Mental Health: Rise in student suicides just the tip of the pandemic iceburg
The New York Times reported in late January on a surge in student suicides in Las Vegas, noting that Clark County reported 18 suicides over nine months of school closure – double the number of the entire previous year.
Many of my female friends share my concerns about the impact of COVID on their school-aged children for reasons ranging from:
Lack of physical contact with friends at school and elsewhere.
Growing inability for parents to balance work responsibilities with adequate oversight of younger children.
The challenge of remote learning, including its impact on high schoolers’ grades and SAT scores as they apply to college, with little ability to visit campuses.
College students (particularly first years) studying and trying to socialize from their bedrooms instead of enjoying normal on-campus activities and interactions.
According to data from the World Health Organization, someone commits suicide every 40 seconds – 800,000 per year – and for every suicide, 20 more were attempted. That means 5-7 people will commit suicide during the time it takes you to read this column.
One in five COVID-19 patients develops a mental-health problem. According to a Center for Disease Control and Prevention study, the proportion of children’s mental health-related emergency department visits among all pediatric ED visits increased starting in April 2020 and remained elevated through October. Compared with 2019, that figure increased 24% for children aged 5-11 and 31% for children aged 12-17.
The CARE humanitarian organization issued a report last September stating that women were nearly three times more likely than men (27% vs. 10%) to report their mental health had been impacted by the pandemic, citing issues such as skyrocketing unpaid care burdens and worries about livelihoods, food, and health care. Women were nearly twice as likely as men to report having trouble accessing health services, including access to maternal, sexual, and reproductive health. The report also noted a global rise in exposure to gender-based violence, with part of that due to COVID-19 lockdowns.
In addition, calls into crisis hotlines that normally decrease by 30% or more over the summer increased last year. A higher proportion of these calls actually came by text from teens stuck at home and not wanting to be noticed reaching out, which reduces the ability to have a dialogue. In addition, more than a third of youth receiving mental health services in the United States get them in an academic setting. With so many school facilities closed, mental-health advocacy groups say historically marginalized student demographics such as Black, Latino, and LGBTQ children are at even greater risk.
In recent days, the focus has shifted to how Congress and the Biden Administration can address this part of the growing public-health emergency.
On Feb. 1, 27 U.S. Representatives asked House leadership to accelerate bringing 13 bills back to the floor that were passed in 2020 but did not become law despite bipartisan support. That’s not an uncommon problem in this era of gridlock and hyper-partisanship, but it is unconscionable.
And then there’s the IMD Exclusion.
About one in eight visits to hospital emergency rooms involve a mental health or substance use condition. Very few of those people end up in beds because of a federal policy called the Institutions for Mental Disease (IMD) Exclusion.
The IMD Exclusion was part of the 1965 law that established Medicaid. It prevents the program from funding care for mentally ill adults while they live in hospitals or even adult homes with more than 16 beds. It basically created a financial incentive for states to kick the mentally ill out of hospitals. As a result, the country has lost more than 450,000 beds since the 1950s.
COVID-19 has exacerbated the problem. Reports across the country are surfacing about the closing of psychiatric beds as COVID-19 patient numbers increase. In some cases, patients are being discharged even though many still showed signs of psychosis and mania. Those closures are forcing patients to turn to community organizations that help people outside of hospitals, but those organizations are struggling to meet that need.
Rep. Brian Fitzpatrick (R-PA) and Rep. Eddie Bernice Johnson (D-Texas) have led bipartisan efforts to repeal the IMD Exclusion. Fitzpatrick has said “the IMD exclusion has turned into federally mandated neglect of those suffering from mental illness. Repealing the exclusion will remove a major barrier to care for patients and make our communities healthier.”
Readers should reach out to their representatives to support these efforts.
Beyond that, the Biden administration needs to focus some of its public-health messaging on mental health and behavioral issues, including stress and coping strategies; support easy-to-access psychoeducational webinars for Americans who are at higher risk and need intensive, brief intervention; and offer training for all licensed counselors, social workers, psychologists, and psychiatrists who need help with delivering effective services during the pandemic, while reducing the difficulty in being reimbursed for those services.
While it’s true that these initiatives will require federal investment, an investment in mental health pays off by both breaking the destructive socioeconomic cycles that result and by increasing the quality of life for individuals and families everywhere.
Sarah Chamberlain is president and CEO of the Republican Main Street Partnership, which supports a broad alliance of moderate Republicans committed to enacting common-sense, bipartisan legislation on kitchen-table issues. This is a follow-up to a column she wrote in October 2020 for Forbes magazine.
Mental-health related bills that need Congressional attention
The letter signed by 27 Representatives highlighted the following 13 mental-health related bills passed by the 116th Congress but not signed into law that they’re urging congressional leaders to move forward without delay:
H.R. 1646, the HERO Act (Elise Stefanik, R-NY-21)
H.R. 5572, The Family Support and Services Act (Elise Stefanik, R-NY-21)
HR 4564, the Suicide Prevention Lifeline Improvement Act (John Katko, R-NY-24)
HR 5469, Pursuing Equity in Mental Health Act (Bonnie Watson Coleman, D-NJ-12)
HR 2466, the State Opioid Response Grant Authorization Act (David J. Trone, D-MD-06)
HR 5855, the Bipartisan Solution to Cyclical Violence Act (C.A. Dutch Ruppersberger, D-MD-02)
HR 1109, the Mental Health Services for Students Act (Grace F. Napolitano, D-CA-32)
HR 2519, the Improving Mental Health Access from the Emergency Department Act (Raul Ruiz, D-CA-36)
HR 7293, the STAND UP Act (Scott Peters, D-CA-52)
HR 3539, the Behavioral Interventions Guidelines Act (Drew A. Ferguson, R-GA-03)
HR 4585, the Campaign to Prevent Suicide Act (Donald S. Beyer, Jr., D-VA-08)
HR 4861, the Effective Suicide Screening and Assessment in the Emergency Department Act (Gus. M. Bilirakis, R-FL-12)
HR 5619, the Suicide Prevention Act (Chris Stewart, R-UT-02)
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.
Photo Credit: Getty Images/iStockphoto/Penn Today