Page 10 - RU RWJ Medicine Magazine • Winter 2021
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Individuals are reporting negative repercussions physically, socially, financially, and emotionally, he says. All of these losses are coming at a time of social unrest, a contentious election, and mixed messaging from authority figures.
“People have the idea that we’re under these restrictions and there’s no end in sight. There’s definitely increased depression, and it’s having an impact on people’s day-to-day activity and their normal sense of hopefulness,” says Dr. Aziz.
The CDC study also showed several types of individuals, in addition to essential workers, who may be experiencing more pandemic-related mental and behavioral health issues. Specifically, rates of suicidal thinking were significantly higher in young adults age 18 to 24 (25.5 percent), Hispanics (18.6 percent), non-Hispanic Blacks (15.1 percent), and unpaid caregivers (30.7 percent).
“These groups would really require extra screening and support, since they seem to be at highest risk for developing depression and suicidality,” says Dr. Aziz.
Addressing Barriers to Assistance
Ensuring individuals have access to the help they need could be a challenge, however.
“In the month before a suicide, 45 percent of patients see their primary care doctor, but only 20 percent of them actually see a mental health professional,” notes Dr. Aziz. “In the United States, most antidepressants are actually written by primary care physicians, so part of the crisis is that people are either not able to access care or are not directed toward the appropriate care service. And in some cases, there is such a shortage of mental health professionals, those services are not available for them.”
As a result, it is critical to educate primary care physicians with respect to screening for depression, hopelessness, helplessness, and suicidal thoughts, Dr. Aziz says.
“In what can be a quick primary care visit, it may not be something that is always assessed for,” he explains. “Additionally, if a patient reports such thoughts or increased depression or hopelessness to their primary care doctor, the clinician may not always know how to respond or where to send people for treatment. So, we also need to increase access to those services, including adding more psychiatrists, psychologists, and social workers available to help.”
The most important thing is early identification, Dr. Aziz stresses.
“I’ve made it a part of my practice that the first thing I always ask my patients now is ‘how are you doing in these times? How has the pandemic affected you? Has anyone been sick? What’s your day-to-day like?’ And I always ask them about how they are doing with the restrictions. Are they going out? If so, are they taking precautions?” he says.
Dr. Aziz says he tries to address four issues during his conversations with patients: a safety assessment; encouragement of increased social
An 1.4
8 Robert WoodJohnson | MEDICINE
estimated million suicide
attempts and
48,34 4 deaths by suicide
annually in 2018.*
*Source: Centers for Disease Control and Prevention (CDC)

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