Many teens are still cut off from valuable connections since the pandemic shut down schools. Friends and teachers are less available. Remote learning has shifted reality pausing clubs, sports and extracurricular activities that gave so many teens added purpose and connection. This new isolation is triggering feelings of anxiety, depression and worse.
Teen suicide is a growing crisis in America. The CDC reports one in four young adults contemplated suicide during the pandemic. And, suicide consistently ranks as the second leading cause of death for youth ages 10 to 24. What are the warning signs of suicide? And how can at-risk youth be identified with time to intervene?
Cincinnati Public Radio’s Michael Monks hosts Call to Mind Live: Preventing Teen Suicide in a Pandemic of Isolation, a Well Beings Virtual Tour Event. Ohio teens and mental health experts join to share the complexities of teen suicide, warning signs and specific things parents, teachers, and others can do to help.
WELL BEINGS is a major national campaign from WETA addressing health needs in America with a focus on youth mental health.
The WELL BEINGS TOUR is made possible by Otsuka, Kaiser Permanente, Bank of America, American Psychiatric Association Foundation, One Mind, Movember, National Alliance on Mental Illness, The Dauten Family Foundation, Dana Foundation, Hersh Foundation, Mental Health Services Oversight & Accountability Commission, Frances Von Schlegell and John E. Von Schlegell, Robina Riccitiello, Sutter Health, and Jackson Family Enterprises. Partners include CALL TO MIND at American Public Media, PBS NewsHour Student Reporting Labs, Forbes, PEOPLE, Mental Health America, The Steve Fund, and The Jed Foundation.
Call to Mind is American Public Media’s initiative to foster new conversations about mental health. Call to Mind is bringing mental health conversations into the open, increasing public knowledge and engagement, to empower people to find the support they want and need.
“There is no greater agony than bearing an untold story inside you.” Maya Angelou
From the time that written language was invented, people have been writing down their thoughts, experiences, hopes, and feelings as a way to document their experience, work through complicated emotions, and keep a record of daily events. It has been long documented that journaling can have a positive impact on both mental and physical health; specifically, journaling daily can reduce feelings of depression, anxiety, and anger as well as less doctor visits, better immune systems, and reduced symptoms of chronic disease (like arthritis)(1). Furthermore, journaling daily can lead to a greater sense of meaning and purpose in addition to increasing the ability to work through life stressors and leading to high levels of self-awareness(1). And journaling can take many forms, from traditional pen and paper to bullets written on a phone app: there are benefits in all of its many forms.
Below are some tips for getting started and increasing your comfort with journaling(2):
- Start small and have realistic expectations: you do not need to spend a lot of time (start with just five minutes) or write anything prolific (you are writing) to experience the positive effects.
- Write at the time of day that is best: some people prefer to write before starting their day, others make it the last thing before bed. Do what works best for you.
- There are no wrong topics: write what you want, whether that is a story about your day, things you would like to accomplish, or simply listing what you are grateful for. Again, make this experience your own.
- Be accountable: it is better to write for a short period of time on a busy day than to not write anything. Make the commitment each day to journal and stick with it.
- Make your journal private: this should be a space for you to discuss things that are deeply personal so your journal is not something that you have to share with others. Keep your journal in a private place.
Remember: if you get stuck or need some fresh ideas, a Google search will produce many different writing prompts and examples of what works for others.
March 3, 2021
Open Letter to Ohio’s Congressional Delegation Concerning Rule Change in the Six Protected Classes of Medicare Part D
The organizations undersigned on this letter advocate for Ohioans with critical needs for medication. Our patients must have dependable, affordable access to medicines that allow for optimal physical and mental health, and in some cases, to keep them alive.
We are writing to raise our concern for a recent action that impacts the affordability and accessibility of medicines offered through Medicare Part D. The Six Protected Classes of medications offered in Medicare Part D is subject to a change that will reduce availability of critical medicines for patients with complex medical needs.
On the final day of the Trump administration, the Center for Medicare and Medicaid Innovation (CMMI) modified the Part D Payment Modernization Model, to allow for significant changes to Medicare prescription drug coverage starting in 2022. The changes are aimed at medicines in the Six Protected Classes which are:
▪ Anticonvulsants, which treat epileptic seizures.
▪ Antidepressants, which treat depression and other psychiatric illnesses.
