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#JamesDonaldson on #MentalHealth – Coronavirus: #Dr.LornaBreen Committed #Suicide Because Her Brain Was ‘Altered’ By #COVID-19

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Dr. Lorna Breen who works in the emergency room of the NewYork-Presbyterian Allen Hospital died by #suicide this week. It was a piece of shocking news as the doctor has been tending to #COVID-19 patients and was so dedicated to fulfilling her duties even if it was risky. 

In fact, she caught the #virus herself but recovered. Her father who is also a #doctor told The New York Times that after recovering from the #coronavirus infection, she returned to the E.R. just a week and a half later. It was said that since it was a risky situation, her family decided to intervene to convince her to stay home and brought her to their house in Charlottesville, Virginia where she took her life.

Now, her sister, Jennifer Feist and her husband Corey, recently appeared on “Today Show” to talk about her life and death. She stressed that the stressful working conditions in the E.R. as a frontline worker in this time of #pandemic played a big part in her sister’s decision to end her life. 

Feist further said that since her sister was also infected by #COVID-19, she believes that the #virus “altered” her brain that resulted for Breen to make such an extreme decision.

“She had COVID. And I believe that it altered her brain, and then she went back to the most horrific, unimaginable conditions,” Feist told show host Savannah Guthrie when asked if Breen’s work condition in the hospital was strenuous. “And for somebody whose life’s calling is helping people, and she just couldn’t help enough people. And the combination was just untenable.”

Feist went on to say that her sister worked more than 12 hours per shift in a surrounding that Breen described as Armageddon-like because of the massive number of people who are sick and they don’t have enough equipment to tend to them all. She also witnessed many deaths at the height of the #COVID-19 #pandemic and Breen felt bad that she was not able to help everyone.

Feist said that her sister told her, “There are so many sick people everywhere. I can’t leave. Nobody’s leaving. I have to stay and help.”

Because she can’t stop working and her workplace is always hectic, Breen’s family thinks that her #mentalhealth was affected. For speaking out to the public about her sister, Guthrie said that she hopes that health officials will support the #mental and physical well-being of frontliners and other #healthcareworkers who work to save people from the #pandemic. 

“She couldn’t stop working, and she certainly couldn’t tell anybody she was struggling,” Feist said. “And that needs to be a conversation that changes. People need to be able to say they’re suffering and to take a break.”

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

Coronavirus COVID-19 Doctors New York, USADoctors test hospital staff with flu-like symptoms for #coronavirus (#COVID-19) in set-up tents to triage possible #COVID-19 patients outside before they enter the main Emergency department area at St. Barnabas hospital in the Bronx on March 24, 2020 in New York City. New York City has about a third of the nation’s confirmed #coronavirus cases, making it the center of the outbreak in the #UnitedStates.

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#JamesDonaldson on #MentalHealth – What One #Doctor’s #Suicide Taught Us

Physicians are perfectionists who suffer in silence

Jennifer Senior

By Jennifer Senior

Just over a month ago, I got a call at 10:30 at night from a doctor friend who works in one of the busiest emergency rooms in New York City. She’d just returned from a brutal shift, a miserable slog of impossible intubations and fruitless C.P.R. One patient, more or less her age, died just minutes after she’d placed him on a ventilator. She was so stunned she burst into tears.

My friend is not the type to burst into tears. She is generally a model of towering nerve.

A few days later, she went to one of the walk-in #mentalhealth forums at her hospital, expecting to see a large group. Instead, she had the psychiatrist and psychologist all to herself. In hindsight, maybe it made sense. As an emergency physician, she explained to me, “You’re supposed to see things and move on.” Project confidence and toughness; plow forward. It’s the reason you’re not reading my friend’s name now. She knows what patients and colleagues expect.

In the months and years ahead, we’re going to have to train ourselves to be especially attentive to the #mentalhealth needs of our first responders to this #pandemic. In the aftermath of a disaster, they’re at a far greater risk for post-traumatic #stress, substance abuse and major #depression than the average civilian. Yet seeing themselves as vulnerable is disruptive — antithetical, even — to their self-concept. They’re the healers in this equation, not the ones who need to be healed.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

It wasn’t just my friend who taught this to me. Last week NBC ran an interview with the sister of Lorna M. Breen, the medical director of the emergency department at New York-Presbyterian Allen Hospital who died by #suicide on April 26.

