Assessing mental health for depression and suicidality during the COVID-19 pandemic
This is a the 2nd story in our two-part series on how to keep yourself and others mentally healthy during this time of high-stress and social/physical isolation. Jody Passafume was a Licensed Mental Health Counselor and a Licensed Clinical Social Worker for 32 years and has a Masters' Degree in Counseling. She is a member of Holy Trinity, Columbus and has graciously agreed to share her expertise and wisdom on the subject. Part two of this series focuses on how to identify depression and the potential for suicide in others and how you can help.
Assuming you are taking all precautions recommended by the CDC as you check in on others, here are some things to keep in mind.
If person-to-person (while maintaining social distancing) is not an option, a FaceTime or Skype application would be helpful in assessing how an individual is doing. Visuals are quite helpful but not entirely necessary. If visuals are not available, your listening skills for the non-verbals come into play.
With visuals: Look for significant changes in appearance—unkempt, not showering, dirty clothes, etc. Depression robs a person of energy, motivation, and ability to complete tasks among other things. Facial expressions will be downcast, have no expression or animation while talking (flat affect), lack of eye contact, may show signs of significant crying, and a generally subdued mood. Use your listening skills for cues listed below.
Without visuals: Listen for significant changes in personality—negativity, lack of ability to engage in a conversation or answer questions, inability to imagine or talk about the future. You may hear large sighs or experience long pauses before responses. Others might be flippant or sarcastic and unable to get serious about your inquiry--generally, a lack of energy or willingness to engage to any extent.
While you might start the conversation with “How are you doing?” make sure you dig deeper. Our culture has “Fine!” so engrained; it has no true meaning anymore. If further description is not offered, ask more open-ended questions, e.g., “What have you been doing today?” “Do you have any plans for tomorrow?” “How are your resources holding out?” The goal is to get them engaged in any conversation so you can listen for those signals noted above.
If, in your conversation you suspect an individual is contemplating suicide or harming themselves (or others), don’t ignore your instincts. Contrary to what some believe, asking a person if they are thinking about hurting themselves or killing themselves will NOT put the idea in their head. It’s either already there or it’s not. If it is, they will likely be relieved you picked up on it. If it’s not, they will recognize you care about them enough to at least ask. That having been said, it is not your job to assess the lethality of their thoughts. What you can do is tell them how much you care about them, how important it is to use the resources available, offer to help them get access to those resources, and ask to pray with them. If you feel your relationship is valuable to them, you may also try to extract a promise from them to seek help or to not do anything harmful until you are able to be present to support them.
Always have the Suicide Hotline number at hand (800.273.8255). Make yourself aware of local resources for mental health emergencies. Ascertain if your locale has a mechanism for a “wellness check” by First Responders or Mental Health Professionals. Identify a Mental Health Professional in your congregation or community and ask if they are willing to act as your consultant should the need arise.
Finally, it is infinitely important you take care of your own mental health! You must practice what you are asking others to do. And if you have had to address a particularly traumatic or harrowing situation, utilize your own resources immediately. During this crisis, debrief with your colleagues regularly. What we have learned about PTSD is the sooner a person talks about and processes their experience, the better the long-term outcome. You cannot help anyone if YOU are not in a psychological space to do so!
Additional Mental Health Resources Provided Through the State of Ohio:
Ohio Crisis Text Line
Text keyword "4HOPE" to 741 741
OhioMHAS Help Line
Find Substance Use Disorder and Mental Health Treatment
Disaster Distress Helpline
Text "TalkWithUs" to 66746
Spanish-speakers: Text "Hablanos" to 66746
Available 24 hours a day, 7 days a week, year-round