▪ Antineoplastics, which prevent or inhibit the growth of cancerous tumors.
▪ Antipsychotics, which treat acute psychosis, schizophrenia, and bipolar disorder.
▪ Antiretrovirals, which treat HIV.
▪ Immunosuppressants, which prevent organ rejection in transplant patients.
The modifications would drop the requirement that all drugs included in the six protected classes are covered on plans’ Part D formularies. Drugs in the HIV class would have a one-year delay until protection status would also be removed in 2023. Any plan participating in this CMMI model would be permitted to include only one drug on the formulary in each of the six protected classes, a further reduction from the current standard of two drugs per class throughout Part D.
These changes will impact thousands of Ohioans with complex illnesses, who depend on protections that ensure that the treatments they need are available to them. The changes will reduce the variety of prescription drugs needed by people with mental illness, cancer, HIV, seizure disorders, and people who have had organ and tissue transplants.
We ask that our federal lawmakers preserve the integrity of the Medicare Part D program and its six protected classes. The patients we serve must have access to the full range of treatment options to ensure physicians and patients can address individual medical needs.
On behalf of the Ohio patients we serve, we urge you to encourage the Biden administration to stop the Six Protected Classes model from moving forward.
Thank you for considering our request.
Academy of Medicine of Cleveland and Northern Ohio
American Liver Foundation
Beacon Charitable Pharmacy
Charitable Healthcare Network Ohio
Cincinnati Area Senior Services
Easter Seals Central and Southeast Ohio
Epilepsy Foundation Ohio
Healing Hearts of Central Ohio
Kidney Foundation of Ohio, Inc.
Mental Health America of Ohio
Prevent Blindness Ohio
National Alliance on Mental Illness Ohio
Ohio Foot and Ankle Medical Association
Ohio Osteopathic Association
Ohio Pharmacists Association
Ohio Psychological Association
Ohio Public Health Association
Ohio State Grange
Sleep. We all do it. We all know it is important. The average human spends about 230,000 hours over their lifetime sleeping, so why are many of us so bad at it? Best estimates show that, at any given time in the United States, about 40% of adults report not getting enough sleep(1). Infants need about 15 hours of sleep per day and the number of hours needed gradually decreases until adulthood, with experts recommending seven to eight hours per night(1). Getting the right amount of hours of quality sleep can provide a plethora of health benefits. Research has consistently shown that people who get enough sleep and feel restful are more likely to get sick less often, stay at a healthier weight, lower their risk for serious health problems (like heart disease), use alcohol at lower rates, feel less stressed, have better interpersonal relationships, are less likely to smoke cigarettes or use narcotics, perform better at school and work, and avoid injuries (like auto accidents)(1). Experts have also identified factors that can contribute to difficulty falling or staying asleep, such as stress, anxiety, pain, caffeine use (usually from coffee, tea, and soda), alcohol use, narcotics use, health conditions (like heartburn or asthma), and some medications(1). Additionally, there is the possibility of an undiagnosed or untreated sleep disorder, like sleep apnea or insomnia(1). In addition to having trouble falling asleep or staying asleep, a sleep disorder could cause you to still feel tired after a good night’s sleep, feel sleepy during the day, or have a difficult time doing everyday activities (like driving a car), as well as possibly experiencing frequent loud snoring, pauses in breathing or gasping while sleeping, itchy feelings in legs or arms at night that feel better when you move or massage the area, and trouble moving your arms and legs when you wake up(1). If you feel like you may have a sleep disorder, please talk with your doctor about your concerns and if a medical sleep study may be beneficial for you.