“I know my sister felt like she couldn’t sit down,” she said. “She couldn’t stop working. And she certainly couldn’t tell anybody she was struggling.”

One wouldn’t want to extrapolate too much from Breen’s case. Suicides can be idiosyncratic, individual, painfully mysterious; the data on the incidence of #suicide in frontline workers is mixed. But it ought to be noted that Breen was the second #American health worker to die by #suicide in this #pandemic — the first was a 24-year-old Staten Island E.M.T., on April 24 — and she did not have a known history of #depression or suicidal ideation.

Here are some facts about physicians that should put us all on notice. In general, #doctors die by #suicide at more than twice the rate of the general population, the highest of any profession. They also experience far more burnout. And the specialty with the highest levels of burnout? Emergency medicine.

Some of the reasons for this are guessable. Emergency room doctors work far more grueling hours than most physicians and under more stressful circumstances, often seeing people on the very worst days of their lives. But when I phoned Dr. John R. Matheson, former president of the Washington State chapter of the American College of Emergency Physicians and founder of its Wellness Committee, he gave me a much more subtle, characterological explanation for why his subspecialty can be so depleting.

“We tend to be perfectionists,” he said. “And disease processes aren’t always straightforward. When you’re a high achiever and you’re very driven and you can’t do what you want to do, it can be very disheartening.”

Now introduce a novel, wantonly contagious #virus into the already-chaotic emergency room, a #virus that behaves in dumbfounding and pitiless ways. It’s your problem to solve. But you haven’t the tools to fix it — shift after shift, day after day, at a scale of suffering you’ve never witnessed. For people who are action-oriented and hellbent on finding solutions, this is a recipe for existential disaster. First responders are suffering from a crisis of utility.

“We’re almost observers in this,” Matheson said. “We can put patients on oxygen. We can intubate them in the I.C.U. But we’re mainly trying to allow the body to heal on its own. Dealing with Covid largely means dealing with a feeling of helplessness.”

Which explains my friend’s distress that night. She told me point-blank that she felt like a failure. “There’s no algorithm,” she kept repeating. “There’s no if-then.”

But getting first responders to reckon with these feelings isn’t easy. It’s why my friend found herself alone with two therapists in a setting clearly intended for large groups. Last week, I phoned Dr. Craig L. Katz, a psychiatrist in the Mount Sinai Health System who’s helping to organize their eight hospitals’ #mentalhealthresponse for their workers. “It’s been hard getting them to come to us,” he told me. “We’ve had to go to them.”

Dr. John Draper, the executive vice president of National Networks for Vibrant Emotional Health, told me that in the week after Sept. 11, their local New York City hotline, LifeNet, got more phone calls from #healthprofessionals offering to help than asking for it. That’s how they cope. “And guess what?” he said. “We’re hearing again from them now.”

The solution, he said, may be that first responders find ways to counsel one another peer-to-peer, whether it’s online or over the phone. They know what they need to hear. As for the rest of us: He suggests we refrain from platitudes about their heroism. “They’re perfectionists,” he said. “They’re so aware of what they haven’t done or aren’t doing or might have missed. What’s better is to say: ‘I can only imagine how hard it is. I can only imagine it’s a sacrifice.’ ”

For what it’s worth, here’s what helped my friend.

You were trying to help.

You did the right thing.

It was the disease. Not you.

[If you are having thoughts of #suicide, call the #NationalSuicidePreventionLifeline at 1-800-273-8255 (TALK) or go to SpeakingOfSuicide.com/resources for a list of additional resources.]

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#JamesDonaldson on #MentalHealth – Researcher: #Coronavirus #Pandemic Increases Risk Of Physician #Suicide

BY CHRISTOPHER CHENEY  |

TOPICS

Physicians #MentalHealth #COVID-19

The #pandemic has increased stressors on physicians such as being redeployed to new care settings and #anxiety over potential #virus exposures.


KEY TAKEAWAYS

On April 26, an emergency room physician in New York who had worked with #coronavirus patients committed #suicide.

