It’s been nearly a year since the first case of covid-19 was reported in Arkansas; the changes to daily life and stress from living in a pandemic have caused many to report heightened feelings of anxiety and depression.
Adults in the U.S. reported considerably “elevated mental health conditions” as a result of the pandemic, according to information from the Centers for Disease Control and Prevention. The study was conducted from June 24 to 30.
Younger adults, racial and ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation amid the pandemic, the CDC reported.
About 38% of adult Arkansans polled from April 23 to May 5 in a Kaiser Family Foundation study reported experiencing symptoms of anxiety or depressive disorder. From Nov. 11 to 23 that number jumped to 44.2% of Arkansans.
One of the main problems with mental health services is a stigma often associated with seeking care, said Dr. Buster Lackey, executive director of the National Alliance on Mental Illness Arkansas chapter.
“People have a stigma of mental health and often do not get services at all,” he said.
The Arkansas Democrat-Gazette spoke to mental health experts including Peggy Kelly, chief clinical officer of Youth Home, a nonprofit residential program in Little Rock and Lackey about how to access mental health care, signs to look out for, and steps to take to improve your mental health. The newspaper also gathered information from the World Health Organization and the CDC on these topics and gathered resources from panelists on its "Coping with Covid" panel.
How and when to access mental health care
• See how long symptoms last.
If symptoms of a mental health diagnosis last for more than two to three weeks, it is best to seek help.
• Start with an outpatient appointment.
Many outpatient offices, including Behavioral Health Services of Arkansas, accept both in-person and telehealth appointments. Those interested can visit BHSArkansas.org for more information.
• Ask about a sliding scale fee.
Many outpatient providers offer a sliding scale fee based on income and some offer grant funding, which allows uninsured individuals to access services. Behavioral Health Services of Arkansas offers both.
• Visit a local community mental health center.
Arkansas Community Mental Health Centers provide a range of treatments including therapy, substance abuse treatment and recovery support.
• See if a state sponsored program can help you.
The Promoting Positive Emotions program through the Arkansas Department of Human Services offers free education, outreach, crisis counseling and referrals to those affected by the pandemic. The department is partnering with local providers across the state. More information can be found online: https://www.staypositivearkansas.com/
• Anyone experiencing a mental health crisis can go to any emergency room and have a mental health screening.
Arkansas has five crisis stabilization units where people can receive stabilization services and access to area mental health services.
• Consider what level of care you need.
Residential programs are needed when a less intensive level of care such as outpatient therapy for individual or family therapy has failed and the patient is not showing signs of improvement. Prior to admission to a residential program, the patient will be reviewed and assessed how those symptoms are impacting the safety of the patient and/or family and how they may be impacting quality of life.
The UAMS AR-CONNECT program also helps Arkansans who need immediate care get assistance and connects them with local treatment options: https://psychiatry.uams.edu/clinical-care/arconnect/.
How to spot warning signs of suicide and what to do about it
• Noticing signs may be difficult to detect over phone calls, video calls or by text.
Pay attention to spoken or written words about having no reason to live, being a burden, feeling trapped, or hopeless.
Some signs may also include if people who are typically easy to reach and quick to respond but have not recently responded, withdrawal from usual activities, increased use of drugs or alcohol, changes in behavior or mood changes.
Other signs may include talking about feeling unbearable pain, taking great risks that could lead to death, talking or thinking about death, giving away important possessions, saying goodbye to family or friends, putting affairs in order or making a will.
• Ask directly and without judgement while trying to remain calm.
An example of something to say is: “I have noticed you seem more irritable lately and you mentioned just wanting to give up. I am wondering if you are having thoughts about harming yourself?”
Sometimes, people are relieved to know someone has noticed and cared enough to ask.
• Have a plan in place on how you will respond to the person’s answer.
Consult a mental health professional about possible next steps in care before having the conversation.
Call the National Suicide Prevention Hotline 1-800-273-8255 or text the Crisis Line by texting ‘Hello’ to 741741, these are 24/7 free and confidential resources. In some cases if the person is unable to control thoughts or urges, it may require a trip to the emergency room or calling 911.
