Ex­perts ex­pect ‘tsunami of need’

Pan­demic, racial protests add to 2020 struggles, stress of teens

Daily Camera (Boulder) - - Front Page - By Jessica Sea­man

The num­ber of sui­cides among young Coloradans re­mains un­changed dur­ing the coro­n­avirus pan­demic com­pared to pre­vi­ous years, but school and health of­fi­cials ex­pect to soon see a “tsunami of need” for men­tal health care.

There were at least 31 sui­cides among 10- to 17-year-olds between March and Au­gust, which is the same num­ber of deaths recorded on av­er­age for the same pe­riod dur­ing the three prior years, ac­cord­ing to pro­vi­sional deathcer­tifi­cate data from the Colorado health de­part­ment.

So far, get­ting a full un­der­stand­ing of the men­tal and emo­tional toll of COVID-19 has been dif­fi­cult, in­clud­ing gaug­ing the ef­fect it’s hav­ing on chil­dren and teens. But men­tal health pro­fes­sion­als said they are start­ing to see more de­mand for coun­sel­ing and in-pa­tient hos­pi­tal stays.

“There’s a de­layed ef­fect for youth around their men­tal health,” said Dr. Ja­son Wil­liams, di­rec­tor of op­er­a­tions for the Pe­di­atric

Men­tal Health In­sti­tute at Chil­dren’s Hos­pi­tal Colorado.

And the fact that sui­cides among chil­dren and teens re­main el­e­vated is notable be­cause over­all such deaths de­clined 6.3% in the state dur­ing the first six months of the pan­demic.

An es­ti­mated 612 Coloradans died by sui­cide dur­ing that pe­riod, which is down from the 3-year av­er­age of 653 deaths dur­ing the same pe­riod, ac­cord­ing to data from the state health de­part­ment.

Chil­dren and teens aren’t just strug­gling with the pan­demic. There’s also the ef­fect of the eco­nomic cri­sis, the re­cent po­lice bru­tal­ity protests and the long shadow of sys­temic racism. And there’s grow­ing chal­lenges to ac­cess af­ford­able hous­ing and food.

More than a decade ago, dur­ing the Great Re­ces­sion, places like Mesa County also saw stu­dents strug­gle with a rise in do­mes­tic vi­o­lence and fam­i­lies in jail, said Jon Burke, men­tal health and cri­sis co­or­di­na­tor for Mesa County Val­ley School District 51.

“We have a pan­demic on top of an eco­nomic down­town,” he said, adding that he is ex­pect­ing schools to see a “tsunami of need” come their way.

“We’re prep­ping the best that we pos­si­bly can for what we ex­pect,” Burke added. “It’s nerve-wrack­ing. We’re re­ally wor­ried ul­ti­mately about what we will be able to pro­vide.”

Pan­demic weighs on wors­en­ing men­tal health

The num­ber of sui­cides among chil­dren and teens is rel­a­tively small, but such fa­tal­i­ties have been grow­ing for years in Colorado, be­com­ing the lead­ing cause of death for younger peo­ple in 2014. Men­tal health ex­perts say that if the num­ber of deaths is re­duced it could also po­ten­tially lower sui­cides among adults in the fu­ture.

De­pres­sion and anx­i­ety also are on the rise among young peo­ple. Both are risk fac­tors for sui­cide, but hav­ing a men­tal ill­ness does not mean a per­son will harm them­selves, Wil­liams said.

Other risk fac­tors in­clude sub­stance use, lack of a trusted adult and sig­nif­i­cant changes in a per­son’s life, such as the death of a loved one. The pres­sure to per­form well in school, so­cial me­dia and cy­ber­bul­ly­ing also are risk fac­tors for ado­les­cents, ac­cord­ing to a re­port re­leased by the Colorado At­tor­ney Gen­eral’s Of­fice in 2019.

Now, with the pan­demic, chil­dren and teens also are likely to ex­pe­ri­ence anx­i­ety about not know­ing what is go­ing to hap­pen if they get sick with COVID-19. And there has been a loss of so­cial con­nec­tion as stu­dents were out of school for months, with some still in re­mote learn­ing this fall.

“Re­la­tion­ships are im­por­tant and the fact that they aren’t able to have those and main­tain those in a way we are used to is cre­at­ing a profound sense of grief and loss,” said Michelle Sim­mons, a li­censed pro­fes­sional coun­selor in the Den­ver area.

There are con­stant re­minders of the sever­ity of the pan­demic, such as the masks that are re­quired to be worn in many places in­clud­ing schools, which can heighten such anx­i­ety or even cre­ate a sense of not car­ing or hope­less­ness be­cause it is out of their con­trol, Wil­liams said.

