The Pandemic After The Pandemic

Known since the 1950s for mental health care, The Northshore is now battling with a need unlike anything ever seen.
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Starting in the 1950s, if you heard someone was being “sent to Mandeville,” it meant they were receiving mental health care, often involuntary. The term came about with the opening of the Southeast Louisiana Hospital, a mental health facility that grew to treat as many as 2,000 adults, adolescents and children, just east of the rapidly developing Northshore destination.

The hospital later gained national media attention when then-governor Earl Long was committed to the facility in 1959.

In the last 70 years, St. Tammany Parish’s population has grown more than 880%, from 26,988 in 1950 to 264,570 in 2020. For comparison, in the same period, Orleans Parish’s population decreased 32.7% from 570,445 in 1950 to 383,997 in 2020.

With the increase in population, the Northshore has seen a significant increase in the need for medical services and providers, especially following Hurricane Ida, as well as the annual threat of massive hurricanes hitting the region and the ongoing COVID-19 pandemic. Meeting the growing mental health demands of the area is a major concern.

“We have seen a skyrocketing need for mental health services,” said Tanmay Mathur, CEO of Covington Behavioral Health, the largest inpatient mental health hospital on the Northshore. Over the last four years, the hospital has grown from 60 to 100 beds.

“The reason for that growth is to meet the need,” he said. “As we’ve grown, we’ve added service lines. We treat adult mental health, adult substance abuse, and offer adolescent mental health services. We also added a specialty service line for veterans and first responders who are dealing with PTSD, trauma and, oftentimes, the combination of substance abuse.”

Mathur said three drivers cause people to experience anxiety, depression, substance abuse and suicidal thoughts — social isolation, financial insecurity or uncertainty about the future.

“Usually just one of these can be a trigger, but the pandemic has caused a perfect storm where you’re having all three of these things happening at once. It’s now causing what I’m calling ‘the pandemic after the pandemic.’ Then, last August, Hurricane Ida hit, and that drove anxiety and depression, people without their homes, without shelter and not knowing how that’s going to be resolved, financial insecurity, substance abuse. It certainly takes a toll on people’s mental health.”

Nick Richard, the executive director of the National Alliance on Mental Illness (NAMI) – St. Tammany, warns the aftereffects of the storm on mental health haven’t fully manifested yet.

“There’s this clock that starts ticking after major natural disasters like hurricanes, and it’s usually anywhere from 24 to 26 months immediately after that we see an increase in suicide,” Richard said. “We started tracking data locally, in St. Tammany. If you look at Gustav, Isaac, Katrina, the floods that we had in 2016 — like clockwork, every single time, immediately two years following that, the average increase in suicide was 41%. Some of them were as high as 46%. What worries me is the combination of the storm and the pandemic. It’s like the clock’s ticking with diesel on the fire because we don’t know how pandemics affect people long term mentally because we’ve never dealt with them. We’ve never had anything this large scale.”

Richard said people considering suicide do so because they feel like they have no other option, that nobody cares, and that others would be better off without them.

“We have to jump out ahead and try not only to educate people but direct them into the most appropriate place for care prior to them getting to that point of wanting to take their life,” he said. “To not only help people not feel that way, but to educate their loved ones on how to identify those things and reach them prior to that.”

Susan Bonnett Bourgeois, president and CEO of the Northshore Community Foundation — which works to unite human and financial resources to enhance the quality of life in St. Helena, Tangipahoa, Washington, and St. Tammany parishes — said the storm and the pandemic have been life-altering for the whole community. Suicide prevention is a growing area of focus for the foundation.

“I am not a mental health professional, but with repeated exposure to many (small) traumas your brain has a PTSD reaction just like it’s had major trauma,” Bourgeois said. “We’ve been through many traumas — from natural disasters to the pandemic, going all the way back to oil spills and Katrina. There’s just this constant drumbeat. We have made it our goal to make sure we disrupt that pattern of suicides. We’re not going to wait until 20 to 24 months after, sit back and say we are having a mental health crisis and watch the same statistic play out.”

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A Generation in Danger

In December, U.S. Surgeon General Dr. Vivek Murthy issued an advisory to outline the pandemic’s unprecedented impacts and highlight the urgent need to address the nation’s mental health crisis in youth.

“Mental health challenges in children, adolescents, and young adults are real and widespread. Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade,” Murthy wrote. “The COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating.”

Richard agreed, saying young people, from 12 years old to college age, are hardwired to be autonomous from their parents and socialize with their peers.

“That’s a part of our healthy development as teenagers,” he said. “Two things the pandemic did was remove our ability to go anywhere and do what you want and be around peers. This is how we learn how to be adults. There are going to be long-standing issues that we have to recognize — increased depression rates, suicidal thinking, anxiety and all these types of things — so much so that the surgeon general actually issued a report. I don’t think there’s ever been a surgeon general’s report on mental health like that. We’re hearing a lot more about it. We’re seeing that here. That’s something I don’t anticipate going away anytime soon.”

Mary Burckell, St. Tammany’s Health and Human Services director, serves as the liaison between parish government and social service agencies within the community. She said that the fact that one of the only ways young people could meet with their peers during the pandemic was through social media has had a negative impact.

“We’ve seen the studies; we know that social media can be harmful to teens, and that was their only way to connect,” Burckell said. “Social media shows the best of the best. It doesn’t show the ups and downs of everyone’s life, and sometimes we can forget that that’s only what’s being shown. That can be very problematic for making people feel very isolated and alone.”