For physicians, #suicide risk factors during the #coronavirus #pandemic include moral injury and fear from having insufficient personal protection equipment.

Putting student loans into forbearance and mitigating legal liability would ease stressors on physicians.

Already an at-risk group, #doctors are at increased risk of #suicide during the #coronavirus #pandemic, a physician #suicide researcher says.

Physicians and other frontline healthcare workers on the frontline of the #coronavirus disease 2019 (#COVID-19) #pandemic are under physical and psychological strain. As of April 9, more than 9,000 #healthcareworkers had tested positive for #coronavirus, the #CentersforDiseaseControlandPrevention reported.

The April 26 #suicide death of a New York emergency room physician appears to be related to the #pandemic, according to the New York Times.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle


GET THE LATEST ON #HEALTHCARE LEADERSHIP IN YOUR INBOX.

Lorna Breen, MD, was the medical director of the emergency department at New York-Presbyterian Allen Hospital. She died in Charlottesville, Virginia, where she was staying with family, the Times reported.

Breen’s father, Philip Breen, MD, told the Times that his daughter was afflicted with #COVID-19 and returned to work after recuperating for about a week and a half. He told the Times his daughter had witnessed grim conditions at Allen Hospital and appeared detached the last time he spoke with her. “She was truly in the trenches of the frontline,” he told the Times.

Physicians and others in crisis can contact the #NationalSuicidePreventionLifeline at 800-273-8255.

The #COVID-19 #pandemic is placing doctors at higher risk of #suicide, says Mirret El-Hagrassy, MD, a postdoctoral research fellow at Spaulding Rehabilitation Hospital’s Neuromodulation Center and Harvard Medical School in Boston.

“It has increased the risk, considering all the risk factors and underlying #mentalhealth vulnerabilities. The #pandemic increases the social stressors. The career-associated stressors are being exacerbated in a way that they were not before,” says El-Hagrassy, co-author of a research article on physician #suicide published by JAMA Psychiatry in March.

The research article found that #female physicians have a higher #suicide risk than the general #female population by two statistical measures. #Male physicians were found to have a higher #suicide risk than the general male population by one statistical measure.

PHYSICIAN #SUICIDE AND THE #PANDEMIC

The #pandemic is associated with several physician #suicide risks, El-Hagrassy says.

  • The moral injury and fear from having insufficient personal protective equipment (PPE)
     
  • The risk of physicians exposing themselves and vulnerable family members to the #virus
     
  • Physicians isolating themselves from others to lower the risk of spreading the #virus
     
  • Physicians being redeployed to work in unfamiliar care settings such as anesthesiologists being reassigned to work in ICUs, which heightens concern over legal liability
     
  • Pressure from the business aspects of medicine, including physician practices being pushed to the brink of financial ruin
     
  • Layoffs, furloughs, and cutbacks in pay and raises as healthcare organizations teeter from the financial blows of the #pandemic such as cancelation of elective surgery
     
  • Some residents and fellows are struggling to find jobs, which heavily impacts physicians in the United States on visas
     
  • In their JAMA Psychiatry article, El-Hagrassy and her co-authors found physicians who were divorced, widowed, or single faced higher #suicide risk, and the #pandemic will likely exacerbate this risk

There are ways to ease physician #suicide risk during the #coronavirus #pandemic, El-Hagrassy says.

  • Provide adequate PPE: “The biggest factor is making sure physicians and other frontline workers are protected. Physicians need to get their personal protective equipment, so there is less risk of them getting infected or infecting their families. It is not just the fear of getting infected—it is the fear of spreading the #virus to patients,” she says.
     
  • Lenders could put physician’s student loan debt on hold during the #pandemic.
     
  • Mitigate legal liability: “The judicialization of medicine should be eased because it is a major factor for physician #mentalhealthdisorders and #suicide,” El-Hagrassy says.
     
  • Employers could reduce or eliminate requirements for physicians to disclose #mentalhealthhistory on job applications.
     
  • Privacy should be enhanced for physicians for who want to seek #mentalhealth help. “Telemedicine psychiatry can be helpful for physicians because they don’t have to go into an office, where they can be seen in a waiting area,” she says.
     
