HJAR Jan/Feb 2022

HEALTHCARE JOURNAL OF ARKANSAS I  JAN / FEB 2022 27 Joseph W. Thompson, MD, MPH President and Chief Executive Officer Arkansas Center for Health Improvement Hospital Association and the American Academy of Child andAdolescent Psychia- try issued a statement declaring a “nation- al health emergency” in children’s mental health. “The pandemic has intensified this crisis: across the country we have witnessed dra- matic increases in Emergency Department visits for all mental health emergencies, including suspected suicide attempts,” the groups wrote. “The pandemic has struck at the safety and stability of families. More than 140,000 children in the United States lost a primary and/or secondary caregiver, with youth of color disproportionately impacted. We are caring for young people with soaring rates of depression, anxiety, trauma, lone- liness and suicidality that will have lasting impacts on them, their families, and their communities.” 3 Arkansas Children’s Hospital confirms the emergency in our state: in September, mental health disorders accounted for nearly 2.5%of the hospital’s emergency department visits, a 150% increase frompre-pandemic levels. 4 Another crisis that has been exacerbated by COVID-19 is our nation’s drug overdose epidemic. Overdose deaths were already soaring before the pandemic as the synthetic opioid fentanyl flooded the U.S. illicit drug supply, but after the arrival of COVID-19, these deaths spiked to unprecedented lev- els. More than 100,000 people died of drug overdoses in the U.S. during a 12-month period ending in April 2021, according to provisional data from the National Center NEARLY two years into the COVID-19 pan- demic, there is mounting evidence of the devastating impact it has had onAmericans’ mental health. The pandemic has created or exacerbated a plethora of mental health stressors in our daily lives, including iso- lation and loneliness resulting from social distancing, challenges with child care as schools shifted to remote learning, loss of income as many businesses closed their doors, disruption of routines, uncertainty about the future, worries about our health and the health of our loved ones, inability of families to visit loved ones when in hospitals or nursing homes, and, unfortunately, grief for those we have lost. The pandemic has also led to many people postponing or hav- ing reduced access to healthcare, including mental health and substance abuse services. According to the Household Pulse Survey, a joint project of the U.S. Census Bureau and the Centers for Disease Control and Pre- vention’s National Center for Health Statis- tics, about one in three U.S. adults reported symptoms of anxiety or depressive disorder as of September 2021. In comparison, only about one in 10 adults in the U.S. reported these symptoms in 2019. 1 Even before the pandemic, the pediatric health community was warning of a grow- ing mental health crisis among the nation’s young people. By 2018, suicide had become the second-leading cause of death among people ages 10 to 24. 2 In October 2021, the American Academy of Pediatrics, of which I am a member, along with the Children’s for Health Statistics. That is a 28.5% increase from the 78,056 overdose deaths that oc- curred in the same period the year before. 5 In addition to the mental stressors previously mentioned, pandemic-related factors that may have contributed to elevated overdose numbers include disruptions in the quality and quantity of users’ drug supplies, drug- taking in isolation and reduced access to addiction and recovery services. Unfortunately, Arkansas is among the states seeing the highest increases in over- dose deaths. An analysis by The Common- wealth Fund found that Arkansas is one of 10 states where overdose deaths increased by more than 40% in 2020 compared to 2019. 6 Policies that would help address these crises during the pandemic and beyond include: • Strengthen and support mental health and substance use providers. Historically, public and private pay- ers have not sufficiently reimbursed or built strong provider networks for mental health and substance abuse services, resulting in inadequate or absent sources of care in many parts of our state. The Affordable Care Act and other laws have made strides to- ward achieving parity between men- tal health services and other kinds of medical services, but gaps remain, and federal and state lawmakers can and should domore to close them, particu- larly disparities in access among low- income communities, communities of