How To Help With Depression, Suicidal Thoughts Caused By The Pandemic
LAUREN GILGER: More than 10% of adults reported thoughts of suicide in the past 30 days, and three times more Americans have reported signs of depression since the pandemic began. That's according to the Journal of the American Medical Association. The statistics are clear, but as Gov. Doug Ducey said [Sept. 10], they are not just statistics.
DOUG DUCEY: They represent people in our lives: Our parents, our kids, our friends, our neighbors and our coworkers. Many of them are struggling during this time of increased isolation and heightened stress. And we must be there for them.
GILGER: Suicide was already a significant threat before the pandemic changed everything. Nearly 1,500 Arizonans took their own lives last year, and suicide is the leading cause of death among those between the ages of 10 and 14. We cannot yet know how much worse it will get. That's because of a six-month delay in death certificate data. But the state is bracing for those numbers to climb post-pandemic and working to reach young people and adults alike before it's too late. Here's State Department of Health Services director Dr. Cara Christ:
CARA CHRIST: From COVID-19 to influenza to suicide. There are so many challenges that people across the state are facing. So while we have prioritized suicide prevention strategies over the past few years, the impact of COVID-19 makes it more important than ever.
GILGER: Earlier, I spoke with Kelli Donley Williams, a suicide prevention specialist for the Arizona Health Care Cost Containment System, or AHCCCS. And I started by asking her what we know now about the pandemic's impact so far and what we need to know to fight back.
KELLI DONLEY WILLIAMS: We know from our behavioral health providers that we are seeing an increase in services related to treating depression and anxiety among adults. And we find that really interesting because those providers were previously serving students at public and charter schools. And the providers are saying that as kids are coming back to school, the same services are needed for children. But over the summer, they saw a dramatic increase in services that adults were requesting that they weren't previously. So that follows national data that would suggest that Americans are experiencing increased behavioral health needs related to the COVID pandemic.
GILGER: Yeah, yeah. So what more do professionals like you who are involved in this world need to know to be able to plan ahead? I understand experts at this point are sort of bracing for these numbers to really go up.
DONLEY WILLIAMS: Well, what we would like more than anything is to get the word out about what behavioral health resources are in the community. So that way, as normal daily activities begin to resume and hopefully daily life goes back to normal after a vaccine's in place. Folks know how to get care if they need care. And they're not at a loss for how to use their insurance to get into behavioral health services or how to find a provider if someone in their household is experiencing anxiety, depression, suicidal thinking or substance use.
GILGER: So let's talk then about how this is making things more difficult in the moment, right? Like, is caring for a loved one who's suffering from a mental health issue right now or considering hurting themselves more difficult because of the pandemic? I know we're seeing a lot more isolation.
DONLEY WILLIAMS: I don't think it's more difficult. I think there's a hesitation to go into an emergency room or to schedule a doctor's appointment unless it's absolutely necessary. But what we encourage individuals is to call the crisis line or to review with a doctor by telehealth to be able to determine if it is a behavioral health emergency. Of course, if someone is experiencing suicidal thinking, it is a behavioral health emergency and it is totally appropriate to either go to an emergency room or call the crisis line for advice.
GILGER: Do you think this is more, I guess, insidious in a way, though, because it's sort of an underbelly? Like, lots of people who might not have experienced these kinds of issues in the past might be experiencing them now and not know exactly what they are or how to recognize them?
DONLEY WILLIAMS: I do think it's insidious in that it's broken down community. We have folks who looked forward to going to church every Sunday, and that was their way to be in their community. And they may live alone, and they're not able to do that right now, or they don't feel comfortable doing that right now. Or, for example, students who are not able to participate on their sports teams. And they've looked forward to this for years, to be able to get on the high school football team or the high school swim team. And those things aren't functioning the way they would outside of a pandemic. And so I do think it's insidious because it inherently makes us isolated. And I think that we're hesitant to check on individuals because we don't want to either get them sick or we don't want them to get us sick. And so folks who live alone right now are probably feeling more alone.
GILGER: Yeah, yeah. We know that getting access to mental health care can be difficult even in, in normal times, right? Like, what can people do now? You're talking about calling the crisis line, but what resources are available once they do that to help people at this point?
DONLEY WILLIAMS: Sure. So AHCCCS actually received a federal grant to fund a website called ResilientArizona.org, or you can call 211. And there's crisis services available to anybody who calls. It doesn't matter if you have Medicaid insurance or private insurance. There are crisis counselors available to be able to talk you through what next steps may look like and help connect you with a provider in the community.
GILGER: What about resources and advice for those people who are trying to help others, like family members, loved ones who are looking to help someone who might not be quite so willing to get the help?
DONLEY WILLIAMS: That can be a very difficult conversation. We recognize that, especially if you've noticed an increase in substance use, a change in sleeping patterns, a change in just moodiness or irritability. Those can all be warning signs for suicidal thinking. And we know that that can be so hard to have that conversation with someone. So what we recommend is getting that person alone and having a really one-on-one intentional conversation about where they're at in their mental health. And if that person does confide that, yes, they are considering taking their own life by suicide, immediately getting them into care and being certain not to leave them alone until you can hand them off to a behavioral health professional.
DONLEY WILLIAMS: There are mobile crisis teams that can even come to your home, if that's what's required of the situation. Or, you know, it is not inappropriate if you have a suicidal person with you to drive to an emergency room. They will figure it out and they will help you with the next steps.
GILGER: Kelli, how is the increase in opioids that we've been hearing about and other substance abuse issues crossing with this, I guess? Are you seeing these happen at the same time or be often in the same boat?
DONLEY WILLIAMS: So we know that individuals who are experiencing a behavior health crisis often turn to substance use to try to feel better. And it's something like 70% of suicides nationally, the individuals who die by suicide have alcohol in their system. So what we recommend from our team is that if you have someone in your home who's dealing with a behavioral health crisis and let's say that individual has not expressed suicidal thinking, it is still critically important for that period of time to remove substances from your home. So our first step is get alcohol, which is a depressant out of your home for a period of time. Make sure that if you have any prescription drugs that are unnecessary to get those to a drop box or to a pharmacy that will accept them. And even over-the-counter medications — if you do not need them in your home and you have someone who's in a behavior health crisis, get those out of your home for the time being as well. We recognize that behavioral health encompasses both substance use and mental illness for a very specific reason. Individuals who are suffering from mental illness, whether it's temporary, like situational depression or a long-term diagnosis, may also use substances to feel better for the short term. And so we try to make sure that services for both are always paired. So if you have someone who is drinking too much and is experiencing depression, those are, of course, related.
GILGER: All right. That is Kelli Donley Williams, the suicide prevention specialist in AHCCCS here. Kelli, thank you so much for joining us this morning to talk about this.
DONLEY WILLIAMS: Thanks for having me.
If you or someone you know may be considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (En Español: 1-888-628-9454; Deaf and Hard of Hearing: 1-800-799-4889) or the Crisis Text Line by texting 741741.