  • Prejudice against those who seek #mentalhealthservices in general and among physicians particularly should be addressed.
     
  • Physicians can conduct virtual daily check-ins with their colleagues on mobile devices or home computers.

“If we use this time of the #pandemic to establish measures that protect physicians, it might lead to better outcomes down the line. We should move in that direction. There are a host of factors that could be improved during this period that might reduce the stressors and the potential for physician #suicide both for the short-term and the long-term,” El-Hagrassy says.

#Doctors can call the Physician Support Line (888-409-0141) for free and anonymous psychiatric counseling.

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#JamesDonaldson on #MentalHealth – Three Tips To Manage #Mental And Emotional #Stress During The #COVID-19 Crisis

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 Mike McKinnon

SAN DIEGO (KUSI) – May is #mentalhealthawareness month and as the #coronavirus #pandemic continues, people are getting fatigued – which can lead to challenges with #mental and emotional health. Calls to #suicide hotline continue to be up almost 900%.  

Dr. Heidi Hanna joined us on Good Morning San Diego to discuss easy ways to manage #mental and emotional #stress. She supplied KUSI News with the following information to compliment the tips she described on air.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

What to look for if you are concerned about yourself or someone else?
• Watch for changes in behavior and emotion – extreme irritability, sleep and appetite changes
• Excessive use of technology to escape, can overstimulate the nervous system and increase comparison mentality (play games, but keep them non-violent, pro-social)
• Unexplained body pains, aches, digestive problems, headaches, etc.

How to shift #stress during these challenge Covid-19 times:
1. Pause – take a few deep breaths and try to get connected to this present moment and the fact you’re safe right here and now.
2. Take a break – turn off the “noise” in your environment, actual noise or information overload.
3. Prioritize self-care – sleep, nutrition, movement, social connection
4. Reach out – give and get support
5. Ask for help – if you feel overwhelmed or unsafe

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#JamesDonaldson on #MentalHealth – The #Coronavirus #Pandemic Is Pushing #America Into A #MentalHealthCrisis

#Anxiety and #depression are rising. The U.S. is ill-prepared, with some clinics already on the brink of collapse

Isolation and economic upheaval caused by the coronavirus pandemic are already resulting in a sharp spike in people seeking mental health help. (Amanda Andrade-Rhoades for The Washington Post)
#Isolation and economic upheaval caused by the #coronavirus #pandemic are already resulting in a sharp spike in people seeking #mentalhealth help

By William Wan

The Washington Post is providing this important information about the #coronavirus for free. For more free coverage of the #coronavirus #pandemic, sign up for our daily #Coronavirus Updates newsletter where all stories are free to read.

Three months into the #coronavirus #pandemic, the country is on the verge of another health crisis, with daily doses of death, #isolation and fear generating widespread psychological trauma.

Federal agencies and experts warn that a historic wave of #mentalhealth problems is approaching: #depression, substance abuse, post-traumatic #stress disorder and #suicide.

Just as the initial outbreak of the novel #coronavirus caught hospitals unprepared, the United States’ #mentalhealth system — vastly underfunded, fragmented and difficult to access before the #pandemic — is even less prepared to handle this coming surge.

“That’s what is keeping me up at night,” said Susan Borja, who leads the traumatic #stress research program at the #NationalInstituteofMentalHealth. “I worry about the people the system just won’t absorb or won’t reach. I worry about the suffering that’s going to go untreated on such a large scale.”

Data shows #depression and #anxiety already roiling the nation.

Nearly half of #Americans report the #coronavirus crisis is harming their #mentalhealth, according to a Kaiser Family Foundation poll. A federal emergency hotline for people in emotional distress registered a more than 1,000 percent increase in April compared with the same time last year. Last month, roughly 20,000 people texted that hotline, run by the Substance Abuse and Mental Health Services Administration.

Online therapy company Talkspace reported a 65 percent jump in clients since mid-February. Text messages and transcribed therapy sessions collected anonymously by the company show #coronavirus-related #anxiety dominating patients’ concerns.