Clearly getting enough quality sleep is important, so how do we learn to sleep better? Luckily, there are numerous suggestions by sleep experts that can help you have better sleep habits. First, make your bedroom a sleep-inducing environment by creating a quiet, dark, and cool environment equipped with a comfortable mattress(2). You can achieve this by using earplugs or a “white noise machine, using blackout shades/curtains or an eye mask, and a fan to keep your space well-ventilated and ideally between 60 and 75 degrees(2). Next, establish a relaxing pre-sleep routine and stick with that routine each day(2). About one before bed, take a bath, read a book, watch television, or practice relaxation exercises but make sure to avoid stressful, stimulating activities (such as doing work or discussing emotional issues), as this can cause the body to secrete the stress hormone cortisol, which is associated with increasing alertness(2). Another recommendation is to go to sleep when you are tired; if you are not asleep after 20 minutes, get out of bed, go to another room, and do something relaxing, like reading or listening to music until you are tired enough to sleep(2). One other suggestion is to keep your internal clock set with a consistent sleep schedule, even on the weekends and during holidays; specifically, going to bed and waking up at the same time each day sets the body’s “internal clock” to expect sleep at a certain time night after night(2). Finally, it is recommended that you avoid naps during the day, limit the amount of food and beverage consumed in the evening, and exercise earlier in the day(2). Hopefully, some of these tips can help you get better sleep each night and feel fully rested each day. Sweet dreams!
Photo by Ketut Subiyanto from Pexels
View article on Cleveland.com
CLEVELAND, Ohio – Ohio Gov. Mike DeWine’s budget recommendations increase funding for mental health and addiction treatment services that have been vital throughout the COVID-19 pandemic.
The proposals have garnered the support of organizations addressing the challenges created by the pandemic. But do they go far enough to address the potential mental-health fallout of the crisis, which experts say could last even longer than the pandemic itself?
Advocates said the budget recommendations are a significant step. They’re grateful to see an increase amid the crisis, though they say more investments could be needed to create long-term stability for services that have traditionally gone underfunded.
Investing in mental health and behavioral health is critical for Ohio’s “return to normal” after the pandemic, said Scott Osiecki, the CEO of the Alcohol, Drug Abuse and Mental Health Services Board of Cuyahoga County. Issues like anxiety, depression, stress and grief could linger well after the coronavirus vaccine is widely available.
“It’s a basic need, like housing,” Osiecki said. “Behavioral health is really important to the overall health of the community.”
The cleveland.com series “Coping Through COVID” aims to help Northeast Ohio residents manage the stress of COVID-19 by examining by examining the mental health aspects of the pandemic. The series tells individuals’ stories and explores various challenges and coping strategies with experts.
DeWine’s budget recommendations include a 10.9% increase in funding for the Ohio Department of Mental Health and Addiction Services in fiscal year 2021, and another 1.9% increase in FY 2022. The state legislature could alter any of the recommendations before approving a final budget.
Terry Russell, the executive director of the National Alliance on Mental Illness (NAMI) for Ohio, said he is “cautiously optimistic” the legislature will adopt the DeWine’s recommendations. But he cautioned that reducing the proposed level of funding could leave Ohio scrambling to address the fallout from the pandemic.
“Any reduction of that would be a disaster,” he said. “It would literally put the mental health system in crisis.”
For examples, experts point to domestic violence programs. They say the pandemic has created a “perfect storm” of risk factors for domestic violence, and more than half of Ohio’s domestic violence programs have reported an increase in the number of people seeking shelter or requesting services.
DeWine’s budget includes $1 million per fiscal year for domestic violence programs, but the Ohio Domestic Violence Network is lobbying for an increase to $5 million per year, the organization’s executive director Mary O’Doherty said.
Domestic violence programs have been hurt by recent cuts to grants from the Victims of Crime Act, the federal program that provides money for therapy and other services. Ohio’s domestic violence programs lost $7.7 million for the next fiscal year, and have seen budget reductions of nearly 40% over the past two years, O’Doherty said. The network is asking the state to provide more money to make up for those losses.
“We are a pretty critical part of the social safety net, and we just need to do a better job of funding these programs,” O’Doherty said.
Addressing the issues exacerbated by the pandemic
Advocates have long argued that mental health, addiction treatment and domestic violence programs have been underfunded in the U.S., resulting in limited access to treatment in many communities. The problem has been exacerbated by the pandemic because many providers were forced to limit in-person services and switch to telehealth.
Some of DeWine’s budget recommendations target the issues that have been a focus during the pandemic. For example, the recommendations include $2.25 million per year to help parents, pediatricians and teachers identify signs of mental health conditions. Experts say that could be critical, because it’s unclear how children will be affected by taking classes from home for a full year.
The recommendations maintain funding in several key areas for the ADAMHS Board, Osiecki said. The Northeast Ohio collaborative – which includes the ADAMHS Boards in Cuyahoga, Lorain, Lake, Geauga, Summit and Medina counties – could get $7.5 million for withdrawal management and crisis stabilization funding.
