it puts people at risk for things that are the biggest killers in the United States: suicide, overdose and diseases related to alcohol abuse.”
Advertisement: 6:42
VDO.AI
Also read: Indians talking mental health aren’t ‘millennial snowflakes’. Time for bosses to catch up
Since the middle of March, the number of people filing for unemployment benefits has reached around 33 million. Americans’ life satisfaction has eroded rapidly throughout that same period, according to a poll released Friday by Gallup. The percentage of U.S. adults who are very content with their current lives and optimistic about their future outlook has dropped to a low not seen since November 2008 during the Great Recession, showed the analysis of more than 4,000 surveys.
“One of the main things people should take away from this paper is that employment matters,” said Benjamin Miller, chief strategy officer at the Well Being Trust and a clinical psychologist who worked on the paper. “It matters for our economic livelihood, and for our mental and emotional health.”
The financial uncertainty caused by the coronavirus pandemic, coupled with the pervasive sense of isolation exacerbated by stay-at-home orders, makes this moment unprecedented—different from any other economic downturn in recent history—and thus, potentially difficult to model based on past events.
“It’s useful to have a wake-up call,” said Ken Duckworth, chief medical officer at the National Alliance on Mental Illness. “Unemployment is going to have a very important impact on deaths of despair.”
Already data is showing lower-income Americans are more impacted by coronavirus-related stress than their wealthier counterparts: A Kaiser Family Foundation study that showed 26% of people making less than $40,000 a year said the virus had a “major negative impact” on their mental health; only 14% of people making $90,000 or more a year said the same held true for them.
Johns Hopkins Bloomberg School of Public Health started measuring “mental distress” starting in March drawing on studies from the SARS epidemic of 2003. Early in the month, hotspots like California, Washington, New York and Massachusetts reported mental distress “significantly increased” — even when adjusting for variables like age and income. Distress was higher among people who used alcohol or marijuana more frequently in the past week or who’d consumed more media or social media. It was also higher in younger people, perhaps surprising given that Covid-19 is more lethal for older people.
Also read: Locked down and anxious, more and more Indians are making panic calls, seeking therapy
New York Governor Andrew Cuomo said his state is seeing a rise in drug use, alcohol consumption and domestic violence. “It has caused serious mental health issues,” he said in a public briefing last week. He encouraged New Yorkers to take advantage of a hotline set up for those in emotional distress. Meanwhile, on the national level, the Substance Abuse and Mental Health Services Administration reported an 891% increase in calls to its Disaster Distress Hotline in March compared with a year earlier.
“We’ve seen from past work that policies play a really important role in shaping people’s experience and well-being,” Julia Raifman, assistant professor of health law at Boston University School of Public Health, said. New York, for example, asked psychologists and psychiatrists to volunteer to provide some free mental health care, which she said was a positive step. “I hope we’ll see other states start to do that. I think there’s a lot of room for innovation here.” States that had more generous unemployment benefits during the last recession saw fewer suicides, Raifman said.
Miller’s paper this week proposes long-term solutions like helping unemployed people find meaningful work or training the armies of contact tracers who will be sent out into communities to identify people at risk of a mental health crisis. He sees building up community-based mental health care services as a way to serve more people in need. Congress granted $425 million for mental health and substance use disorder initiatives in the Coronavirus Aid, Relief and Economic Security Act, or CARES, but Miller called that “almost an embarrassment” considering airlines got $25 billion in aid. “We are not taking this seriously as a nation,” he said.
The Crisis in Youth Suicide
Too often, suicide attempts and deaths by suicide, especially among the young, become family secrets that are not investigated and dealt with in ways that might protect others from a similar fate.
Credit...Gracia Lam
Jane E. Brody
By Jane E. Brody
Dec. 2, 2019
76
The death of a child is most parents’ worst nightmare, one made even worse when it is self-inflicted. This very tragedy has become increasingly common among young people in recent years. And adults — parents, teachers, clinicians and politicians — should be asking why and what they can do to prevent it.
In October, the Centers for Disease Control and Prevention reported that after a stable period from 2000 to 2007, the rate of suicide among those aged 10 to 24 increased dramatically — by 56 percent — between 2007 and 2017, making suicide the second leading cause of death in this age group, following accidents like car crashes.
“We’re in the middle of a full-blown mental health crisis for adolescents and young adults,” said Jean M. Twenge, research psychologist at San Diego State University and author of the book “iGen,” about mental health trends among those born since 1995. “The evidence is strong and consistent both for symptoms and behavior.”
Along with suicides, since 2011, there’s been nearly a 400 percent increase nationally in suicide attempts by self-poisoning among young people. “Suicide attempts by the young have quadrupled over six years, and that is likely an undercount,” said Henry A. Spiller, director of the Central Ohio Poison Center, who called the trend “devastating.” “These are just the ones that show up in the E.R.”