“People are really afraid,” Talkspace co-founder and CEO Oren Frank said. The increasing demand for services, he said, follows almost exactly the geographic march of the #virus across the United States. “What’s shocking to me is how little leaders are talking about this. There are no White House briefings about it. There is no plan.”

The #suicides of two New York health-care workers highlight the risks, especially to those combating the #pandemic. Lorna Breen, a top New York emergency room doctor, had spent weeks contending with #coronavirus patients flooding her hospital and sometimes dying before they could be removed from ambulances. She had no history of #mentalillness, her relatives have said in interviews, but struggled increasingly with the emotional weight of the outbreak before she died. Days later, reports emerged that a Bronx emergency medical technician also killed himself.

Have you had trouble accessing #mentalhealthservices because of the #coronavirus #pandemic? We want to hear from you.

Researchers have created models — based on data collected after natural disasters, terrorist attacks and economic downturns — that show a likely increase in suicides, overdose deaths and substance use disorders.

And yet, out of the trillions of dollars Congress passed in emergency #coronavirus funding, only a tiny portion is allocated for #mentalhealth. At the same time, therapists have struggled to bring their practices online and to reach vulnerable groups because of restrictions on licensing and reimbursement. Community behavioral health centers — which treat populations most at risk — are struggling to stay financially solvent and have begun closing programs.

“If we don’t do something about it now, people are going to be suffering from these #mentalhealth impacts for years to come,” said Paul Gionfriddo, president of the advocacy group #MentalHealth America. That could further harm the economy as #stress and #anxiety debilitate some workers and further strain the medical system as people go to emergency rooms with panic attacks, overdoses and #depression, he said.

Just as the country took drastic steps to prevent hospitals from being overwhelmed by infections, experts say, it needs to brace for the coming wave of behavioral health needs by providing widespread #mentalhealth screenings, better access to services through telehealth, and a sizable infusion of federal dollars.

Dire warnings in data

When diseases strike, experts say, they cast a shadow #pandemic of psychological and societal injuries. The shadow often trails the disease by weeks, months, even years. And it receives scant attention compared with the disease, even though it, too, wreaks carnage, devastates families, harms and kills.

#Mentalhealth experts are especially worried about the ongoing economic devastation. Research has established a strong link between economic upheaval and #suicide and substance use. A study of the Great Recession that began in late 2007 found that for every percentage point increase in the unemployment rate, there was about a 1.6 percent increase in the #suicide rate.

Has your child tested positive for the coronavirus? Share your experiences with The Post.

Using such estimations, a Texas nonprofit — Meadows Mental Health Policy Institute — created models that suggest if unemployment amid the #coronavirus #pandemic ends up rising 5 percentage points to a level similar to the Great Recession, an additional 4,000 people could die of #suicide and an additional 4,800 from drug overdoses.

But if unemployment rises by 20 percentage points — to levels recorded during the 1930s Great #Depression — suicides could increase by 18,000 and overdose deaths by more than 22,000, according to Meadows.

“These projections are not intended to question the necessity of #virus mitigation efforts,” cautioned authors of the Meadows report, “but rather to inform health system planning.”

Even as some states begin easing stay-at-home restrictions, concerns persist about the psychological damage wrought by the pandemic. Texas is among the states relaxing coronavirus measures, with shoppers visiting Houston's Galleria mall on Friday. (Mark Felix/AFP/Getty Images)
Even as some states begin easing stay-at-home restrictions, concerns persist about the psychological damage wrought by the #pandemic. Texas is among the states relaxing #coronavirus measures, with shoppers visiting Houston’s Galleria mall on Friday

#Suicide experts and prevention groups have deliberately refrained from discussing too widely death projections such as those from the Meadows Institute. Experts say reporting excessively or sensationally on #suicide can lead to increases in #suicide attempts, an effect known as contagion. And the factors involved in any #suicide are often complex, they point out.

“Could the numbers go up? Yes, but it isn’t inevitable. We know #suicide is preventable,” said Christine Moutier, chief medical officer for the #AmericanFoundationforSuicidePrevention.

Research has shown interventions make a marked difference, such as limiting access to guns and lethal drugs, screening patients for suicidal thoughts, treating underlying #mentalconditions and ensuring access to therapy and crisis lines to call and text. “That’s why we need to act now,” Moutier said.