The recommendations also increase the state’s continuum of care budget from $76 million to $82 million; the line item pays for services like suicide prevention, crisis response and treatment and recovery services, Osiecki said. The ADAMHS Board is hoping the final budget approved by the legislature includes an increase of closer to $15 million instead of just $6 million, he said.
The recommendations also begin to address some of the state’s long-term needs, advocates said. NAMI Ohio has been advocating for years for funding for people with a debilitating mental illness who often wind up in jail or a homeless shelter.
The budget also provides funding to help people living with debilitating mental illness. That group, which Russell estimated to include 50,000 people living in Ohio, have often lacked the community support they need. The result has either been an increased burden on their families or homelessness or jail time, he said. The governor’s recommendations include $5.5 million per year to help various systems coordinate to meet their needs, and $6 million per year to improve residential facilities for adults with a serious mental illness.
Domestic violence services struggle for funding
Advocates acknowledged that money is tight during the pandemic, but there are certain areas where they’d like to see more investment.
Domestic violence services have already seen budget cuts of roughly 40% over the past two years and are expecting another 30% cut in VOCA funds next fiscal year, O’Doherty said. The result is that many shelters have been forced to lay off staff, reducing the number of workers and counselors who are available to assist women and children in crisis.
Domestic violence programs could use additional funding to hire more staff, O’Doherty said. Staffing limitations are causing many programs to struggle to meet the needs of women in crisis who are seeking help.
“Right now, our programs turn away people every day,” O’Doherty said. “It would help us meet the need.”
O’Doherty said part of the issue with funding domestic violence could be that it often goes underreported, so it’s difficult to pinpoint how prevalent it is. But a U.S. Centers for Disease Control and Prevention survey from 2015 found one in five women experience severe physical violence from an intimate partner during their lifetime.
During the pandemic, many advocates have worried that women being isolated at home with an abuser led to a decrease in calls to domestic violence hotlines early in the crisis. O’Doherty is hopeful that attention to the issue could persuade some lawmakers to increase support.
“It’s a significant social issue that families live with day in and day out. It’s just like substance abuse or mental health, or any other kind of social issue society deals with,” she said.
To meet the state’s long-term mental health needs, NAMI Ohio is primarily focused on changing the way the money is used, Russell said. He believes services should take an individualized approach to care, rather than a one-size-fits all approach to mental illness.
“We need to be looking at the individual with the mental illness, and not the system,” he said.
Advocates are also focused on the employees and counselors who provide services, because the strain on the workforce isn’t unique to domestic violence programs. Agencies that provide mental health and addiction treatment services have also seen significant turnover during the pandemic.
Investing in a pipeline to train and retain workers could be critical for the long term, advocates said. That would help reduce turnover and help agencies provide better services.
“The workforce was struggling even before this,” Osiecki said. “There’s not enough people to provide services. And this is throughout the whole state. Actually, the whole country.”
Are you, a family member or a friend in crisis? or do you need mental health or substance use services? Here’s a list of agencies that can help.
- Frontline Services: 24-hour crisis hotline 216-623-6888
- Suicide prevention hotline: 800-273-TALK or 800-SUICIDE
- Cuyahoga County suicide prevention, mental health/addiction crisis, information and referral hotline: available 24 hours at 216-623-6888
- National Alliance on Mental Illness (NAMI) Greater Cleveland: Non-crisis hotline 216-875-0266 (Monday through Friday, 10 a.m. to 4 p.m.)
- Alcohol, Drug Abuse and Mental Health Services (ADAMHS) Board of Cuyahoga County: Online new service finder tool
- Ohio Department of Mental Health and Addiction Services: Online resource for COVID-19 related information and services available amid the pandemic
- Ohio CareLine: Emotional support call service from the Ohio Department of Mental Health and Addiction Services. Toll-free at 1-800-720-9616
- Ohio Crisis Text Line: Text keyword “4HOPE” to 741 741
- Find Substance Use Disorder and Mental Health Treatment: https://findtreatment.gov
- Disaster Distress help line: available 24/7 at 1-800-985-5990 or TTY at 1-800-846-8517. Also available by texting “TalkWithUs” to 66746; Spanish-speakers can text “Hablanos” to 66746.