Tuesday, October 10, 2023

By Don Sapatkin

Good morning. As hatred, violence and killing envelop Israel and Gaza, our founding editor shares a brief thought and a musical prayer for healing. In other news: High school students who took days off from school cited anxiety and depression among the top reasons besides physical illness.

A cultural anthropologist who studies water insecurity’s impact on mental health is honored with a MacArthur Foundation fellowship (the one for “geniuses”). The government shutdown may have been averted for now, but the deal did not include reauthorization of a vital law aimed at fighting the opioid epidemic. And emergency department visits for eating disorders increased significantly during the pandemic among young and older adults and skyrocketed among teens in Ontario.

Sending you light

A personal note: As an American Jew and a citizen of the world struggling to process what is happening right now in Israel and Gaza, I can only think about the endless cycles of trauma and retraumatization that keep occurring — how people steeped in trauma continue to inflict more trauma, occupation, slaughter and hatred on each other. My thoughts beyond that simple observation are too inchoate and disorganized to share right now, but I do want to share this song for healing that I find moving and comforting.

I’ve had the privilege of hearing it performed it at Yom Kippur services. And let me say: Shalom and Salaam (peace in Hebrew and Arabic). –Rob Waters

Anxiety, depression keeping kids out of school, survey finds

Anxiety was the second-biggest reason for missing school, after bad weather, according to a survey of high school students last month that excluded absences due to physical illness. About 16% of students who reported staying out of school at least one day in the past year for reasons other than being physical sick said they were too anxious to attend, and 12% (the fifth-biggest reason) said they were too sad or depressed to go, EducationWeek reported. In between were “I overslept because I stayed up too late (15%) and “To relax at home” (13%). Nearly 20 other reasons were given less often, including “school is boring” (8%) and in-person bullying (5%).

The EdWeek Research Center surveyed 1,034 high school students from Aug. 31 through Sept. 21. The nationally representative results “show how worsening student mental health can contribute to chronic absenteeism,” according to EducationWeek. A quarter of all respondents reported being absent for a week or more in the past year. More than half (52%) of students surveyed said they needed mental health services during that time.

Many schools have expanded their mental health offerings since the pandemic, and 40% of all students surveyed reported receiving mental health services at school. Another 49% said they didn’t need them. Twelve percent said they needed mental health programs or services and didn’t get help from their school, with more than a quarter of that group saying their school wasn’t offering them at the time. School itself was viewed as a source of emotional challenges: Asked which factors had a negative impact on their mental health, the top two answers were stress related to finishing schoolwork/homework (34%) and grades/test results (28%).

Anthropologist studying water scarcity’s impact on mental health wins ‘genius’ award

Many scientists think “experiences of resource insecurity seem to track closely with PTSD, anxiety and depression,” cultural anthropologist Amber Wutich told Axios for a story about water scarcity’s impact on mental health last November – 11 months before winning a MacArthur Foundation fellowship, better known as a “genius” award, for her own solutions-oriented work.

Wutch’s research, drawing on her training in anthropology and development and years of ethnographic fieldwork in Latin America, investigates the impact of water insecurity on human well-being, according to her MacArthur Foundation profile. A professor of anthropology at Arizona State University’s School of Human Evolution and Social Change and director of its Center for Global Health, Wutch takes a “justice-oriented” approach to research, working in troubled communities whose residents invite her in to observe and help solve the problems they are facing. She focuses on water insecurity, which she told NPR “is an outcome of human manufactured systems” – extraction, for example, or the failure of centralized water infrastructure – that can occur anywhere. Climate change is making it far worse.

Wutich’s early work focused on a community in Cochabamba, Bolivia, that was the epicenter of a battle over control of water after the International Monetary Fund and World Bank allowed a U.S.-based company, Bechtel, to privatize the city’s water supply and limited the community’s access to safe drinking water. The centralized water system eventually failed. Wutich, now 45, examined the substitute water-sharing arrangements organized by residents as a form of social infrastructure and documented how water insecurity led to significant anxiety and distress.

Her research has expanded since then to include informal solutions to water access problems and the broader mental health effects of water insecurity. “We can learn from how humans have survived water insecurity, across cultures and across human history, to overcome our own water challenges,” she said.

