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(CW: Suicide) The decline in the nation’s suicide rate during the first year of the COVID-19 pandemic may suggest advancements in preventative programs and treatment, but stakeholders contend a closer look reveals a complicated picture — one that raises questions on why the decline did not occur evenly across racial and ethnic groups. Dr. Christine Crawford, associate medical director at NAMI, says a potential positive that as a result of the pandemic is the increased willingness among people of all racial and ethnic groups to talk about their mental health and well-being. She hopes such openness can lead to new opportunities for expanding mental health care supports and services within underserved communities. “I think more people are able to better appreciate just how significantly impairing depression and anxiety and other mental health symptoms really are,” Crawford says. “My hope for the future is that not only can we normalize conversations around mental health and emotional wellness, but we can also normalize conversations around mental health treatment.”
Even though Congress created 988, Congress didn’t fund it. Right now, when people experiencing a mental health crisis call 911, most of the time they end up in a hospital or in jail. “More than 2 million people each year with a mental illness are booked into our nation’s jails and prisons. It’s a huge number,” says Hannah Wesolowski, NAMI CAO. Advocates like her see 988 as a chance to significantly shrink that number. “We have funded mental health this way for decades. It is pennies here, pennies there. It is out of the goodness of people’s hearts that organizations are there to support people experiencing mental health conditions. I’m hoping policymakers make the investments that we know we need to make,” said Wesolowski.
After stopping my anxiety medication too quickly, I needed expert assistance quickly. I have good health insurance, but finding an appropriate professional became a lengthy, frustrating process. The lack of current or reliable online information for mental health was a big problem, even for me — and I’ve worked in health care. In 2021, a research survey from the National Alliance on Mental Illness revealed growing dissatisfaction with online mental health information. The survey involved both individuals with mental health conditions and those seeking assistance for family members. Eighty percent of responders who used navigational tools to find treatment or services reported difficulties with data availability and accuracy.
“This is a once-in-a-generation opportunity to fundamentally transform part of the mental health system that for far too long has been underfunded and under supported,” said Hannah Wesolowski, NAMI CAO. “There’s a lot to happen between now and calling it a success.” Last week, bipartisan legislation was introduced to provide federal funding and guidance for states to rev up their 988 crisis response infrastructure. The Administration plans to request nearly $700 million for launching 988 in its upcoming federal budget.
The psychiatric staff at Children’s National saw a change with COVID — common issues are amplified with mild depression leading to major depression. Across the country, only about 10% of hospitals have pediatric psychiatric services and only about 7% provide inpatient care, resulting in children waiting in the ER for beds, sometimes for weeks on end. The section on ﬁnding help for a struggling child links to NAMI and a NAMI blog post on navigating the overwhelming volume of new mental health apps.
“Members of the military have to function at a very high level and that takes a toll,” said Sherman Gillums Jr., NAMI Chief Strategy Officer and retired Marine officer. “We are taught to mask anything that is wrong with us, to adapt and overcome. Military culture looks at asking for help as a liability, from recruitment to training to the rest of one’s career.” Mr. Gillums noted that more troops were sharing their experiences with sexual harassment, assault and mental health struggles on social media. “This could be an intergenerational shift,” he said, “starting with young people who see themselves as humans first beyond their uniform and weapon.”
As a parent talking about emotional or mental well-being isn't always easy. The key is to ensure children feel comfortable expressing their feelings and getting help when they need it. "It's important to know that showing that you're concerned about their behaviors will not make things worse; it'll help acknowledge what they've been thinking and feeling, making you both more connected. Your role isn't to diagnose your child; keep your message simple: You've noticed behaviors that you are concerned about. You want to support them," says Jennifer Rothman, Senior Manager of Youth and Young Adult Initiatives at NAMI.
The 988 Implementation Act builds on the 2020 legislation that designated 988 as the new three-digit number for the National Suicide Prevention Lifeline. That bill authorized states to add surcharges to the monthly telephone bills of consumers to help fund the line but provided no other funding to states to run it. So far, according to NAMI, only four states (CO, NV, VA, WA) have done so. “It’s going to take federal investment as well as state and local leadership to make a 988 crisis continuum available to everyone,” said Hannah Wesolowski, NAMI Chief Advocacy Officer. “While Congress gave states this mechanism for a new funding stream, it is discouraging to see so few states leverage the opportunity.”
Legislation in more than two dozen states has passed or is pending to fund 988 services or study funding, according to NAMI. "Currently, as a country, we're not ready for this rollout," said Hannah Wesolowski, NAMI Chief Advocacy Officer. "There's so much demand out there and so many elements to knit together to really prepare to fully provide a mental health response to a mental health crisis."
Legislators introduced the 988 Implementation Act, a bill to help fund the 988 rollout and implementation. Hannah Wesolowski, NAMI Chief Advocacy Officer, said about 80% of calls to the Lifeline can be de-escalated over the phone. Of the 20% that can't, she said, about 70% can be resolved with the help of mobile crisis response teams. The rest can go to crisis stabilization centers, after which a majority can be discharged back into the community without being hospitalized. "Mobile crisis teams, which provide an alternative to law enforcement, are so critical. Relying on law enforcement is just an ineffective way to respond to [mental health] crises. That's not the job law enforcement signed up for, nor should we be asking them to do that," Wesolowski said.
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