“It’s hard for kids to es­cape from that,” he said.

A con­cern with the pan­demic is that, for many months, chil­dren and teens have not been go­ing to school or vis­it­ing other places, such as their pe­di­a­tri­cian’s of­fice. So it’s pos­si­ble some men­tal ill­nesses aren’t get­ting caught un­til they are in a later stage, Wil­liams said.

Tips into Safe2tell also de­creased at the start of the pan­demic, be­fore in­creas­ing again in the sum­mer.

And Colorado Cri­sis Ser­vices saw a 9% de­cline in calls between March and July, with more than 5,800 calls com­ing from those between 13 and 25 years old.

Sui­cide is still the lead­ing rea­son ado­les­cents reach out to the statewide Safe2tell sys­tem, but there also has been an in­crease in re­ports for wel­fare checks.

Wel­fare checks are re­quested over con­cerns about an­other per­son, and can be re­lated to sui­cide or for gen­eral safety. One con­cern is that the in­crease in wel­fare checks might re­flect po­ten­tial child abuse or do­mes­tic vi­o­lence that is hap­pen­ing at homes but isn’t be­ing re­ported be­cause un­til re­cently stu­dents haven’t been in school with those who are manda­tory re­porters, At­tor­ney Gen­eral Phil Weiser said.

At Chil­dren’s Hos­pi­tal Colorado, doc­tors have no­ticed that more of the chil­dren and teens they are treat­ing fol­low­ing sui­cide at­tempts are com­ing in with “more lethal at­tempts” that cause se­vere in­jury and re­quire a med­i­cal stay, Wil­liams said.

The hos­pi­tal’s gen­eral psy­chi­atric unit has 18 beds, and on av­er­age about 13 of them are filled dur­ing May, June and July. But this year, the unit has been near ca­pac­ity, with 17 pa­tients, Wil­liams said.

“We have not seen that in the past five years,” he said. “We do see that as a di­rect cor­re­la­tion to the pan­demic.”

After­shocks from racial jus­tice protests

Chil­dren and teens also are deal­ing with the trauma from racial in­jus­tice, which has been pushed to the fore­front by the po­lice bru­tal­ity protests that have oc­curred since the death of Ge­orge Floyd, the Black Min­nesotan killed when a white po­lice of­fi­cer knelt on his neck for nearly nine min­utes.

Racial trauma stems from ex­pe­ri­ences with dis­crim­i­na­tion or hate crimes or cu­mu­la­tive oc­cur­rences of ev­ery­day dis­crim­i­na­tion and mi­croag­gres­sions, ac­cord­ing to the Amer­i­can Psy­cho­log­i­cal As­so­ci­a­tion.

On top of the racism, death and protests, the pan­demic also has spot­lighted racial in­equal­i­ties as peo­ple of color have ex­pe­ri­enced higher rates of in­fec­tions and death.

“Kids were go­ing through racial stress in their lives any­ways,” said Apryl Alexan­der, as­so­ciate pro­fes­sor at the Grad­u­ate School of Pro­fes­sional Psy­chol­ogy at the Uni­ver­sity of Den­ver. “COVID high­lighted the dis­par­i­ties that ex­ist in our sys­tem and ex­ac­er­bated them.”

Sim­mons has a two-week wait­list for ther­apy ap­point­ments — some­thing that has never hap­pened be­fore.

And among her pa­tients are teenagers, rang­ing in age from 14 to 19, who have at­tended the protests and are strug­gling with the trauma from the events, in­clud­ing the de­ploy­ment of tear gas and non-lethal pro­jec­tiles by po­lice.

Some of the pa­tients are show­ing signs of acute stress dis­or­der, which can be­gin soon after a trau­matic event. If the symp­toms — which in­clude anx­i­ety, fear, trig­gers and flash­backs — per­sist for a longer pe­riod, a per­son can be di­ag­nosed with post-trau­matic stress dis­or­der, Sim­mons said.

Those ex­pe­ri­enc­ing acute stress dis­or­der in­clude both Black and white teenagers, she said.

“We are raised to be­lieve that po­lice are safe,” Sim­mons said. “Kids are re­ally sort of reck­on­ing with what it is that they have been taught be­fore and try­ing to match that with what their real ex­pe­ri­ence has been.”

(Sim­mons works with Cen­tura Health’s mo­bile cri­sis unit and helped The Post fa­cil­i­tate a com­mu­nity dis­cus­sion on youth sui­cide in 2019. Cen­tura is a spon­sor of The Post’s on­go­ing Cri­sis Point project.)

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