Paradigm Shift

If there is good news in modern mental health, it’s that treatments have advanced over the decades and associated stigmas are disappearing. People are even more open to care, and society is working to address community needs.

“A big reason people don’t reach out for help is because of what others may say or think,” Richard said. “When we decrease that fear — that it’s a negative implication — that alone increases people reaching out.”

NAMI St. Tammany works with and trains families of those living with mental illness, as well as law enforcement and emergency medical technicians, to identify when someone is going through a related crisis. Training includes how to deescalate and calm the situation and direct those involved to the most appropriate place for care.

“Our government agencies, schools, private hospitals and nonprofit sector have really come together to address mental health as a group and as a community,” Burckell said. “We’ve identified a gap in crisis services in that first responders and emergency rooms have taken over that mental health responsibility. That’s really not their training or their main purpose, so now we’re looking at how we can take the burden off of those first responders, off of those hospitals.

“We have opened a crisis receiving center (on the campus of the former Southeast Louisiana Hospital, which the state closed, and St. Tammany purchased and leases to public and private mental health providers, including Northlake Behavioral Health System) so they don’t have to go to the ER or jail,” she said.

The Good News

Openness to care, along with expanding services on the Northshore, has created a greater sense of hope in the local mental health community.

“I see a lot of expansion, a lot more services, a lot more things being done,” Burckell said. “Someone should not have to get in their car and drive across the lake or to Baton Rouge to get mental health services. That’s just not realistic. If you’re trying to hold a full-time job or you’re going to school and you’re trying to get treatment, if you have to add a two-hour drive, it just becomes even more of a hill to climb to get that treatment.”

Richard said the advent of tele-psychiatry is breaking down even more barriers.

“For years, people struggled on their own and tried to suck it up and figure it out,” he said. “They had the thought that they were not going to walk into somewhere in Covington, Mandeville or Slidell because ‘somebody might see me.’ That’s the beauty of telehealth and using platforms that allow people the convenience of accessing mental health professionals on a phone or computer virtually and privately.”

While mental health problems can be life threatening, Richard said there’s plenty to be hopeful about.

“Compared to other chronic illnesses, mental health has one of the highest rates of recovery if you can receive appropriate services. We know we can help people with mental health conditions. We know we can help prevent suicide as well. The real problem is that we can’t increase access to services overnight. So, the question becomes how do we get creative?”

 


DATA
St. Tammany Parish Mental Health Statistics
During the first year of the pandemic, (2020) the number of suicides in St. Tammany Parish remained steady, while drug overdoses continued to increase and calls to 211 (the emergency line for mental health) more than doubled.

Suicides
2015-40
2016-36
2017-36
2018-52
2019-47
2020-48

Drug Overdoses
2015-59
2016-63
2017-80
2018-86
2019-111
2020-126

211 Calls
(Emergency line for mental health)
2015-3,221
2016-3,481
2017-2,942
2018-2,898
2019-3,375
2020-7,205

 


 

Healthier Northshore Update

Celebrating two years this fall, the program has united healthcare systems and businesses toward a common goal.

In September 2020, St. Tammany Health System and Ochsner Health partnered with more than 50 of the Northshore’s leaders in the healthcare, community, civic and government sectors to form Healthier Northshore. The advisory body is focused on improving the overall health of residents in St. Tammany, our state’s healthiest parish, and neighboring Washington, rated the least healthy parish.

Healthier Northshore aims to educate residents on the value of preventive care, promote early detection and connect residents to available community resources for treatment.

Co-chaired by Joan Coffman, president & CEO of St. Tammany Health System in Covington; and Tim Riddell, M.D., medical director of Ochsner Health’s Northshore Region; the idea for Healthier Northshore was sparked by Ochsner’s ” 40 by 30” initiative, which aims to lift Louisiana’s national health ranking to No. 40 by 2030.

Coffman said medical experts now agree that social determinants, like health behaviors and socio-economic factors, are responsible for 80% of health outcomes.

“We know that the effort to raise the overall level of health — not healthcare, but health — across specifically St. Tammany and Washington parishes is really going to take a multiorganizational approach from public organizations, governmental entities, healthcare entities and community service organizations all working together to improve that overall health,” Riddell said. “So, the idea of Healthier Northshore is to serve as an avenue for bringing that collaboration together.”

Anne Pablovich, community health coordinator at St. Tammany Parish Hospital and the organization’s team leader in the initiative, said it is refreshing to see community leaders in St. Tammany and Washington parishes pull together to make a difference in improving the region’s overall health.

“We need some real grassroots efforts to change some of the societal norms here,” she said.W”e’re trying to broaden that reach and gain a little bit more awareness about the initiative, to reach some new organizations and let people know what we’re about. We’ve created a website – healthiernorthshore.com and started to build a brand identity on social media, pushing some of the events that we’re participating in to expand and broaden our reach.”

Susan Bonnett Bourgeois, president and CEO of the Northshore Community Foundation, which works to unite human and financial resources to enhance the quality of life in St. Helena, Tangipahoa, Washington and St. Tammany parishes, said “The biggest takeaway I’ve seen is the collaboration that is happening among otherwise competing hospital systems and individual businesses. All the healthcare agencies are coming together with this larger and common purpose which is really positive and very reassuring for better outcomes.”