September Forecast 2021 Update - BEHAVIORAL HEALTH IMPACTS OF COVID-19 - Spokane County

BEHAVIORAL HEALTH IMPACTS OF COVID-19
        September Forecast 2021 Update

Brief Overview: Development and Further Reading

Background:
• Developed by combining academic literature, a wide variety of data sources,
  and the exper:se of the DOH Behavioral Health Strike Team
• Highly subject to future waves, government ac:ons, societal trends, social and
  economic impacts
• Con:nually informed by new research and data sources

Further reading:
• Statewide Impact Forecast (updated monthly)
• Behavioral Health Situa:onal Report (updated weekly)

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Different paths for
communities based on risk /
protective factors,
September 2021

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Key Things to Know

  Areas of focus for September 2021:
  • Back-to-classroom instruction for students around the state
     • Associated youth surge (there was no summer “slump” in Behavioral Health patterns for youth
       and adolescents)
     • Potential for school anxiety / refusal, behavioral acting out, withdrawal, regression
     • Parental / Caregiver anxiety about schools closing again, or having to balance work and
       childcare
• Expectations and associated anxiety around social participation and reconnection in the context of
   a pandemic that continues:
  •   Anxiety about participation in social events.
  •   Sense of overwhelm in crowds, or in groups.
  •   Unsure of social dynamics, re-establishing and reconnecting with others, making small talk.
  •   Fear of pressure to participate in things.

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Plan for Uncertainty and Change in Return to School

It can be helpful for parents and caregivers to make a plan. You may not need to use it,
but creating a plan can reduce anxiety. For example
        What will you do if your child becomes ill?
        What’s the plan if your child’s school closes temporarily?

  The THINK toolbox for parents, caregivers, educators, mentors/coaches and students
  can offer some resources for managing the stressors and anxiety that may emerge as
  students return to “in-person” school.
  https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/821-148-
  BackToClassroomToolbox.pdf

Key Things to Know

• “Return to workplace” shifts for many employers may also cause some unexpected behavioral
  health responses.
  • Some employees may be fearful about expectations, uncertain about in-office policies and
     procedures related to safety and health, frustrated by the addition of a commute, or confused
     as to their own mixed emotions about the ‘end’ of the pandemic and the opportunities and
     challenges associated with coming back to in-office work.
  • Interpersonal relationships in the workplace may also cause more frustration and anxiety for
     some in the workplace.
• Members of the BIPOC community may be at higher risk of BH symptoms related to workplace
  return if they are returning to environments where they have previously experienced (or are
  concerned about the ongoing or magnified experience of) discrimination, racism or
  microaggressions.

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Key Things to Know
• As more and more people test positive for COVID, the long-term diagnostic sequalae are
  important to consider:
  • Long haul COVID – GI symptoms, exhaustion, respiratory sx are among the most common
  • Cognitive Dysfunction: UK study
   N = 81,337 participants (People who had recovered from COVID-19, including those no longer reporting symptoms), exhibited
   significant cognitive deficits versus controls when controlling for age, gender, education level, income, racial-ethnic group, pre-
   existing medical disorders, tiredness, depression and anxiety. The deficits were substantial for those who had been hospitalized as
   well as those who were not hospitalized who had biological confirmation of COVID-19 infection (N = 326).
   https://www.thelancet.com/action/showPdf?pii=S2589-5370(21)00324-2

• Anxiety and depression (and a potential for an uptick in PTSD) may increase in the next few
  months related related to variants of the virus, particularly Delta, but other variants of interest
  and concern as well. (Pulse survey shows potential return to baseline pre-covid)
• Vaccine efficacy / hesitancy/ breakthrough in context of variants: reinforcing ideas that are
  simple, consistent and reduce anxiety by focusing on actual risk (rather than perceived risk, which
  people consistently don’t accurately determine).
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Potential for Violence and Aggression

➲   Different viewpoints      ➲   Impulsivity & Emotion
                                 Dysregulation
                                                             ➲   More contact
    Viewpoints are often         Impulsivity is scll high.       More in person social
    held as “correct” or                                         contact, more
    “incorrect” and as “Us       We have a harder cme            ambiguity about how to
    vs Them”, leading to         controlling our                 engage with others.
    more rigidity, anger         emoconal responses.
                                                                 People can often
    and judgment.                                                respond differently or
                                                                 uncharacteristically
                                                                 (with more aggression
                                                                 or hostility) in crowds
                                                                 compared to small
                                                                 groups.

Anxiety, Depression (Census Bureau)

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Resources:

DOH - Forecast and situational reports, guidance and resources:
https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID
19/HealthcareProviders/BehavioralHealthResources

WA State – General mental health resources:
https://coronavirus.wa.gov/information-for/you-and-your-family/mental-and-
emotional-well-being

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Questions?

Washington State Department of Health is commi5ed to providing customers with forms
  and publica;ons in appropriate alternate formats. Requests can be made by calling
       800-525-0127 or by email at civil.rights@doh.wa.gov. TTY users dial 711.