Pandemic Increasing Suicidal Ideation

One in four people aged 18 to 24 seriously contemplated suicide in June, according to new research from the Centers for Disease Control and Prevention.

The data are the latest in a series of reports highlighting increases in anxiety, depression and suicidal ideation since the COVID-19 pandemic began.

The data do not have a breakdown for college students, but they do break responses down by age groups. People who are in the traditional age group for college students seem to be especially vulnerable to mental health issues, compared to other age groups, and experts believe colleges should be investing more in mental health services during this time. With the ongoing recession, though, some worry that counseling and other services will be on the chopping block.

"I think mental health services are an 'easy' thing, in some people's minds, to cut," said Nadine Kaslow, professor of psychiatry and behavioral sciences at Emory University and past president of the American Psychological Association. "I'm very worried."

The CDC surveyed about 5,400 people in the last week of June on how their mental health has been during the pandemic. About 41 percent reported at least one negative mental health issue, including symptoms of anxiety or depression, or increased substance use to cope with stress.

Over all, about 11 percent of respondents said they had seriously considered suicide over the past 30 days. Those aged 18 to 24 were significantly more likely to report this, with 25.5 percent saying they had seriously considered suicide. Minority groups and essential workers were also much more likely to report considering suicide.

Rashon Lane, a behavioral scientist at the CDC who authored the study, said it's important to recognize that these identities can intersect across different populations.

"It's important to think through how we can provide mental health services to be more culturally appropriate," she said.

Lane recommends using social support strategies to help young adults feel more social connectedness, as well as offering more comprehensive treatment options for students, like harm reduction services.

"Collectively, we're seeing some troubling or concerning patterns," she said.

Of those aged 18 to 24, about one-quarter also said they had increased their substance use to cope with the pandemic, and about three-quarters reported facing at least one adverse mental health symptom.

Alongside the CDC data, other reports predict the pandemic and recession will lead to a rise in suicides. The Well Being Trust predicts there will be as many at 75,000 "deaths of despair" from the pandemic, stemming from substance misuse or suicide. Other research has shown the relationship between unemployment and suicide rates.

"It’s almost as if everybody is psychologically carrying a heavy load of packages," said Victor Schwartz, chief medical officer at the Jed Foundation, a nonprofit that advocates for the mental health of teens and young adults, and clinical associate professor of psychiatry at New York University. "If you were in a hot place carrying a bunch of bags uphill and not knowing how long you had to go, that would cause physical stress and symptoms."

This is the psychological equivalent, Schwartz said.

He worries that colleges are going to slash their budgets, including those for mental health services, due to the recession.

"Colleges will have more mental health demands than ever," he said.

Higher education has, for the most part, improved services and increased young people's comfort with seeking help, Schwartz said. But there's too much demand, so colleges are going to have to think creatively about serving students with an array of issues with an array of solutions, not just traditional counseling, he said.

They'll also have to be nimble, at least for the coming academic year.

"Everybody is going to have to constantly be working with two or three plans," he said. "Everybody’s going to have to become improvisers."

Kaslow emphasized the need for colleges to train people to be gatekeepers, who are people in the community who can recognize the warning signs that someone is depressed or suicidal. This will be more difficult, as it's harder to gather cues and clues when people are wearing masks or on Zoom, she said.

People will also have to take what college students say seriously. If they say they feel hopeless, people can't respond by saying that everyone feels that way, Kaslow said.

"So many college students are saying things like, 'This is the worst year of my life,'" she said. "All of the developmental things that come with the transition to young adulthood are being impacted by this."

Colleges also need to maintain services, and Kaslow recommends they start doing universal screenings of students' mental health.

College leaders need to be prioritizing mental health, said Sarah Ketchen Lipson, an assistant professor of health law and policy at Boston University.

"They’re in a position right now to make a lot of decisions about what they’re investing in," she said. "In a lot of cases, there are a lot of complicated decisions to make related to finances in higher education right now."

Colleges need to maintain their virtual mental health services during this time and continue promoting them, she said. They also need to normalize mental health for students and raise awareness of how mental health and academic performance are linked. Students should also be part of the conversation of how best to support their mental health, she added.

Continuing telehealth options for counseling will be important as the pandemic continues, said Andrew Lee, president of the American College Counseling Association.

"It is clear that these unprecedented times have irrevocably changed our profession. What was once considered a more fringe or novel way of service delivery has now become an essential mode of service provision," Lee said in an emailed response. "While it is unlikely that all students will only desire to receive services via technology, this shift has legitimized the use of remote telehealth sessions."

Seeing budget cuts and furloughs at colleges across the nation has been disappointing, said Katherine Wolfe-Lyga, director of the Counseling Services Center at the State University of New York at Oswego and secretary of the Association of College Counseling Center Directors. But she recognizes the economic issues colleges are facing.

Oswego won a grant to support infrastructure for suicide prevention, which she said could not have come at a better time.

"The financial difficulties that institutions and our students are facing are worrisome. We have seen many college administrators prioritize mental health support systems on campus and hopefully they will maintain that level of commitment as we collectively struggle through this," Wolfe-Lyga said in an emailed response.

It's especially essential given the mental health impacts of financial pressures on students.

"Financial concerns are an important factor that can exacerbate pre-existing mental health concerns or bring students in for treatment," Lee said. "As these issues will likely continue or worsen, it is likely that the need for mental health services on college campuses will continue to rise."

Faculty need to use compassionate flexibility, as well, said David Palmiter, a full professor of psychology at Marywood University.

"Sometimes people say that might mean a lowering of academic standards, but I don’t think so," he said.

Marywood found support groups to be successful in the spring. Creating programs outside of traditional counseling can help serve students who may not yet be comfortable with the idea of sitting down one on one with a therapist, Palmiter said.

"Most people who can benefit from counseling do not get it," he said, adding that he hopes one good thing that comes out of this crisis is a better societal understanding of mental health.