Monday, May 11, 2020

Mental Health Challenges of Social Distancing

UMC issued the following press release authored by Ruth Cummins.


Social distancing and staying home to avoid transmission of the COVID-19 virus is good for public health, but that isolation can be deeply concerning for those with psychiatric issues that include suicidal tendencies.


“I’m concerned about patients who depend on their care, and now don’t have as good access as they did in the past,” said Dr. Jefferson Parker, professor of psychiatry in the University of Mississippi Medical Center’s Department of Psychiatry and Human Behavior.

In recent weeks, “I haven’t seen my patients very much because of the disruption of appointments due to the virus,” Parker said. “We have rapidly expanded telehealth and phone contact, and video technology can sometimes be as effective as an in-person visit, but that’s not available to everyone.”

A new opinion paper in JAMA Psychiatry is probing the effects of social distancing and other forms of isolation and how they can lead to an enhanced risk of suicide.

“Human connection is really good for people, and isolation is bad for people,” Dr. Ken Duckworth, the medical director of the National Alliance on Mental Illness, who was not involved in paper, said in a recent interview on the TODAY show.

“No social interaction will harm mental health, and less connection … is going to cause additional stress for people,” Duckworth said in that interview.

UMMC is ramping up in-person appointments at Psychiatry and Human Behavior’s clinic in the Riverchase Medical Suites, 2550 Flowood Road in Flowood. But many group meetings for patients coping with mental illness and addiction, such as Alcoholics Anonymous, have been canceled due to social distancing needs.

“The social interaction that occurs before and after a meeting, or a religious service, is important, and by and large we’ve lost that,” Parker said.

The timing of the pandemic is particularly dangerous for those with escalating stress from loss of income or job, fears about the food supply or inability to pay bills. Suicide rates have increased in this country for two decades, adding to some people’s risk factors.

In recent weeks, “there has been a spike in calls to the national suicide hotline,” Parker said. “That’s a good thing for people to make the call, but it’s not good if more people are suicidal.” That number is 1-800-273-8255.

If someone is considering self-harm, “one of the first things we tell those patients is to go to the Emergency Department. If they are still at home, that increases their risk because they’re not getting the help they need,” Parker said.

Health care front-line workers also may be at greater risk for stress- or anxiety-induced issues due to their role in responding to the effects of the virus. The recent suicide of a New York emergency room physician who succumbed to the pressures of caring for very sick and dying COVID-19 patients “was heart-wrenching,” Parker said.

“Even before that happened, emergency department personnel had a higher suicide rate than other hospital personnel,” he said. “There are acute consequences to seeing so many deaths. In many cases, these people are isolated from their own support systems.

“I do fear for them, and when this all quiets down, it will be important to step and help them meet their own needs.”

Dr. Joy Houston, an associate professor in Psychiatry and Human Behavior, cares for many patients in UMMC’s Emergency Department who need assessment for psychiatric issues including depression and anxiety, suicidal tendencies and psychotic episodes.

The virus “has actually shifted things for us toward people whose condition is more urgent in nature,” Houston said. “Our volume overall is down, but a larger percentage of those we see, we end up hospitalizing. It’s reassuring in that people who are coming in are people who we would want to come in.”

She and Parker urge those who have a mental health emergency to visit their emergency room.  That’s far more important than concerns about COVID-19 infection, Parker said.

Visits by phone or via telehealth are making a difference for both established and new patients, Houston said. “We’ve certainly had an uptick in new patients in the last few weeks,” she said. “We really need that video link so that we can see them. That gives us so much more information about what someone’s mental status is.”

Although isolation can increase some patients’ risks, it can actually be good for others, Houston said. “For some of our patients, COVID-19 has almost been a respite,” she said. “For a number of them, it’s helpful to be at home and not to be expected to go out and interact.”

The Mississippi State Department of Health is reporting each day the state’s number of new COVID-19 cases and new deaths, and state health officials continue to urge residents to stay at home. Parker and Houston encourage those with mental health challenges, especially thoughts of suicide, to reach out to available support systems.

“For family members or friends who are concerned about someone else, this is the time of all times to reach out to each other and provide whatever support you can,” Parker said.  “ Don’t hesitate to call the hotline, reach the Emergency Department, or call your medical provider.

