As the country has been battling the COVID-19 pandemic, schools and mental health providers are battling a different kind of pandemic that doesn’t seem to have an end — suicide.
“We’re seeing this interesting relationship where overall ED visits have dropped, where psych ED visits are doubling, which certainly suggests there’s overall mental health crises happening,” said Dr. Jessica Hawks, a child and adolescent psychologist and director of outpatient services in the Pediatric Mental Health Institute at Children’s Hospital Colorado.
“Specific to the El Paso County region, we’ve also seen a doubling in the number of suicide completions of youth since the onset of the pandemic ... We have seen more frequent, and more severe, suicide attempts. Within psych-related ED visits, we’ve seen a 10 percent increase in the number of patients presenting with the chief complaint of suicidal ideation. We’re also seeing a higher number of patients who have attempted suicide becoming admitted into our pediatric intensive care unit.”
The Colorado Department of Human Services is attempting to address the youth mental health crisis through its Below the Surface program, which aims to help teens of all backgrounds successfully navigate academic and social pressures; bullying and harassment; substance use; depression and anxiety; gender and sexuality identities; family instability; and additional challenges.
Below the Surface selected 58 youth from 43 schools and colleges who will help craft marketing messages and manage local outreach campaigns that drive use of the Colorado Crisis text line. One of those students is Briseily Cejudo, a senior at Atlas Preparatory School, a charter school in Harrison School District 2. Cejudo has seen firsthand how the pandemic has impacted students’ mental health.
“When I started going online, it took a hit on me because I wasn’t learning face-to-face with my teachers, and I wasn’t as motivated to do my classwork,” she said. “I noticed that was a pattern that was happening with my friends as well. This year, where we’re remote the entire year and probably not going to go back, it’s just been something that you get used to and find ways to cope with it. What I do is I like to go and hike, since I have more free time to do that. With my friends, some of them are going back in-person and some of them are doing half-days. It’s been better for them since they’re getting the in-person learning.”
As part of her work with Below the Surface, Cejudo will help market the program and raise awareness of the Colorado Crisis text line.
“We’re learning about marketing techniques and we’re trying to get the word out and spread awareness, so we were starting off with areas we think would be best suited for that marketing,” she said. “Basically what we’re doing is getting the posters the program coordinators have and put posters up, we would have pens to hand out to people at schools.”
The text line has seen heavy use during the pandemic with more than 258,500 calls and texts in 2020, up from about 168,000 in 2019, according to a news release from the Colorado Department of Human Services.
While social isolation from quarantining and remote learning contributed to the rise of this youth mental health crisis, Hawks said that there are a number of other factors to consider.
“Based on that national survey data, 78 percent of youth reported that the top contributor to their mental health worsening was feeling isolated or lonely,” she said. “That is a very strong contributor. There are other things to be thinking about as well. Certainly just the loss of security and safety in general, and that hits on a lot of things. There are a lot of families that have been negatively impacted by the loss of jobs, creating housing insecurity, food and financial insecurity, a lot of fears about family well-being, even the loss of loved ones, as many have found. They know somebody that has lost their life to COVID at this point. Just a change in routine over the last year has been really difficult for youth. The disruptions in the continuity of learning, and they’ve gone back and forth between online and in-person, that’s really been challenging. The change in routine has a real significant domino effect.”
Schools are recognizing the need for additional mental health support as well. In December, D2 received a $24,500 grant from Kaiser Permanente as part of the insurance company’s Thriving Schools initiative. D2 is partnering with the Mindfulness and Positivity Project to provide social and emotional training for teachers to implement mindfulness practices in their classrooms.
“At a systems level, as a state, we really need to be thinking about how we are purposefully investing and allocating resources to ramp-up mental health services and supports within the schools, because youth are going to continue to need access to mental health supports,” said Hawks. “We know there’s a better chance that a broader range of kids are going to be able to have access to that in the school setting. We need those resources, and we need schools to be asking kids about their mental health. That can look like a lot of different things, but it might include something like doing universal screenings of students to identify those kids that are experiencing severe mental health concerns.”
The Mindfulness and Positivity Project was started by Cheyenne Mountain School District 12 teachers Meg Frederick and Jeff Kenefsky.
“When we were doing our team teaching years ago, [then-superintendent] Walt Cooper started our convocation that year and he said, ‘The greatest concern facing us right now is the mental health and wellness of our students,’” said Frederick, who is now retired and focuses on the Mindfulness and Positivity Project full-time. “This was before COVID. He said, ‘I’d like for you guys to consider, as teachers, what you can do.’ Most classroom teachers say, ‘Well, that’s not my problem. I’m not a counselor; I’m a math teacher; I’m an English teacher.’ Jeff and I started doing a tremendous amount of research, we worked with his wife Jackie, who’s a licensed clinical therapist, and a bunch of counselors and teachers and students and parents, and we took some classes and workshops. We said, ‘You know what? There are, very simply, intentional practices that teachers can do in the classroom, with their students, two or three minutes a day that will significantly improve their mental health and well-being.’”
Frederick has seen the impact the pandemic has had on both teachers and students.
“When COVID hit everything got so much harder for kids,” she said. “We started doing a podcast, and we started trying to reach students on other platforms. We’ve had a tremendous amount of listeners on our podcast, so that’s been fun to do. Right now, we are working in District 2. Teachers are suffering just as much as anybody else. They’ve been so stressed and anxious, and it’s been really difficult to just get into the schools and actually say, ‘This is really worth your time.’ When someone comes in and says, ‘Hey, we want you to implement this program,’ you say, ‘No, I don’t have time. I’m up to my eyeballs in everything I’m doing.’”
Frederick is working with the leadership at Harrison High School on a new mental health initiative.
“Harrison is having, starting in the month of April, their ‘Panther Pawsitivity Month,”’ she said. “They’re going to highlight each week an aspect of mental health to address. They’re going to do a positivity week, a kindness week, a gratitude week, a self care week, and then just really do some awareness about how we can, with intentional and simple practices, improve our lives and transform our stress into something good for us and decrease anxiety and increase our happiness.”
According to Frederick, the kind of work the Mindfulness and Positivity Project is doing can help students at risk for suicide and suicidal ideation. “We don’t call ourselves a ‘suicide prevention program,’ yet that’s exactly what we are,” she said. “We all know that increases in stress and anxiety and depression and loneliness, that is the foundation for suicidal ideation and completed suicides, when those emotions are unmanageable. We teach a lot of self-compassion. It’s OK not to be OK.”
As a former teacher, Frederick is familiar with the impact suicide can have on students.
“When you have to go into your classroom and there’s an empty chair in there, and you have to explain to your students why that chair is empty, you say, ‘I never want this to happen to anyone ever again,’” she explained. “I think what we try to do is create a culture where paying attention to your mental health, to the ability to create for yourself a more positive outlook on your life, to accept that stress and anxiety and depression and loneliness can be a part of life, but they don’t have to be the overwhelming factor.”
In addition to mental health programs in schools, there are steps parents can take with their children at home. “The number one thing that caregivers and parents can be doing is asking their kids how they are, and checking in with them regularly, being available,” said Hawks. “There’s a lot of fear from parents about asking these kinds of questions, because they’re afraid if they ask they might be planting ideas. We know the opposite is true. It’s very, very protective for youth for a parent to ask, ‘Are you having thoughts about suicide? Are you feeling sad, are you feeling worried?’ Ask those questions of your kids, because that can start a conversation that can help a parent understand where their kid is at and help them get more intensive professional support if needed.”
Text “TALK” to 38255 to access the Colorado Crisis Line.