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A Dual Pandemic: The Public Health and Mental Health Crisis
A Dual Pandemic
The Public Health and Mental Health Crisis
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By Sara Boerenko, LCSW, Public Health Director, Montgomery County
Prior to March 2020, the nation was in the midst of a mental health and opiate crisis. There was a lack of providers, a lack of program staff, and high rates of suicide and overdose in the United States. Going forward through the COVID-19 pandemic, suicide and overdose did not stop. The workforce crisis and shortage of providers grew. In Montgomery County, we saw an increase in the need for behavioral health services, access to care and community-based services to meet people “where they are at.”
As a dual department, we were able to integrate COVID work with behavioral health work. Our staff, while making daily quarantine/isolation calls to patients, also inquired about how patients were doing mentally. Staff asked patients how they were feeling, talked to them about the fears they had and how they were taking care of their own mental health. Often the stress of isolation was due to not being able to work, not being able to see family and loved ones; fears related to obtaining basic needs such as food, milk, diapers, baby formula.
We helped connect our patients with crisis hotline numbers and food pantries that made home deliveries, worked with our legislator to arrange Meals on Wheels to drop food to elderly, and assisted with getting families basic needs to alleviate the mental stress of isolation.
Upon opening the county in a safe manner, we immediately began hosting small Narcan trainings for our community. We held five trainings, limiting the groups to seven people, spaced out, and under 20 minutes. By doing this, over the course of four months, we trained 34 new people on opiate overdose response procedures. We also met with community members one-on-one to provide individual trainings. In all, we had 47 new community members trained on how to use Narcan.
Further, in our down time, we assembled and delivered over 500 opiate overdose response bags to local volunteer fire departments, our police departments, ambulance services, and community-based organizations that were getting back to home visits.
Since social media was used so much to disseminate information, we ran weekly mental health and substance use campaigns offering messages of hope to our community. Our largest ad campaign ran for three months and advertised the local HELPLINE number with a message: “The Link: substance use – overdose – suicide.”
Our teams also continued to host and train the community on Mental Health First Aid. A typical class of 25 participants was cut down to 10; however, we held five classes at capacity and welcomed 50 new mental health first aiders to our county. We also took calls from community members that who had lost family and were looking for a friendly voice to talk to as a way to combat the loneliness and isolation they were feeling.
Staff in our department offered phone calls to those needing support. A few community members did ask to see us in person. When it was possible and safe, I did allow a few (four) community members to come to our department to meet with me to discuss how they were struggling with various aspects of this new normal. One of the people I met with still calls me every so often to say hello and sent our department a beautiful Christmas card.
There are endless stories of what the Montgomery County Public Health and Mental Health Departments did during the pandemic on top of the workload of managing the actual pandemic. But the hard work, the heavy lifting starts now. We see the damage done as a result of services halting for two years and we need to get back to overall health and wellness. We learned that for the next pandemic, we are better prepared to assist with a holistic approach to our community. We know how to provide behavioral health services in conjunction with emergency preparedness measures to ensure wellness.
It’s Time for Public Policy Solutions to the College Mental Health Crisis
By John Richter, MPA, Director of Public Policy, Mental Health Association in New York State
Evidence of a growing mental health crisis on college campuses has been accumulating for nearly two decades and has undoubtedly been made worse by the COVID pandemic. Despite periodic media attention to this trend, until very recently, lawmakers have not offered legislative solutions and seem inexplicably unaware that a problem even exists. The Mental Health Association in New York State, Inc. (MHANYS) has launched a campaign to bring awareness to the crisis and to encourage public policy solutions here in New York.
Some of the first indicators that a crisis was brewing are found in a Healthy Minds Study (HMS) that gathered student mental health and utilization data annually between 2007 and 2017. The large internet-based survey of 155,026 students from 196 U.S. colleges and universities revealed some startling trends in prevalence and treatment-seeking behavior. For example:
• The proportion of students with a diagnosed mental health condition increased from 21.9% in 2007 to 35.5% in 2017,
• Rates of depression increased from 24.8% in 2009 to 29.9% in 2017, and
• Rates of suicidal ideation went up from 5.8% in 2007 to 10.8% in 2017.
During the same time frame there was a significant uptick in students seeking mental health treatment, which either reinforces the prevalence data (i.e., more students with symptoms) or reflects shifting attitudes about mental health (reduced stigma)—or both.
The COVID-19 pandemic has only made matters worse for college students, contributing to an added measurable spike in anxiety, depression, and suicide among college students. The pandemic introduced a level of fear, uncertainty, and isolation so profound that its impact has increased the incidence of moderate to severe anxiety and depression among first-year college students by 40% and 48% respectively.
The pandemic has without a doubt contributed to a perfect storm of mental health challenges on college campuses and some lawmakers in New York are paying attention.
In 2018, Disability Rights Advocates brought a class-action lawsuit against Stanford University on behalf of three students at the University alleging that the University repeatedly violated state and federal anti-discrimination laws in its response to students with mental health disabilities, including those who have been hospitalized for self-harm and suicide attempts. Central to the lawsuit was Stanford's involuntary leave of absence policy and procedures which were characterized in the suit as punitive and onerous.
The lawsuit ended in a settlement wherein Stanford, without an admission of liability, agreed to revise its involuntary leave of absence policy, ensure sufficient staffing to support students with mental health disabilities, and increase training for anyone involved with implementing the policy. The University also agreed to pay the plaintiffs' legal fees which amounted to nearly half a million dollars.
The Stanford University lawsuit underscores a lack of parity between physical illnesses and mental illnesses in many college leaves of absence policies. But despite attention to the escalating mental health trends in colleges and universities through exposure in the media and the Stanford University lawsuit, there is an astonishing scarcity in legislative response at both the national and state level.
Fortunately, here in New York, that’s beginning to change. Legislation introduced by Senator Anna Kaplan and Assemblywoman Aileen Gunther (S.7659/ A.9753-A), includes provisions to increase mental health literacy, require the review of college student leave of absence policies and create more telehealth/virtual counseling opportunities within the State University system.
MHANYS has launched a campaign to draw more attention to the college mental health crisis and is calling for a summit of higher education and mental health stakeholders, and state lawmakers to help shape a public policy response to the crisis here in New York. MHANYS released a white paper, Mental Health & Higher Education in New York: A Call for a Public Policy Response, in February 2022 to raise awareness about the crisis and to call for a public policy response. The summit is planned for the fall 2022.
As part of its campaign, MHANYS is promoting public policies to increase mental health literacy on campuses and encourage whole health parity. That’s why MHANYS supports S.7659/ A.9753-A, which addresses both of these needs on SUNY and CUNY campuses. MHANYS supports similar provisions in the law that would apply to independent and private colleges and universities.
For more information about MHANYS College Mental Health campaign please contact John Richter, Director of Public Policy, MHANYS at 518-434-0439, or at jrichter@mhanys.org.
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