A Troubling Pandemic Side-Effect

By Adam Drapcho
THE KEENE SENTINEL
When the Centers for Disease Control and Prevention released its findings about suicide rates for 2021, the conclusion — that rates had increased — was both unwelcome and unsurprising for local mental health experts, who said the pandemic was particularly difficult for people in mental health crisis.

The data report, issued Sept. 30, found a 4 percent increase in deaths by suicide nationally in 2021, after two years of that rate declining.

Numbers specific to New Hampshire aren’t yet available from the federal agency, but local mental health advocates say there’s no reason to think the state’s an exception.

“I will tell you, though it’s anecdotal, our providers are seeing a lot of people who are suffering, through the pandemic and beyond,” said Phil Wyzik, executive director of Monadnock Family Services in Keene. “Things were not great before the pandemic; the pandemic didn’t make them any better.”

In fact, the pandemic made things worse on both ends of the mental health-care equation.

On the patient side, isolation and economic concerns could accelerate any illness that was already present, Wyzik said. Meanwhile, many of those same factors were burdening the individuals working in an already understaffed health care system, according to Susan Stearns, executive director of New Hampshire’s chapter of the National Alliance on Mental Illness.

Stearns called the pandemic a “collective traumatic event” that coincided with the threat of climate change and society’s difficulty addressing systemic racism. These are challenging experiences that can test a person’s wellbeing.

“At the same time, our mental health-care providers are going through the exact same experiences,” she said.

Prior reports from the CDC show that suicide has been one of the most prominent health risks in New Hampshire, as it is nationally.

Suicide was the 9th leading cause of death in the state, according to 2020 statistics published by the federal agency, and the second leading cause of death for people aged 10 to 44.

Only a glimpse

Suicide rates show only part of the picture, and it’s important to consider the other parts, according to Jenny O’Higgins, senior policy analyst for the N.H. Department of Health and Human Services’ Division for Behavioral Health.

“What we look at when we’re thinking about these issues, fatality is only a glimpse of these challenges that our friends and families and neighbors are experiencing,” O’Higgins said. “There are many folks out in our community struggling with illness, seeking recovery and looking for a better quality of life.”

Tragically, standing between that better life and the person in crisis has sometimes been the systems that exist supposedly to help them.

A Wall Street Journal analysis found that one out of six calls to the National Suicide Prevention Lifeline between 2016 and 2021 were ended before the caller could connect with a counselor. And — as in other parts of the country — getting an initial appointment with a local provider could require someone to wait at least several weeks, which, Wyzik said, might be too long.

“If you reach out for help and someone says your next appointment is three months away, they might say, ‘Forget it,’ ” he said.

These shortcomings were in mind when the state instituted or joined a couple of new initiatives recently. In July, New Hampshire joined other states across the U.S. by adopting 9-8-8 for calls, texting and chats for people experiencing a mental health crisis. Like 9-1-1 for public safety emergencies, 9-8-8 was conceived to be an easily remembered number to route crisis calls to the already existing network of more than 200 call centers set up for the National Suicide Prevention Lifeline.

9-8-8 came online as an addition to N.H. Rapid Response — which went live Jan. 1 — and is another 24/7 service for people experiencing a mental or behavioral health emergency. N.H. Rapid Response can deploy mobile response crisis teams to help the caller, avoiding a law-enforcement response. A Concord Monitor investigation found that more than 60 percent of people fatally shot by police in New Hampshire over the past decade had a mental illness.

“These are big culture shifts, and it’s very positive,” O’Higgins said, acknowledging some of the hiccups that the new systems have experienced.

Not all who received a visit from the new mobile response teams reported a positive interaction, and there are shortcomings with the 9-8-8 system. Significantly, 9-8-8 can’t currently track the caller’s geographical location, in the same way that 9-1-1 can. Calls are routed based on the area code of the calling number, which doesn’t help much if the person no longer lives in the state where they first got a cellphone.

“We know that there are significant calls that are de-escalated, and mobile teams are being deployed,” O’Higgins said. “And we know that there are times when it is complicated and it isn’t working the way we imagined it.”

Crisis response, O’Higgins noted, is difficult to predict and create systems for because each call by nature is unique.

“But what we are looking for is that the system that we’ve set up is not the barrier. Every phone call that doesn’t go well is someone’s life at risk,” she said. “It is extremely important that, every call, we do the best that we can.”

Reaching out a hand

There were 36,909 Americans who died by suicide in 2009.

One of them, Noah King. The 28-year-old was a 2000 graduate of Keene High School, a hockey player, a golfer and — unbeknownst to any of those close to him — someone struggling with his mental health, according to his mother, Penny King.

Penny turned to a support group for survivors of suicide loss in order to deal with her grief, a process that required her to accept there will be some things she will never understand about Noah’s death.

“You don’t ever understand, because I wasn’t in his head,” she said. “You come to accept that your loved one was in a struggle. Most likely, [they] didn’t ask for help, despaired, for some reason couldn’t see solutions to whatever issues they were struggling with.”

Penny knew that Noah had been looking for work in the months leading up to his death. She also knew he had injured his ankle playing hockey, but she didn’t know about his other pain — nor did anyone else.

“Noah was an extrovert, all his friends were very surprised,” Penny said. “All his friends said he was the last person they ever would have imagined would do something like that. But circumstances overwhelmed him.”

Penny said she thinks the stigma surrounding mental health kept her son from reaching out, so she is choosing to share his story to help others speak up.

“I would like people to know, suicide isn’t any different from cancer, diabetes, heart disease. I believe suicide has a physical as well as a mental component,” she said. “… The more people talk about it, the less likely it is to happen.”

Penny is not alone in calling for public action. With suicide being one of the greatest health risks facing the country, experts are calling for a broader response.

“Suicide prevention is everyone’s business, we can’t just leave it to the professionals,” said Stearns of NAMI. “We all have an obligation to be educated and have those conversations with the people we love and the people we come into contact with.”

Resources are available online and through programs offered by groups such as NAMI. People concerned about a friend or family member can call 9-8-8 or the state’s mobile response team at 833-710-6477 to ask for advice.

Sometimes the most powerful prevention is a person who shows they are willing to be present for uncomfortable conversations, according to O’Higgins.

“These challenges breed in isolation. When we have connection, it tends to be a protective factor,” she said. “When you think about someone having a challenging time, having thoughts of suicide, or substance-use disorder or another mental health challenge, the first person you’re going to tell is not a master’s level clinician; it’s going to be your friend or neighbor, your spouse or sister. It’s someone you already have a connection to.”

“If you are thinking of someone, act on that thought and tell them you’re thinking of them,” O’Higgins added.

Penny said that anyone in Noah’s family or friend group would have “done anything” to help, had they known he needed it. She doesn’t blame or judge her son, or anyone else who has taken their own life, but she wishes they could have heard her message.

“They’re important, and life is precious,” she said, “and that we need to hold on, because tomorrow is going to be different.”

The National Suicide Prevention Lifeline is in place for individuals in crisis or for those looking to help someone else. 1-800-273-8255, or dial 9-8-8.

New Hampshire’s Rapid Response can be reached by calling or texting 1-833-710-6477, or by starting a chat at www.nh988.com.

The Crisis Text Line is a free and confidential texting service for emotional crisis support. Text “HELLO” to 741741 at any time.

Funding for the Monadnock Region Health Reporting Lab comes from several sources, including The Sentinel and several local businesses and private donors. We continue to seek additional support. The newsroom maintains full editorial control over all content produced by the lab.

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