Behavioral Health News, Fall 2020
By Peter Provet, Ph.D.
President & CEO, Odyssey House
When Governor Cuomo ordered the closure of non-essential businesses across New York State in response to rising coronavirus infection rates, Odyssey House stayed open.
Our essential residential treatment centers, outpatient services, supportive housing apartments, and primary health clinics in East Harlem and the South Bronx are located in some of the most socially and economically disadvantaged neighborhoods in NYC. These communities, already suffering from health disparities of social injustice and equity, were hit hard by a highly infectious and deadly virus that overwhelmed local social service providers and brought tragedy to many families. We couldn’t, and we wouldn’t, close our doors in a time of such urgent needs.
With just a few weeks to prepare for this unprecedented public health crisis, we moved quickly to introduce procedures that limited the risk of infection in our facilities, maintained essential treatment and housing services, and shifted administrative systems to remote functions.
These early measures not only kept the doors open for the vulnerable populations we treat, but they also helped keep our employees as safe as possible while they carried out essential services.
It was not only staff who worked together to keep services running; clients also pitched in to keep each other safe. Residents in substance abuse treatment centers with hundreds of beds quickly adopted new behaviors that ranged from keeping physically distant, wearing masks, increasing handwashing and other sanitation protocols, to accepting limits on visits and outside travel. And for people with serious mental health challenges living in our supportive housing facilities, helping them incorporate new health guidelines became a life or death priority.
Ready to Meet Increasing Needs
The long-term impact of the coronavirus on the health and well-being of New Yorkers is still unfolding. Fears that a second, or more, wave of infection will return, that the economy will take a long time to recover, and that substance abuse and other mental and physical health problems will increase are very real. Government leaders warn of significant cuts to services and urge all Americans to prepare for difficult times ahead while we rebuild from this public health crisis.
Those of us who work in the behavioral health field know that social disruption on this scale is likely to fall hardest on the underserved people we care for. Research studies warn of increased substance misuse, overdose deaths, and suicides with young adults and racial minorities among those disproportionately affected.
In August, The Centers for Disease Control and Prevention (CDC) released its Morbidity and Mortality Weekly Report – the results of a survey of 5,412 adults taken in late June – that showed 41% reporting at least one adverse mental or behavioral health condition. Those conditions include symptoms of anxiety, depression, and increased substance use to cope with stress or emotions related to COVID-19.
The researchers also found that nearly 11% reported having seriously considered suicide in the 30 days before completing the survey, compared with about 4% in a 2018 survey who said they’d considered suicide in the past 12 months. The worrying CDC data also found that certain groups were shown to be even more susceptible to suicide: 25.5% of young adults, aged 18 to 24; 30.7% of self-reported unpaid caregivers for adults; 21.7% of essential workers; as well as racial minorities —18.6% of Hispanic respondents and 15.1% of Black respondents.
COVID-19 Must Not Stall Progress on the Opioid Epidemic
We are doing all we can at Odyssey House to prepare for increased demands on our services and we will not turn anyone away who comes to us for help. We were starting to make a dent in the opioid epidemic and are concerned that the coronavirus pandemic will undermine that progress and exacerbate the health risks in our communities.
Our mission is to help New Yorkers in need overcome drug and alcohol abuse, improve their physical and mental health, and defeat homelessness. By working together, we demonstrate that this is possible even in the midst of a global health crisis.
Before the pandemic hit, suicide and drug overdoses had been a growing concern among health professionals.
According to the American Foundation for Suicide Prevention, there were an estimated 1.4 million suicide attempts in the U.S. in 2018, which included 48,344 deaths — or an average of 132 per day.
Nearly 72,000 Americans, or 197 people a day, died from drug overdoses in 2019, an increase of 5% over 2018, and a new record, according to CDC preliminary national data for 2019.
The American Medical Association voiced its concern that states across the country were reporting an increase in opioid-related fatalities, particularly from fentanyl, the powerful synthetic opioid.
If you list the societal stressors that make our mental health and addiction crisis worse, COVID-19 exacerbates almost all of them: social isolation, economic instability, transportation disruption and challenges to getting support, anxiety related to social isolation, and societal unrest.
In addition to COVID-19, the opioid crisis, racial inequality in the U.S., disinvestment in communities, lack of access to care, and poverty, have taken a devastating toll on people of color across America.
Narcotic prosecutors are concerned that U.S. border closings disrupted illegal drug trafficking, leading to higher concentrations of synthetic fentanyl to make up for heroin “shortages,” potentially causing inconsistencies in what is sold and used on the streets. As a result, drug users are inclined to experiment with new drugs they are unfamiliar with, which could lead to greater overdoses and deaths.
So Many Lives Hang in the Balance
As Americans everywhere struggle with the enormous health, economic, and educational impact of responding to COVID-19, the fragile lives of people with opioid addictions and related behavioral health challenges have been made immeasurably worse.
There has never been a more urgent time for us to ensure our services are robust and our communities are not neglected. So many lives depend on all our services.