On Wednesday, a coalition representing more than 250 #mentalhealth groups announced it was convening a national response to the problem of #pandemic #suicide — an effort that will include at least one federal agency, the #NationalInstituteforMentalHealth.

‘Poisonous fire hydrant’

For health-care workers, the scope of the pandemic has been stunning. “We’re used to dealing with sick people and seeing terrible things, but what’s devastating with covid is the sheer volume,” said Flavia Nobay, an emergency room doctor who volunteered in New York. (Peter Foley/EPA-EFE/Shutterstock)
For #healthcareworkers, the scope of the #pandemic has been stunning. “We’re used to dealing with sick people and seeing terrible things, but what’s devastating with #covid is the sheer volume,” said Flavia Nobay, an emergency room doctor who volunteered in New York

Front-line workers — health-care providers, grocery store workers, delivery people — are especially vulnerable to the coming storm of #mentalhealthproblems.

“We’re used to dealing with sick people and seeing terrible things, but what’s devastating with #covid is the sheer volume. It’s like drinking from a poisonous fire hydrant,” said Flavia Nobay, an emergency room doctor.

As infections soared in March in New York, Nobay took leave from her duties at the University of Rochester Medical Center to volunteer as an ER doctor in Queens.

Weeks later, the experience still haunts her: Watching families crumple in the ambulance bay knowing they may never see relatives again. Hearing the relentless alerts every few minutes of crashing patients and respiratory arrest. Sending patients home because they weren’t quite sick enough, knowing they may be coming right back. Or even worse, the chance they may not make it back.

“It chips away at your soul,” Nobay said. “You have to hold on to the positive and how you’re helping in the ways you can. That hope is like medicine. It’s as important and tangible as Tylenol.”AD Volunteers fight a #mentalhealthcrisis amid the #coronavirus outbreak Data from Crisis Text Line shows social isolation, unemployment and forced quarantines are having a significant effect on people’s #mentalhealth.

A study of 1,257 doctors and nurses in China during that country’s #coronavirus peak found that half reported #depression, 45 percent #anxiety and 34 percent #insomnia.

Before the #pandemic, #doctors and #nurses were already acutely prone to burnout, research shows, because of the workload, pressure, chaos and increasingly dysfunctional health-care system.

“We’re now hitting a period of uncertainty where a lot of people are asking themselves how long they can keep it up,” said Liselotte Dyrbye, a Mayo Clinic doctor and leading researcher on burnout. “The teapot can only boil for so long.”

Could therapy ease your #coronavirus #stress? How to decide, what to expect and where to find it.

A broken system when it’s needed the most

Amid the pandemic, a homeless woman prepares to sleep in her car at a Houston parking lot. Experts warn that economic strain could bring a wave of mental stress and anguish in the United States. (Go Nakamura/Reuters)
Amid the #pandemic, a homeless woman prepares to sleep in her car at a Houston parking lot. Experts warn that economic strain could bring a wave of #mental #stress and anguish in the United States

This approaching wave of #mental injuries will be met in coming months by a severely broken system.

In the United States, 1 in 5 adults endure the consequences of #mentalillness each year. Yet less than half receive treatment, federal statistics show. As #suicide rates have fallen around the world, the rate in the United States has climbed every year since 1999, increasing 33 percent in the past two decades.

Part of the problem, experts say, is the markedly different way the United States treats #mentalillness compared with physical illness.

In normal times, a heart attack patient rarely has trouble securing a cardiologist, operating table and hospital bed. But patients in #mentalcrises, studies show, consistently struggle to get their insurance to pay for care. Even with insurance, they struggle to find therapists and psychiatrists willing to take that payment. Those who can afford it often end up paying out of pocket.

Experts warn that such parity and access problems may only worsen with the #pandemic, which has upended the functions of hospitals, insurance companies and #mentalhealthcenters.

In a joint letter Wednesday, leaders in #mentalhealth and substance abuse treatment pleaded for the Trump administration’s help. The letter — signed by the American Psychological Association, the American Psychiatric Association, the #NationalAllianceonMentalIllness and 12 other organizations — asked federal officials to save community #mentalhealth centers facing financial collapse.

