Thread by @WheatNOil

I have been avoiding writing a thread about this even though it’s actually my area because I have so many thoughts around it that I’m not sure I can get it all together coherently.

But here goes.

If you thought my previous threads were meandering, strap in!

https://twitter.com/drsusanshaw/status/1382162644560343041

1) Suicide is not a great barometer for mental health. Suicide is sometimes a rare outcome of mental illness. The vast majority of people with mental illness do not die via suicide, and it’s not even true that the most severely ill die that way. It is notoriously unpredictable.

So whether suicide rates are up or down may or may not have any correlation with overall rates of mental illness or population mental health.

2) We’re only talking about suicide rates here because of the politicization of mental health during the pandemic.

What I mean is, while many people were legit concerned about mental health during the pandemic, that wasn’t the case for everyone.

Some people used mental health, specifically suicides, as an argument against lockdowns, without genuine care for actual mental health concerns but instead as a convenient excuse to meet their own agenda.

This extended to all kinds of stories about how the morgues were filled with suicide victims last year.

So now the rate of suicides become some sort of measure upon which to judge lockdowns.

Suicides up = lockdowns killed!
Suicides down = See! Lockdowns worth it!

Side note: the sensationalization of suicides is not new. During the stock market crash of 1929 there were all kinds of stories of brokers jumping to their death & huge suicide rates, but it didn’t end up being true at all. Suicide rates did not increase. They went down!

So we need to divorce suicide rates from some sort of measure of either collective mental health OR lockdown effectiveness.

Because:
A) Things could not impact suicide rates & still be bad for mental health
B) Things can be bad for mental health & still necessary

3) See, spoiler alert, big stressors can have a huge impact on mental health! And a once in a century pandemic is a pretty big stressor!

This is going to impact our collective mental health no matter what restrictions we do or do not put in.

Sometimes life sucks. Sometimes external factors present us with impossible circumstances. Half my job is working with kids who have the shittiest life circumstances and I can’t fix it.

All I do is help them figure out how to deal with the shit.

That’s COVID. It sucks. It’s an asshole.

But we’ve got to deal with it. Avoiding dealing with it will make it worse. And the ways we deal with it is going to hurt emotionally. But we have to deal with it anyway. Because that’s the hand life dealt us.

So instead of focusing on how restrictions impact mental health, we need to accept that the pandemic inevitably fucking sucks and how are we going to support the people it sucks the most for?

4) If we want to see how mental health is impacted, 2020 isn’t the time to check.

We can push through amazing things in the short-term. It’s the long-term grind that wears us doing emotionally.

People tend to come together during times of major events. We often see reductions in suicide rates during wars, etc.

Our own mental health ward was near empty during early pandemic.

However, months and months of avoiding care. Relative isolation. Only virtual mental health appointments. Stress. Uncertainty. Just ongoing fatigue. It gets to you. It wears you down. Mental reserve diminishes.

The mental health impact is a later one.

5) Mental health isn’t impacted equally.

Some people are actually doing pretty well during the pandemic. Not talking to people & working from home is a dream situation.

Or they have more stresses but they have a lot of support to get by.

Other people... less so. They were barely getting by before. They don’t have those supports. They were impacted more harshly. They don’t have access to the right resources.

The people doing a bit better and the people doing worse could even balance out at a population level, but you could still have more mental illness. Because the people doing worse could be doing MUCH worse.

In practice, I can say a lot of kids are struggling. It has ‘never’ been this busy. Hospital care, outpatients, everything. Things are collapsing.

And the vaccine won’t instantly fix that. We’re in for the long haul.

6) So suicide rates will do whatever they do. But mental health treatment needs are skyrocketing now, this year.

Existing resources will not be sufficient.

More money won’t be enough either. It might help, but we don’t even have enough trained professionals TO hire.

It’s going to be tough. I don’t know when it’ll improve but suspect the impact will last a long time.

And I truthfully don’t know how we’re going to manage it all.

Just that we’ll have to.

In summary:
COVID is an asshole. And like all assholes, the mental health impact builds the longer it sticks around and will linger long after it’s gone.

All we can do is rebuild ourselves and our community once we kick its ass. That won’t happen overnight. But we’ll get there.