The pandemic raises concerns about suicide, alongside new advances in treatment
The recent suicide deaths of front line workers, including an ER doctor in New York, who fought valiantly to keep her coronavirus patients alive and herself alive after a bout with the virus, have suicide prevention folks like me concerned. By the time you read this, somewhere between 200 to 300 Kentuckians will have died by COVID-19. Last year, over 700 Kentuckians died by suicide, placing Kentucky squarely near the top of the 20 states with the highest suicide death rates. The question raised by the front line workers’ deaths is: Will the economic stress, physical isolation, grief, decreased access to communities of support during this current pandemic spur on more death by suicide?
After the SARS outbreak in 2003, healthcare workers and individuals who self-quarantined showed symptoms of PTSD. Existing research suggests that sustained economic stress could be associated with higher US suicide rates. The COVID-19 pandemic may have a similar effect. We simply do not know yet. We do know that Americans are struggling with mental health concerns. In a recent KFF poll, 45 percent of adults in the United States reported that their mental health has been negatively impacted due to worry and stress over the virus.
The Crisis Text Line has had a 40 percent increase in crisis texts since March with anxiety being the top concern, and one in five texters mentioning the coronavirus specifically. Active Minds, Inc., a nonprofit addressing suicide risk on college campuses across the United States found that college students have been hit hardest by COVID-19, with 20 percent reporting significantly worse mental health due to the crisis.
According to Express Scripts, the official pharmacy benefit manager for Eastern Kentucky University, the number of prescriptions for antidepressant, anti-anxiety and anti-insomnia medications filled per week increased 21 percent with anti-anxiety drugs spiking the most at 34 percent between Feb. 16 and March 15, 2020.
That’s a lot of bad news. The good news is that necessity as the mother of invention has been working overtime. We are provided opportunities in our crisis. Faith communities have utilized Zoom, Facebook Live, Skype, Facetime, WhatsApp, and other platforms to connect, provide support, hold devotionals, pray, and worship. The Catholic Diocese of Lexington has been holding Facebook Live masses in both English and Spanish. The “Zeder” became the newest invention as Passover was celebrated this year across the country through Zoom. The Ashland Avenue Baptist Church in Lexington celebrated Easter as 154 cars participated in a drive-in service.
Most health care institutions and hospitals are utilizing telehealth. Whereas less than one percent of these health care visits were via telehealth prior to COVID-19, hospitals and health systems are now relying upon telehealth. The Cleveland Clinic logged more than 60,000 telemedicine visits in March alone. Prior to March, the health system averaged about 3,400 telehealth visits per month, an increase of more than 1,700 percent.
Mental health providers across the country and in Kentucky have been able to utilize telehealth to increase access to those who are most vulnerable and to continue care for those who they cannot see face-to-face. Eastern Kentucky University’s Counseling Center and the EKU Psychology Clinic, moved quickly to provide telepsychology to those who were existing clients. However, clinicians across the country have been slow to adopt suicide-focused care to the most distressed and at-risk individuals. This was true before the advent of telehealth, but became even truer after the switch to telehealth. We now have empirical support for suicide-focused treatments and research that supports electronic platforms for providing this treatment.
The EKU Psychology Clinic has been a leader nationally, cited by the Suicide Prevention Resource Center as a best practice in providing suicide-focused treatment via telepsychology, addressing the needs of the most distressed students and community members using the empirically supported Collaborative Assessment and Management of Suicidality (CAMS) approach via a telepsychology platform, Doxy.me. The most vulnerable of individuals are now being delivered the same care during quarantine and, perhaps, at the time they need it the very most.
In this respect, Kentucky leads the way. And, there is hope. While there is research and trends that foment concern, there is also evidence that we can do things differently, adapt to change, and make decisions in the best interest of everyone. Kentuckians will be forever changed by the COVID-19 pandemic. The loss of life and the grief created by the hardships cannot be denied, but, perhaps, this is a time to reflect upon what we can do during this time of transformation and lean in to that opportunity.
The National Suicide Prevention Lifeline is 1-800-273-8255.
Melinda Moore is an assistant professor in the Department of Psychology at Eastern Kentucky University and the co-lead of the National Action Alliance for Suicide Prevention’s Faith Communities Task Force.