Online Therapy, Family Support Key To Preventing Suicide During COVID-19, Experts Say

The COVID-19 pandemic has raised new financial and logistical challenges for many people and cut them off from their usual support systems. All over California, these changes are causing people to feel overwhelmed, anxious and stressed.

Experts say it’s a crucial time to let people know they are not alone. 

During September, National Suicide Prevention Month, many organizations are encouraging those who are struggling to seek help from a mental health professional. Early in the pandemic, calls to suicide crisis lines jumped as people grappled with isolation. 

Staff at WellSpace Health — a community health center system that takes National Suicide Prevention Crisis Line calls from 50 of California’s 58 counties — received roughly 5,900 calls this June, compared to just over 3,000 monthly calls in June of 2019.

Ben Miller, a clinical psychologist and chief strategy officer of national health nonprofit Well Being Trust, said deaths from suicide, drugs and alcohol were on the rise in the United States even before the pandemic because our health system hasn’t provided adequate preventive care.

“By not addressing those issues before COVID, they’re only going to be exacerbated,” he said. “This is a moment, this is a time, this is month for us to pay a lot of attention to issues that are preventable. Keeping people alive should be a priority.”

Lawmakers sent several bills to Gov. Gavin Newsom to try to improve access to mental health care, including one that would create a statewide office of suicide prevention, one that could expand what treatments insurance companies have to cover and one that could help grow a workforce of “peer specialists” with lived mental health expetience.

A report Miller co-authored predicts the U.S. could see thousands of additional suicide and drug and alcohol deaths due to the COVID-19 economic recession between now and 2029, depending on what interventions are put in place. 

Experts say prevention often starts with looking out for red flags and encouraging others to get help — tasks that now fall on families and loved ones who are spending time together at home.

Help From A Distance

At the start of the pandemic, clinicians throughout the state had to quickly adapt to connect with patients virtually. While many were already using telehealth, or phone and video consultation, some started implementing it for the first time. 

Now, experts say it’s changing the landscape of mental health care delivery and allowing professionals to provide more flexible help to more people during this crucial time. 

“Most providers and most patients had virtually no experience with telehealth before this all started,” said Paul Castaldo, a clinical social worker and chief development officer for digital behavioral health company Tridiuum. “Many had doubts about whether they would ever do virtual care, and had concerns about the effectiveness.”

But he says a majority of clinicians now report that they prefer providing care remotely, and that patients are disclosing more sensitive information during remote sessions because they feel more comfortable in their homes. He expects many mental health professionals will continue operating virtually even when in-office visits are widely permitted again.

At the Veterans Affairs Northern California Health Care System, spokesperson Will Martin says virtual support has become a key part of their suicide prevention strategy.

“We’ve seen an exponential increase in folks accessing care this way,” he said. “We think suicide prevention and mental health really fits well with that platform.”

They were already starting to emphasize telehealth options before the pandemic, especially for veterans who live in rural areas or lack reliable transportation. Martin said this is one way to help reduce the stigma that veterans often feel about seeking help.

“Some feel more comfortable talking about their issues with a little bit of distance, they may not feel comfortable looking someone in the eye,” he said. 

But even with remote options, some people won’t seek counseling on their own. The VA is running a mostly-digital suicide prevention campaign that emphasizes the role of family members, friends and caregivers in spotting red flags and persuading loved ones to get help. 

Teens At Home

During the pandemic, young people are likely facing unique stressors related to being in close quarters with family members, said Dr. Mark Edelstein, chief medical officer for a California behavioral health nonprofit called Uplift Family Services.

“The support systems that kids and the rest of us rely on have become more limited at the same time,” he said. “You can’t go out for pizza with your friends, you may not be able to go to church, you may not be able to go to the gym. So it’s kind of a double whammy.”

The nonprofit has worked for the past several months to make sure families they work with have adequate access to mental health services remotely, or in person as needed. 

They’re also encouraging parents or other loved ones in the household to not shy away from conversations about mental health, especially if they notice changes in a child’s behavior.

“That’s really the biggest danger, that suddenly out of the blue, somebody feels so overwhelmed that they’re thinking about the possibility that it would be better to be dead,” Edelstein said. “There’s a point of no return, and we want to catch it early.”

Edelstein says adults who are home with teens during the pandemic should try their best to model healthy behavior for children, and to acknowledge that they may themselves be having a hard time with mental health while also showing that it’s manageable.