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Sharing your emotions and comparing notes with a trusted friend can help you challenge the notion that your circumstances are as negative as they seem.
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Americans are experiencing mental-health conditions such as suicidal thoughts at higher levels during the pandemic, recent data show. But there are lots of resources and strategies available to help, experts say — not to mention teletherapy that’s more accessible than ever.
About 10.7% of Americans surveyed in June said they had seriously considered suicide in the past 30 days, according to a Centers for Disease Control and Prevention study published last month, more than double the 4.3% who said the same in 2018 about their previous 12 months.
Certain groups were particularly likely to say they had experienced suicidal ideation, including younger adults aged 18 to 24 (25.5%), essential workers (21.7%), unpaid adult caregivers (30.7%) and people with less than a high-school diploma (30%). The shares of Black (15.1%) and Hispanic (18.6%) respondents reporting suicidal ideations were also above average.
“While not monolithic, these groups represent people in our society who simultaneously have the least access to resources and protections and the most pandemic-related stressors,” said Jonathan Singer, the president of the American Association of Suicidology and an associate professor of social work at Loyola University Chicago. “We have a patchwork quilt of supports that for the most part consider the needs of these groups of people last instead of first.”
Due to a lack of real-time national data, we won’t know for some time whether actual suicide rates are increasing, Singer said. But “we can reasonably infer that the suicide rate will go up, and it will be higher than it would have been had there not been a pandemic,” he said, pointing to suicide’s independent associations with factors such as unemployment, gun ownership and substance use, all of which have risen during the coronavirus crisis.
“Some of the biggest risk factors for suicide are now part of daily life,” said Stacey Freedenthal, a psychotherapist and University of Denver associate professor of social work, citing isolation, job loss and housing instability as examples.
It’s possible that chronic illness, another suicide risk factor, may also wind up playing a role, Singer added, given mounting evidence that a “long-hauler” subset of COVID-19 survivors experience long-term health effects from the disease.
“ ‘Don’t hesitate to reach out if things aren’t going well. You don’t have to wait till you’re in a suicidal crisis.’ ”
With National Suicide Prevention Month underway, MarketWatch spoke with experts about what to do if you’re thinking of suicide or experiencing other mental-health issues during the pandemic.
Start with the Lifeline
The free, confidential National Suicide Prevention Lifeline (1-800-273-8255) is an easy place to start, said Andres Pumariega, a child and adolescent psychiatrist at the University of Florida who has studied suicide. The Lifeline can help with providing immediate support, coping skills and referrals to mental-health services, he said, and comprises a network of more than 170 crisis centers across the country. Your call to the Lifeline is routed to your closest crisis center, whose counselors will be familiar with the resources available in your region. The website also has a chat function.
If you can’t get through to the Lifeline or experience a long wait time, try again, said Freedenthal. You can also Google GOOGL, -3.88% your local crisis center and call it directly, Pumariega said. If you are in a dire emergency, you can go to an emergency room.
Other services to try: the Crisis Text Line (text HOME to 741741), the Veterans Crisis Line (press 1 after dialing the national Lifeline), the Trevor Project for LGBTQ youth (1-866-488-7386), the Trans Lifeline (877-565-8860) and the Substance Abuse and Mental Health Services Administration’s Disaster Distress Helpline (call 1-800-985-5990 or text TalkWithUs to 66746).
“Don’t hesitate to reach out if things aren’t going well,” Singer said. “You don’t have to wait till you’re in a suicidal crisis — increasingly, crisis lines understand that their job is also crisis prevention.”
Give therapy a chance
The government has lifted regulations on telehealth, expanding access to remote mental-health resources during the pandemic. “If you’ve ever thought about doing therapy, now’s the time,” Singer said. “There are no barriers to transportation or parking; you don’t have to take two hours off work.”
“ Worried you can’t afford therapy? Freedenthal suggests searching for therapists who offer a sliding scale, using lower-cost group therapy, looking for low-cost or pro-bono therapy, or seeking out social-service agencies that offer psychotherapy. ”
If you’re completely unfamiliar with seeking mental-health services, your local crisis center can be a great resource for where and how to access therapy in your community, Pumariega said. See if your workplace offers an employee-assistance program (EAP), which may provide a certain number of counseling sessions and refer you to a mental-health provider.
If you have employer-sponsored insurance, check the list of providers available through your plan, Singer added. The American Psychological Association and American Psychiatric Association both have databases. And companies like Talkspace and BetterHelp offer online therapy services.