How to improve my own mental health
The University of Arkansas for Medical Sciences Center for Health Literacy has an online module on emotional wellness. The resource is free: healthliteracy.uams.edu/resources-for-patients/online-patient-education-modules/.
• Manage the information you consume.
Choose credible sources for health-related information, such as the World Health Organization and the CDC. Consider limiting how often you consume news and social media content to 15 minutes per day.
• Follow a routine.
Even small habits such as making your bed and getting dressed can make a big difference in your overall mood and evoke a sense of accomplishment.
• Exercise when you can.
If you’re working from home and can take breaks, go for a short walk in between tasks or when you’re able to take a break. You can also search the web for free, low-impact cardio or yoga exercises to follow.
• Avoid consuming excess alcohol, tobacco and substance use.
Using these substances can lead to worsening symptoms for people with mental illness. Alcohol is a depressant and may cause increased anxiety and depression, as well as decrease a person’s quality of sleep. Different substances can have different adverse effects for users.
• Do meaningful things with your free time.
Read or listen to a book, learn a new skill, create art, journal or write, play games, put together a puzzle or do a task around your house. Taking time for mindfulness and meditation to focus on the present moment can also reduce overall stress.
• Stay connected with friends and family and your community or faith-based organization.
Ask for help when you need it, and share how you’re feeling with people you trust. If talking about covid-19 is affecting your mental health, set boundaries with the people you love.
How to talk to your child about mental health
• Think the “3 C’s: care, concern and consequences for approaching changes in mood or behavior.
Kelly provided some suggestions for how to approach the conversation:
Care: “I hope you know how much I love you and care about your health”
Concerns: “I’ve noticed you have been sad lately and talking about it not being worth it, and you aren’t hanging out with friends or painting like you used to”
Consequences: “My fear is that you might be experiencing some depression, and I would like to help you find some help to get you feeling like yourself again.”
• Trust your instincts.
If parents or guardians feel something is wrong with their child, they should initiate a conversation, Kelly said.
• Being calm and non-judgmental is critical.
There is a shame often associated with mental health conditions, so making sure the child doesn’t feel judged is critical.
• Share a time when you experienced a similar situation.
This may help normalize the experience and feelings for your child.
Additional expert-recommended resources:
• Substance Abuse & Mental Health Services Administration National Help Line: 1-800-662-4357.
• National Suicide Prevention Line: 1-800-273-8255 for English and 1-888-628-9454 for Spanish.
• National Domestic Violence Hotline: 1-800-799-7233 or text LOVEIS to 22522.
• National Child Abuse Hotline: call or text 1-800-422-4452.
• National Sexual Assault Hotline: 1-800-656-4673.
• Veteran’s Crisis Line: 1-800-273-8255.
Disaster Distress Help: call or text 1-800-985-5990 (press 2 for Spanish).
• Crisis Text Line: Text SIGNS to 741741 for 24/7 free, anonymous crisis counseling.
• National Alliance on Mental Illness (NAMI): https://nami.org/Home.
• NAMI Arkansas https://namiarkansas.org/.
• Arkansas chapter of the American Foundation for Suicide Prevention: afsp.org/chapter/arkansas.
• UAMS Arkansas Building Effective Services for Trauma has a newsletter that includes content on how to support kids who have experienced trauma and a tool to locate trauma-trained providers: https://arbest.uams.edu/
• 7cups.com : Free online chat for emotional support and counseling and free peer-to-peer online support community.
• forlikeminds.com : Online mental health support network for people with or supporting someone with mental health conditions, substance use disorders or stressful life events.
• Supportgroupcentral.com: Free or low-cost virtual support group on various mental health topics.
Headspace: A meditation app. Offers a two-week free trial, then $12.99/month or $69.99/year membership.
Calm: An app for sleep and meditation. Offers a seven-day free trial, then $69.99/year membership.
Ginny Monk of the Arkansas Democrat-Gazette contributed reporting.