ADVERTISEMENT
Continue reading the main story
Had any other fatal or potentially fatal condition leapfrogged like this, the resulting alarm would surely have initiated a frantic search for its cause and cure. But too often suicide attempts and deaths by suicide, especially among the young, become family secrets that are not investigated and dealt with in ways that might protect others from a similar fate.
“We’re at a point now where this issue really can’t be ignored,” said John P. Ackerman, clinical psychologist and coordinator of suicide prevention at Nationwide Children’s Hospital in Columbus, Ohio. “We invest heavily in crisis care, which is the most expensive and least effective means of preventing suicide.”
Unlock more free articles.
Create an account or log in
He proposed instead that more time and money be spent “on identifying kids who are most vulnerable, helping them respond effectively to stress, and teaching them what they can do in a crisis. And we need to start early, in the elementary grades. We haven’t even begun to use the resources that we know work. We have to be proactive.”
In Ohio, he said, “about 40,000 students have been screened for depression and suicide risk, and hundreds of kids have been linked to services. It’s not putting ideas in their heads to ask directly whether they’ve had thoughts of suicide or dying. That doesn’t increase their risk. Rather, it’s relieving. You actually reduce the risk if you help kids talk through these difficult feelings.”
Although no one can say with certainty why suicide has become such a crisis among the young, experts cite several factors that parents, schools and others might be able to modify or control. Dr. Spiller, for example, attributes the rise in suicide attempts largely to the effects of social media and how teens and young adults communicate with their peers.
Editors’ Picks
I’m a U.S. Citizen. Where in the World Can I Go?
The Chicks Are Done Caring What People Think
‘Hamilton’ and the Historical Record: Frequently Asked Questions
ADVERTISEMENT
Continue reading the main story
“Kids now never disconnect,” he said. “They’re connected 24/7. They go to bed with their smartphones. It may be cyberbullying. It may be envy. Maybe many things are going on here.”
One thing the research didn’t find was a link of teen suicides to the opioid crisis. Instead, in school-age adolescents, it found a rise in suicide attempts during school months — September until December, then again January through May — that doesn’t happen in adults.
The rise in attempted and completed suicides by young people correlates directly with their access to smartphones, Dr. Twenge said. “Developmentally, these ages have always been difficult, but that’s been taken to the next level by smartphones, social media and the constant pressure to be online.”
“Eighty-five percent of teens are looking at social media,” she said. “There’s less face-to-face time spent with friends. It’s now the norm to sit home Saturday night on Instagram. Who’s popular and who’s not is now quantifiable by how many people are following you. Kids are spending as much as eight hours a day on social media, where there’s a lot of negativity, competition and jockeying for status and unfiltered access to sites that tell them how to harm themselves.”
Dr. Ackerman, who noted that “young brains are less adept at dealing with complex situations,” likewise believes social media plays an important role in the suicide crisis among the young. But he sees the problem more broadly and said there is a need for schools to help counter it. Staff can be trained and screening done within schools, he said.
“Ultimately it’s a combination of economic, social and technological factors that come together along with family and school issues, and kids are less equipped to tackle these problems,” he said.
Sleep, or rather, not enough of it, is another issue undermining the resilience of today’s teens.
Several studies have found a link between “problematic internet and social media use and sleep disturbance among youth,” and that “these associations contribute to depressive symptoms in this group,” Dr. Twenge and co-authors reported in the Journal of Abnormal Psychology.
ADVERTISEMENT
Continue reading the main story
“Two surveys have shown that teens are not sleeping enough, and having a smartphone in the bedroom results in less sleep and poorer quality sleep,” she said. “It’s too tempting to stay up late looking at the phone, and the blue light it emits keeps the brain thinking it’s daytime. Almost everything done on devices is psychologically stimulating. The brain can’t slow down and relax.”
Her advice: “Avoid looking at devices within an hour of bedtime, and buy an alarm clock. It’s not the technology itself that’s the problem — it’s how we use it. We have to use it more mindfully.”
She urges parents to set reasonable limits about kids’ use of technology. Setting such limits is “not only good for kids, but they appreciate it in the long run,” she said. She noted that modern smartphones have parental control systems built in and parents can set kids’ phones to shut down at 9 p.m.
Experts also urge parents to check in with their teenage children regularly, asking how they’re feeling and whether they ever think about dying. “As early as elementary school, children can have responsible conversations about suicide,” Dr. Ackerman said. “We need to prepare young people to talk about their emotions early in life.”
He and others also emphasized the importance of controlling access to possible means of suicide, which they note is most often an impulsive act. Youngsters should never have uncontrolled access to guns, drugs or other substances that can result in a fatal overdose.
If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources.
No comments:
Post a Comment