Worried you can’t afford therapy? Freedenthal suggests searching for therapists who offer a sliding scale, using lower-cost group therapy, looking for low-cost or pro-bono therapy, or seeing if your nearby social-service agencies offer psychotherapy. You can also search for your community mental health center or a federally qualified health center near you. Academic institutions in your area may offer services from psychiatry, psychology and/or social-work trainees, often at low cost, Pumariega added.
Though you could certainly try out the first therapist on the list, a little research can help narrow down your options to find a good fit, Freedenthal said. Consult Psychology Today’s therapist listings and check out therapists’ websites. See if a provider has been trained specifically in providing online services, Singer added, though it’s not a dealbreaker if they haven’t.
You might also want to look for a therapist who specializes in or has lived experience with an identity that’s important to you, whether that’s gender identity, sexual orientation or race or ethnicity, said Isaiah Pickens, a clinical psychologist and founder of the professional development and media company iOpening Enterprises.
Skeptical about therapy working for you? “Try it out,” Pumariega said. “You’re not making a lifelong commitment to this therapist who you’re hitched to forever,” and you may not necessarily mesh with the first therapist you try.
Many religious leaders have training in counseling
Ministers and religious leaders are often-overlooked resources for counseling, he added. “Many have formal counseling backgrounds and come at the right price, and are accessible for people who are skeptical about psychology and psychiatry,” he said. “They will often refer when needed or feel out of their comfort zone.”
Online groups and books can help
You can also find support groups on Facebook FB, -3.73% or through online directories; if you have persistent suicidal thoughts, check out the group Chronic Suicide Support. Read self-help books: Freedenthal recommends “How I Stayed Alive When My Brain Was Trying to Kill Me” by Susan Rose Blauner and “Choosing to Live” by Thomas Ellis and Cory Newman.
Make a safety plan
A safety plan details your warning signs (such as moods, behaviors or situations) that a crisis could be developing; internal coping strategies you can employ without contacting someone else; a list of people and social settings that can offer a distraction; names and numbers of people you can ask for help; mental-health professionals or agencies to contact in a crisis; and ways to make your environment safe.
Ideally, you’d formulate this plan with guidance from a therapist or Lifeline worker, who can help generate additional options and make your plan as specific as possible, Freedenthal said — but you can also make a plan informally on your own.
If you have suicidal thoughts, remove any firearms or other means of killing yourself from your home, or make them harder to access. Consider having a friend hold on to your gun for a while, if possible, or storing it off-site at a shooting range or pawn shop. If you can’t get your gun out of the house, invest in safe firearm storage; consider leaving gun-lock keys with a family member or storing the firearm with an essential part removed. “The least restrictive option is to store your gun with a photo of somebody you love right on top of it,” Freedenthal said.
“ Confide in a compassionate, nonjudgmental person who’s willing to work with you without trying to ‘fix’ you. ”
Practice basic self-care and maintain social connection
Exercise, get good sleep and spend time outside. Open your windows and let sunlight in. Engage in hobbies, activities or even work tasks that occupy your mind and help push out negative thinking and hopelessness. “Physical distancing should not prevent people from connecting with others,” Pumariega added, even if it’s by phone or on Zoom ZM, -5.15%. Sharing your emotions and comparing notes with a trusted friend can help you challenge the notion that your circumstances are as negative as they seem, he said.
Confide in a compassionate, nonjudgmental person who’s willing to work with you without trying to “fix” you, Pickens said.
Demand change from above
In non-COVID-19 times, a suggested self-care regimen might include yoga, walks in the park and good hydration, Singer said — in other words, what you as an individual can do to make yourself feel better. But “right now, we are living in a time when feeling anxious and uncertain about the future is the correct response,” Singer said. “It doesn’t mean there’s something wrong with you, and in fact, a lot of the anxiety that people are feeling is because of the failure of our systems to provide for our needs.”
So ask what you can demand of your government, company or organization during this time, Singer suggested: For example, if you’re a bus driver anxious about going to work because your company hasn’t erected protective barriers to protect you from COVID-19 exposure, contact your union, gather with colleagues or reach out to your employer. Taking action “actually provides a sense of agency in saying, ‘I am doing something,’ which we have found makes people feel better because they don’t feel helpless,” Singer said.
Check the accuracy of your thoughts
Therapists talk to clients about “catastrophizing,” a line of cognitive distortion that leads people to believe without evidence that the worst will happen. But with enormous disruption to daily life — not to mention widespread housing, employment and food instability — “many people are living in a catastrophe” right now, Freedenthal said.
“But there are still ways that even when there is a legitimate crisis, our thinking can make it worse — and it can be useful to try to check the accuracy of our thoughts,” she said. Come up with coping statements that are true, Freedenthal suggested, like “This isn’t going to last forever” or “This sucks — but there are also good things that can come out of it.”