The letter also asked the government to lift reimbursement restrictions that have prevented therapists from using phone calls to treat patients. On Thursday, the Trump administration indicated it would do so.

A survey of local #mentalhealth and drug addiction centers showed the #pandemic has already left many on the brink of financial collapse, preventing them from providing services that generate much of their reimbursement revenue. More than 60 percent said they would run out of funding in less than three months and had already closed some programs.

In a letter to Congress in early April, #mentalhealth organizations estimated that $38.5 billion is needed to save treatment providers and centers and that $10 billion more is needed to respond to the #coronavirus #pandemic. On Friday, the federal substance abuse and #mentalhealth agency said it had been allocated less than 1 percent of the amount advocated by #mentalhealth groups — $425 million in emergency funding — and has awarded $375 million to states and local organizations.

While Congress recently authorized $100 billion in emergency funds for hospitals and medical providers, very little will go to #mentalhealth and addiction service providers because they mainly receive funding through Medicaid. And most of the emergency provider money is being distributed through Medicare.

“We are facing the loss of #mentalhealth centers and programs at a time when we are going to need them more than ever,” said Chuck Ingoglia, president of the National Council for Behavioral Health, which represents 3,326 treatment organizations.

Glimmers of hope

While almost everyone is experiencing increased stress during the pandemic, the effect for most will be transient. The difficulty is identifying and treating those who develop deeper problems. (Mark Lennihan/AP)
While almost everyone is experiencing increased #stress during the #pandemic, the effect for most will be transient. The difficulty is identifying and treating those who develop deeper problems

There are glimmers of hope, experts say, amid the gloomy outlook.

The sudden push into telemedicine could make services more accessible in years to come. And the national #mentalhealthcrisis could spark reforms and movement toward better treatment.

And while almost everyone is experiencing increased #stress, the effect for many will be transient — trouble sleeping, shorter fuses.

The difficulty is identifying and treating those who develop deeper, worrisome #mental problems such as post-traumatic #stress disorder and severe #depression.

“To control the #virus, it’s all about testing, testing, testing. And for the #mentalhealthproblems ahead, it’s going to be all about screening, screening, screening,” said Gionfriddo of #MentalHealth America.

For years, Gionfriddo’s nonprofit has offered questionnaires on its website — widely used in medicine — to help people screen themselves for #mentalhealthproblems. Since the #pandemic began, those daily screenings have jumped 60 to 70 percent. And since February, the number of people screening positive for moderate to severe #anxiety and #depression has jumped by an additional 18,000 people compared with January.

Speaking from her parents’ home in Pittsburgh, Ananya Cleetus said she has felt the increased strain.

First came the closure of her school, the University of Illinois at Urbana-Champaign, bringing to an end her ambitious plans for the semester in computer engineering. Then came the loss of her therapist, forbidden by licensing rules from treating her across state lines. And #socialmedia didn’t help — all those posts of people baking bread and living their best #quarantinelife, making hers feel all the more pitiful.

It was getting increasingly hard to get out of bed, said Cleetus, 23, who has bipolar disorder and helps lead a student advocacy group.

“It took me a few weeks and talking to friends to finally realize this wasn’t just something wrong with me,” Cleetus said. Since then, she has poured her energies into creating a daily routine and an online guide for fellow students struggling with the #pandemic and #mentalhealth.

“This #virus is messing with everyone. The #anxiety, #isolation, uncertainty,” she said. “Everyone’s struggling with it in one way or another.”

If you or someone you know needs help, call the #NationalSuicidePreventionLifeline at 800-273-TALK (8255). Crisis Text Line also provides free, 24/7, confidential support via text message to people in crisis when they text to 741741.

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William Wan is a national correspondent covering #health, science and news for The Washington Post. He previously served as the Post’s China correspondent in Beijing, roving U.S. national correspondent, foreign policy reporter and religion reporter.

