On the Frontlines

ON THE FRONTLINES The State of Mental Health Care

By Connie Mitchell

There are only so many mental health providers out there, and they were busy before the COVID-19 pandemic. Now, says Dr. Shelah Radke, demand far outweighs supply, causing people with depression, anxiety and other mental health challenges to face waits of up to eight months to see an outpatient mental health professional.

Radke is a co-medical director for the Mercy Behavioral Health access center at Mercy Hospital and is a child and adolescent psychiatric physician hospitalist at Mercy St. Louis. She says helping those in need access care during the pandemic is challenging, but “there have been some good changes – outpatient clinics are working virtually and in person now, which provides a nice mix for patients, depending on their needs.”

In fact, the increased focus on virtual care has improved access for some children. “More and more, schools are cooperating with us and enabling us to provide services like IOP [intensive outpatient] virtually during the school day, meaning a child could potentially leave their classroom, walk down the hall to a school media room and log on to a therapy session with their IOP group, and be able to participate in that essential care model in a confidential fashion, while not requiring parents to drive to and from school and IOP over the course of a day,” she says.

Still, the heavy demand is stressing a system already at capacity. A 2021 study published in The Lancet, the distinguished weekly peer-reviewed general medical journal, examined data from more than 200 countries during the pandemic’s first year and “estimated a significant increase in the prevalence of both major depressive disorder and anxiety disorders since before the pandemic. Increased prevalence was seen for both males and females across the lifespan. These findings are all the more concerning because depressive and anxiety disorders were already leading causes of disability worldwide.” Furthermore, the National Alliance on Mental Illness, an Arlington, Virginiabased advocacy group, estimates that more than 40 million U.S. adults – about 20 percent – have a diagnosable anxiety disorder.

“We have seen the percentage of children with trauma symptoms double in the past two years,” Radke says. “We follow trauma-informed care practices on the inpatient units, which means that all of my patients are screened for trauma symptoms. The number of patients who have symptoms consistent with a clinical level of concern has almost doubled since prior to the pandemic. I’m not sure why this has occurred; several articles have been written on this, and they’re calling it ‘pandemic-related’ [posttraumatic stress disorder].”

Radke urges people to consider the intensive outpatient care option, which provides group and individual therapy sessions twice a week for up to three weeks and has a wait time of only one or two weeks. She also recommends a number of important lifestyle factors that can help manage mental health issues.

She advises taking a multivitamin with activated folate and EPA/DHA (fish oil) daily, getting seven to eight hours of sleep nightly and exercising regularly. “I also encourage people not to wait for others to reach out to them, but to be the one that creates a community,” she adds. “If you’re struggling with negative, selfcritical thoughts or feel hopeless or helpless, I recommend you reach out to your primary care physician first and ask them for direction and care, and if you’re having thoughts of suicide, please reach out to a friend, a colleague, and to one of our many local resources to talk with people who really do want to support you and help you find just the right care connection.”

The Mercy Behavioral Health access center is available 24/7 and can provide direction on accessing area mental health resources. “Mercy Behavioral Health offers free, confidential evaluations for anyone who has a concern about a psychiatric, behavioral or addictive disorder,” Radke notes. “Evaluations, as well as referrals to physicians or community resources, are available 24 hours a day. Call 314-251-0555.” ln Mercy Behavioral Health – St. Louis, 615 S. New Ballas Road, St. Louis, 314-251-4845, mercy.net/practice/mercy-behavioral-health-st-louis

Behavioral Health Response, 314-469-6644, bhrstl.org

National Suicide Prevention Lifeline, 800-273-8255, suicidepreventionlifeline.org

Crisis Text Line, text HOME to 741741, crisistextline.org