COVID-19 has had an undeniable impact on mental health in America. The devastating loss of over half a million lives, the record-high unemployment rates, and the isolation required to mitigate the spread of the disease has weighed on children and adults alike. So much so that antidepressant prescriptions saw a stark increase as Americans did their best to cope with the stressors COVID-19 introduced into their lives.
So the latest report from The Journal of the American Medical Association (JAMA) may be surprising for some. Researchers found that 2020 actually saw a 5.6 percent decrease in deaths by suicide compared to the year before.
What do parents need to know about this new data? And does it mean the mental health of Americans and their children hasn’t been quite as impacted as we might have believed?
There are a lot of possibilities when it comes to what may have contributed to the reduction in deaths by suicide over the last year. One of those possibilities, according to psychotherapist and owner of Prescott Psychotherapy + Wellness Meredith Prescott, LCSW, may be that the increased focus on mental health over the last year resulted in people being more likely to reach out for familial support and medical treatment.
After all, with everyone facing similar struggles, those who needed help might not have felt so alone in asking for it.
“Mental health support has become more accessible and more talked about in a way that we haven’t really seen before,” Prescott explained. “It is more normalized now to seek help, even though we have a ways to go to eliminate the stigma.”
In response to the pandemic, access to mental health services also saw a drastic improvement for many Americans, with insurance companies offering no copay counseling sessions, and individual therapists providing free or low-cost services to those who needed it.
Then there are the ways 2020 forced people to slow down and reevaluate their lives,
“Patients have stated that this year has helped them better conceptualize what they actually need versus want,” Hopkins-trained psychiatrist and regional medical director for Community Psychiatry Leela R. Magavi, M.D. said. “People have shared that simple things, when observed and felt comprehensively, can add significant value and happiness to their day-to-day life.”
She explained that one of the benefits of the world-wide trauma experienced over the last year is that it provided people with a better understanding of the power of mindfulness and living mindfully.
“Many people are taking walks and spending time in nature. Once individuals identify how life is more simple and beautiful with mindfulness and periods of silence and meditation, it can create a pattern of healthy behavior, thanks to neuroplasticity and rewiring of the brain.”
She remains hopeful that some of these positive behavior changes will continue even after the pandemic threat is gone.
Does This Mean Distancing Measures Weren’t Detrimental?
Government officials had to make some impossible decisions over the last year. Protect mental health or physical health? Businesses or lives?
Across the country, schools closed down, businesses were prohibited from providing in-person services, and people were forced to mask up and maintain 6 feet of distance. It was all done in the name of saving lives (and with the understanding that a higher death toll would also be linked to worsening economic and mental health conditions). But there were some who argued the toll these measures would take on mental health as a whole wouldn’t be worth the lives that were saved.
Does this latest data mean they were wrong?
“As a child, adolescent and adult psychiatrist, I would contend that more individuals are experiencing passive death wishes and suicidal thoughts during the pandemic due to psychosocial stressors related to the pandemic,” Magavi said. “The CDC has postulated that there has been a decline in completed suicides; however, we cannot and should not overlook the individuals who have struggled with debilitating suicidal thoughts, which have affected their functionality.”
In other words: while the number of completed suicides may be down, she doesn’t necessarily believe that means the rate of depression and suicidal ideation is.
On the other hand, Prescott said it’s also important to remember that not everyone has taken a mental health hit as a result of the enforced societal changes the last year has brought.
“Some people benefit from being more isolated and working from secluded and controlled environments,” she explained. “Some people actually excel in these environments more than we imagined.”
Moreover, she said that a decrease in deaths by suicide, despite the challenges of the last year, shows the important role technology played in helping to keep us connected. Even when we couldn’t be face to face.
“We, as humans, are more resilient than we recognize,” Prescott said.
Some Groups May Have Been Impacted Differently
All that said, the latest numbers shouldn’t necessarily be taken at face value. Even the report authors acknowledge that just because there was an overall decrease in deaths by suicide, doesn’t mean that decrease applies to all demographics. Some groups may have experienced a disproportionate increase in deaths by suicide in line with the disproportionate burden they carried as a result of COVID-19 mitigation efforts.
Magavi believes that is certainly possible, particularly because minority groups are often overlooked when it comes to receiving a diagnosis and appropriate treatment for mental health conditions.
“The reasons are multifactorial,” she explained. “Many minority individuals tend to minimize symptoms. Some minority parents attribute mood and anxiety symptoms solely to laziness and lack of initiative, and this tends to be a multi-generational, cultural trend. Some physicians are unaware of their biases and consequently misdiagnose individuals.”
In addition to the fact that minority groups saw a higher rate of COVID-19 complications and deaths, it stands to reason these groups may also have experienced a higher rate of mental health impact, and possibly even deaths by suicide.
“Minority groups are often underrepresented in trials, so we need more studies to focus on these individuals,” Magavi said.
Takeaway for Parents
Just because the death by suicide rate went down over the last year, doesn’t mean we no longer have to worry about the impact that year has had. Particularly when it comes to children, Magavi said it is important to keep talking, keep watching, and to remain aware of the potential for mental health issues to arise.
“It is pivotal to ask open-ended questions to learn about how children are feeling,” she explained. Parents can voice their own feelings to create a safe environment, which may encourage their children to open up as well. Listening without judgment is key.”
When kids do express feelings of anxiety, depression, or thoughts of self-harm, she said parents should start by asking how the child might want to be helped.
“Everyone has different ways of processing their feelings and coping with them,” she explained. “Parents should check in with their child often, even if he or she may not be able to reciprocate. They could ask their child if he or she would like to join the family on a weekly walk or engage in some form of physical activity.”
Other suggestions she gave include:
- Bringing the child food and spending time discussing fun-filled memories
- Having the child list things they love about themselves
- Completing gratitude lists alongside the child
Perhaps most important is the need to remember that the impact of COVID-19 isn’t over yet, and may not be for some time to come.
“Just because suicide rates are down doesn’t mean self-harm or mental health disorders are,” Prescott said. “We know people are increasingly anxious, depressed, and suffering in many capacities.”
As time goes on, it’s possible the impacts of trauma will become even more clear. Which is why parents need to stay involved and aware.
“I don’t think we have seen the full effects of the pandemic from a mental health standpoint,” Prescott explained. “I think many people haven’t fully processed what has happened and may be living in survival mode.”
So what should parents be looking out for in their kids?
According to Magavi, “If children exhibit significant weight changes, paranoid behavior due to severe substance use, and are at risk for harming themselves, I encourage friends and family to seek help right away.”
The best place to start is usually their pediatrician, she explained. But you can also go through a psychiatrist or therapist if you already have an established relationship with one.
“It is of utmost importance to remove any weapons or sharp objects from the home and lock away any medications in the home,” Magavi encouraged. “If there are any acute concerns, I would recommend calling 911 or reporting to the nearest ER right away.”
Above all else, remind your children they aren’t alone.
Prescott said, “Tell them you are there for them. Give them hope. Get them help from a
licensed medical professional. Provide them with support and love.”
And trust the professionals you involve to help guide your family from there.