“This is a time when we need to rely on our support systems and sources of strength,” Parker said. “We are all in this together.”


Community members needing help with COVID-19-related stress or anxiety have a number of avenues for help. They can make an appointment by calling UMMC’s Psychiatry and Human Behavior at (601) 984-5831. New patients should choose option 1; established patients, option 2. The National Suicide Prevention Lifeline is 1-800-273-8255.

14 comments:

Anonymous said...

I am clinically depressed, and solitude is a major factor in my life. But even I feel like there is something different from this. I try to avoid extended social interactions, but even the few interactions that keep me balanced (church, movies, concerts, etc.) -- without these the loneliness is almost unbearable. It's time to reopen the economy with protections taken for those at risk, and the decision of how much risk you want to encounter left to yourself. The virus is here and will not go away, but how many more people on the line of suicide, loneliness and despair are worth facing yet another part-of-living risk?

Anonymous said...

I'm starting to channel Howard Hughes - shunning society, lying on the bed, watching TV, eating Campbell Soup, watching my toenails and hair grow. Am still bathing regularly, though.

The Autistic population laughingly says this is the best environment they've ever had - quiet, no interaction with society, perfectly happy to do things in solitude, and no one is bugging them to socialize.

Seriously, this shutdown is mentally hard for regular people so I'm sure it is extremely hard on mental health patients.

Anonymous said...

I've been using violent video games to cope. Specifically Grand Theft Auto. I haven't played video games since GTA on the Playstaion 2. It is very therapeutic.

Anonymous said...

So what this article confirms is that any bad behavior now has a valid excuse for that action due to the Wuflu seclusion ?

Anonymous said...

11:14 I think we will be seeing a change to smaller, more intimate social interaction for the foreseeable future. There is no reason people can't gather in groups that aren't so large that they unnecessarily risk infecting too many people at one time.

I do have one question for you though. The examples you mention for your social functions are all typically large public groups. Do you attend them with a few close friends, or are you just looking for generic social interaction? If you've got some specific friends maybe you can find a way to make the most of your time together without needing to go where there are hundreds of people in close proximity.

Anonymous said...

Diagnosed and certified autist here. Grocery shopping is not as bad when I can wear a mask. Also the gloves help with my OCD. Covid-19 has improved my lot.

Anonymous said...

I'm more worried about the economy. I just read an article on ZH that 1/3 of lost jobs are not coming back. A permanent economic contraction.

Anonymous said...

2:00 pm - I have no idea what ZH is, but have you checked with the Disney Cartoon Channel for an alternate opinion? You'll for sure find something to match your opinion if you look long enough. If you listen closely enough, you'll fine that Tom Selleck agrees with you.

Anonymous said...

" I'm starting to channel Howard Hughes - shunning society, lying on the bed, watching TV, eating Campbell Soup, watching my toenails and hair grow. Am still bathing regularly, though. "

And I thought I was the only person turning into Howard Hughes.

I don't have his money and I haven't started turning the light's off, but I'm halfway there.

It was kind of fun the first week or so. I hadn't had a breakfast of leftover pizza and cold beer since college. Eating that breakfast in my underwear also brought back some great memories.

LOL.



Anonymous said...

Well, I'm not sure if this was depression related . . . but I just heard one of my nieces just caught
"the pregnancy".

Staying in lock down with her boyfriend for two months also caused an unexpected issue.

Anonymous said...

I’ve been coping by going out places, since nothing is actually locked down, and continuing on with, well, just life as it was.

Anonymous said...

11:14 here. To answer your question I feel much more comfortable when I get "lost in a crowd." Like Johnny Carson I tend to become more introverted in small groups. I can make a speech to a large crowd or sing a solo but want to hide in small groups. I think it is because I can act like a big shot to a group while it's more difficult to act in small sessions.

Anonymous said...

@12:43- Enjoy it while it lasts. I'm NT and make jokes about it, but I like it, too.

@5:05 -LOL. We are kindred spirits.

Anonymous said...

At the end of the day, please remember that Chad is an ivy league politician so take everything with a grain of salt before you fall in love with him. I see state auditors performing audits every year for a large state agency, but all the auditors seem to do is play on their smartphones all day for weeks at a time.


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If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

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