COVID-19: US Initiative Aims to Stem the Tide of Suicide, Mental Illness

Deborah Brauser

May 01, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Several federal agencies and private sector groups have launched a national initiative that aims to prevent suicide and mental illness resulting from the COVID-19 pandemic.

Launched by the partnership group the National Action Alliance for Suicide Prevention (NAASP), the Mental Health and Suicide Prevention National Response to COVID-19 program will leverage the group's "collective influence and expertise" to coordinate actions, promote "evidence-informed best practices" at the community level, and amplify messages of hope and support.

Joshua Gordon, MD, PhD

Led by Joshua Gordon, MD, PhD, director of the National Institute of Mental Health (NIMH), and former Congressman Patrick J. Kennedy, the NAASP notes that the first-of-its-kind initiative will focus specifically on the current COVID-19 environment and subsequent challenges that may follow once the pandemic ends.

"We know from our research of past disasters and epidemics that mental health effects are powerful and they grow over the weeks and months after the events," Gordon told Medscape Medical News.

He added that psychiatrists will likely become "the second front line" after the pandemic finally ends, as they will need to take care of the mental health of patients, clinicians, and other individuals who show signs of anxiety, depression, and even post-traumatic stress disorder from COVID-19.

In addition, isolation, loneliness, and economic hardships could all take a long-term toll.

"So making ourselves available and making sure we have the resources we need to be able to care for all patients is going to become more and more important as the weeks wear on," Gordon said.

Fuel for the Fire

In a recent Gallup poll of almost 8000 American adults, 26% of those between the ages of 18 and 44 years said their mental health was already suffering because of COVID-19 practices.

The news has been even more tragic for some frontline workers fighting to save severely ill patients infected with COVID-19.

As reported by Medscape Medical News, an emergency department physician in New York City died by suicide this past weekend. Her father said her work on the front lines of the coronavirus crisis was the cause, adding that she was a "casualty just as much as anyone else who has died" from the pandemic.

"Rates of suicide and overdoses were at historic levels before COVID-19 hit," Kennedy said in a press release from the NAASP. "This pandemic will fuel the fire of our country's mental health crisis unless organizations unite in a call to action," he added.

Gordon agreed, noting that building an effective response to suicide prevention in the US can't be solved by one agency alone.

"Instead, federal agencies must join forces [and] capabilities, leverage resources, and share lessons learned with each other and the private sector to achieve the greatest impact," he said.

One-Stop Shop

The NAASP had already been working on a national response to the national increase in suicide rates, resulting in a strategic research plan as well as employee-based, faith-based, and healthcare-based initiatives.

Under the guidance of a steering committee, the new COVID-related national initiative will focus initially on four main areas. These include shared messaging, crisis care, suicide care, and policy.

There is also a section on the NAASP's website that's specific to the COVID-19 pandemic and that will act "as sort of a 'one-stop shop' to hold different elements that our partners can bring to bear," Gordon said.

"All of these organizations are working together to try and come up with new ideas and new ways we can work together to ensure that we can expand access to care for those who need it," he added.

For example, the NIMH has made a push to study the increased use of telehealth services during COVID-19 in order to build an evidence base for best practices.

"We want to make sure healthcare systems are using best practices. And we want to make sure private employers are making those telehealth resources available to their employees," he said.

The new initiative will also assess and ensure that the Centers for Medicare & Medicaid Services and Veterans Affairs are engaging in best practices when it comes to mental health, and that private insurers are providing appropriate services to members.

"It's making sure the whole ecosystem of mental healthcare in this country is working together and using evidence-based approaches to minimize mental health effects of the pandemic," Gordon said.

"Heal Thyself..."

For psychiatrists during this time, "it's important that they make themselves available as much as possible. Regulations on telehealth have been relaxed, so reaching out on really easy-to-use telecommunication platforms such as FaceTime and Zoom is worth doing — with the right protections," he added.

"Now is the time to really use these technologies to be able to reach your patients."

Gordon noted that it's also imperative that clinicians practice self-care.

"We have a fair amount of knowledge about how to help healthcare workers and we want to make sure that's out there and shared broadly. That's another goal of the steering committee," he said.

Gordon reported that he has been helping run a virtual discussion group for healthcare providers in his own community in New York so that they can talk through issues they are facing in this unique environment.

For clinicians, "make time for your mental health. It's really crucial and will help — not just right now but also in the weeks and months to come. As the immediacy of the pandemic recedes, your mental health needs will become more front and center," he said.

He added that evidence shows that comprehensive care provided to individuals at an early stage mitigates the long-term impact of trauma on mental health.

"A lot of healthcare organizations are providing services for their frontline workers, but a lot of those workers are feeling too busy to take advantage of those resources. But if they take a little time now, it can be protective over the long run."

Gordon noted that clinicians should "really think about the burdens they are facing" and then reach out in a proactive way. "It's an important medical preventative that they can take."

Suicide Prevention Hotline

For a clinician who is feeling severely overwhelmed or having thoughts of suicide, "reach out to a professional for assistance, which could be a colleague or a member of the clergy," he said.

"If you're really thinking about harming yourself, and you don't know where to turn, reach out to the hotlines that are available," Gordon said. This includes the national, which has a hotline at 1-800-273-TALK (8255).

"Reaching out to those resources if you're acutely distressed can be a lifesaver, literally," Gordon said.

As for agencies coming together for the new initiative, Kennedy said "there's no more time" for debate and discussion. "We need all hands on deck to fast track the strategies we know will work."

"The collective work of this national response has the potential to change the way our country views, treats, and talks about mental health and suicide for generations to come," Gordon added.

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