Deal to avert government shutdown didn’t extend a 2018 law to combat opioid addiction and overdoses

The bipartisan continuing resolution that ultimately led to House Speaker Kevin McCarthy’s ouster and paralysis in the Republican-controlled House avoided a government shutdown but did not reauthorize several huge programs that expired on Sept. 30 – including the SUPPORT Act, a comprehensive effort to tackle the opioid crisis, the Politico Pulse newsletter reported. Funding for its programs will continue but lawmakers must pass a reauthorization bill to make changes, according to Politico. Some Medicaid plan options allowing for residential treatment for substance use disorder also expired, leaving states to seek funding elsewhere.

The original SUPPORT for Patients and Communities Act of 2018, passed with overwhelming support in both chambers and signed into law by former President Donald Trump, includes scores of provisions aimed at opioid addiction prevention, treatment and recovery for five years. Among them: support to states for establishing drug courts that divert people arrested on low-level drug charges to treatment instead of prison, requiring most state Medicaid plans to cover medication-assisted treatment, and federal repayment of education and training loans for substance use disorder treatment workers who agree to stay in their jobs for a period to shore up the workforce.

Meanwhile, overdose deaths have soared: Provisional CDC data for 2022 shows all overdose deaths topping 100,000 for the second straight year, with opioid-related deaths up 76% from 2018 to 2022. The rise was driven entirely by fentanyl.

The House Judiciary Committee advanced its five-year SUPPORT Act reauthorization bill two weeks ago on a 28-3 vote with an amendment to schedule the horse sedative known as tranq as a Schedule III controlled substance for three years. Supporters hope that some version of a reauthorization might be included in whatever legislation or short-term continuing resolution Congress passes to keep the government running past Nov. 17.

A reauthorization bill’s specific path forward isn’t yet apparent, however, and it’s unclear what the immediate practical consequences will be, according to Politico. The SUPPORT Act enjoys huge bipartisan support, but the divided House and Senate have a lot on their plates, including reauthorizing the expired Pandemic and All-Hazards Preparedness Act and the global AIDS funding program known as PEPFAR that is credited with saving 25 million lives worldwide since President George W. Bush created it in 2003. Plus, oh yes, funding the federal government.

Emergency department visits for eating disorders soared during pandemic

Visits to hospital emergency departments increased 22% among middle-aged adults (41 and above), 13% among young adults (ages 18 to 26) – and an astounding 122% among teens and adolescents (ages 10 to 17) in Ontario, Canada, during the pandemic. Those were the findings of a rare study that included adults of all ages, Medscape reported. There was no significant change in ED visit rates among adults 27 to 40.

The study, published in the Canadian Medical Association Journal, included the vast majority of community and academic hospital ED visits in Ontario from before the pandemic – Jan. 1, 2017 through Feb. 29, 2020 – to during the pandemic – March 1, 2020 to Aug. 31, 2022.

The authors speculated that a combination of risk factors — including isolation, more time on social media, extended time spent with family, decreased access to care and fear of infection — may contribute to a higher risk of developing or exacerbating an eating disorder, with some of those risk factors hitting adolescents harder at an already tumultuous age. The same study reported very different findings for rates of eating disorder-related hospital admissions: up 54% among ages 10 to 17, down 7% to 8% for ages 18 to 40, and down 30% for ages 41 and older, 8% for ages 27 to 40. They said admissions rates may have been suppressed by constant reports that hospitals were overloaded with COVID-19 cases and that older adults, in particular, may have been more afraid of being infected in the hospital.

You’re Not Alone: Navigating Life with Mental Illness

That’s the title of a three-part interview series by podcaster. Braaains, which describes its mission as “exploring the inner workings of our brains, mental health, & disabilities and how film & television portray them.” The programs discuss major issues in mental health and how to deal with them.

Episode 1, How Stigma Hurts Everyone, includes how to prevent and address stigma “as well as be a good ally.”

Episode 2, The Journey to Diagnosis, examines “how to take the next step when you need help with a mental illness or are looking to improve your mental health.”

Episode 3, When and How to Disclose, goes over how to approach telling other about your own mental health challenges, concerns about discrimination and how to address them, “and why some people incorporate their mental illness or disability into their identity after disclosure.” They have nifty “You’re Not Alone” merch, too.

If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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Type of work:

Don Sapatkin is an independent journalist who reports on science and health care. His primary focus for nearly two decades has been public health, especially policy, access to care, health disparities...