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#JamesDonaldson on #MentalHealth – #Pandemic May Lead To 75,000 Deaths From #Suicide, Drug And Alcohol Abuse, Study Says

(CBS/WVLT) — #COVID-19 has directly claimed tens of thousands of U.S. lives, but conditions stemming from the novel #coronavirus — rampant unemployment, #isolation and an uncertain future — could lead to 75,000 deaths from drug or alcohol abuse and suicide, new research suggests.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

CBS news reported that deaths from those causes are known as “deaths of despair,” and the #pandemic may be exacerbating conditions that lead to them.

“Deaths of despair are tied to multiple factors, like unemployment, fear and dread, and #isolation. Prior to the #COVID-19 #pandemic, there were already an unprecedented number of deaths of despair. We wanted to estimate how this #pandemic would change that number moving forward,” said one of the study’s authors, Benjamin Miller. He’s chief strategy officer for the Well Being Trust in Oakland, Calif.

According to the Well Being Trust, more lives had been lost to deaths of despair in 2017 than ever before.

“The primary response at the time was to look at the opioid epidemic, but that didn’t even come close to cracking all of the issues of #mentalhealth-related to deaths of despair,” Miller explained.

Many things can contribute to deaths of despair, including #loneliness, #isolation, a lack of belonging, limited access to affordable #healthcare, systemic racism, trauma and financial concerns, like a lack of housing and food, according to the Well Being Trust.

The researchers pointed to several factors from the #pandemic that could make problems worse:

– The potential for a serious, even deadly infection from a previously unknown microbe.

– An unprecedented economic shutdown.

– Skyrocketing unemployment.

– Months-long #socialisolation (mandated in many states), sometimes with no set end.

– Uncertainty about treatment and prevention strategies.

According to the researchers, with rapid recovery and the smallest impact on deaths of despair, the #pandemic could lead to nearly 28,000 additional deaths of despair. However, a slow recovery combined with the greatest impact of unemployment could result in more than 150,000 deaths. Researchers believe that, most likely, the number of deaths will be somewhere in the middle with 75,000.

“The #isolation is causing people to lose boundaries on their behaviors,” Miller explained. CBS reported that with social norms set aside, some people are doing more things they wouldn’t normally, such as day drinking. Such habits could be hard to break, which could lead to alcohol abuse.

“Miller pointed out that the study is a projection, and projections can be imprecise. Plus, estimates can change for the better when people start tackling the problems,” CBS reported.

The researchers said the biggest way to help prevent some of these deaths is to get people back to work.

“People have to be working and we have to get people connected to other people,” Miller said.

He said improving access to #healthcare, including #mentalhealthcare, is also significant.

Dr. Elie Aoun, vice chairman of the American Psychiatric Association’s Council on Addiction Psychiatry, called the death projections shocking but not surprising.

“I’ve been seeing this in practices and my colleagues have been talking about it, too,” he said.

Aoun said social #isolation has more consequences for the many vulnerable patients who suffer from #depression, #anxiety and addiction.

“Addiction patients are relapsing, and a lot of patients who don’t have drug use or alcohol problems are drinking more now, sometimes every day from 4 or 5 p.m., and they don’t stop until they sleep,” he said.

Photo by Kat Jayne on Pexels.com
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#JamesDonaldson on #MentalHealth – The Next #Covid Crisis Could Be A Wave Of #Suicides

  • By Cynthia Koons, Riley Griffin and Emma Court Bloomberg

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

The #isolation, grief and economic hardship related to #Covid-19 are creating a #mentalhealthcrisis 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.

Even as the #American economy rebounded after the last recession, suicides and overdoses cut into Americans’ life expectancy. #Mentalhealthexperts 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 #suicideprevention 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 #UnitedStates: #suicide, overdose and diseases related to alcohol abuse.”

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 #NationalAllianceonMentalIllness. “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 #mentalhealth; 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 “#mentaldistress” 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 #socialmedia. It was also higher in younger people, perhaps surprising given that #Covid-19 is more lethal for older people.

New York Gov. Andrew Cuomo said his state is seeing a rise in drug use, alcohol consumption and domestic violence. “It has caused serious #mentalhealthissues,” 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 #MentalHealthServices 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 #mentalhealthcare, 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 #mentalhealthcrisis. He sees building up community-based #mentalhealth care services as a way to serve more people in need.

Congress granted $425 million for #mentalhealth 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.

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