Publications - Grief and Loss

When Teens Visit Doctors, Increasingly the Subject is Mental Health, by Matt Richtel, The New York Times, Mar 7 2024.

“Increasingly, doctor visits by adolescents and young adults involve mental health diagnoses, along with the prescription of psychiatric medications. That was the conclusion of a new study that found that in 2019, 17 percent of outpatient doctor visits for patients ages 13 to 24 in the United States involved a behavioral or mental health condition, including anxiety, depression, suicidal ideation, self-harm or other issues. That figure rose sharply from 2006, when just 9 percent of doctor’s visits involved psychiatric illnesses. The study, published Thursday in JAMA Network Open, also found a sharp increase in the proportion of visits involving psychiatric medications. In 2019, 22.4 percent of outpatient visits by the 13-24 age group involved the prescription of at least one psychiatric drug, up from 13 percent in 2006. The latest study does not posit a reason for the shift. But the pandemic alone was not to blame, it noted. “These findings suggest the increase in mental health conditions seen among youth during the pandemic occurred in the setting of already increasing rates of psychiatric illness,” wrote the authors, a pediatrician and psychiatrist at Harvard Medical School. “Treatment and prevention strategies will need to account for factors beyond the direct and indirect effects of the pandemic.” ”

10 ways to get mental health help during a therapist shortage, by Lindsey Bever, The Washington Post, Oct 29 2022.

“Anxiety and depression have been on the rise in the United States since the start of the pandemic. This has led to a crisis in mental health that has been worsened by the shortage of mental health counselors.  A significant number of mental health professionals are not accepting new clients. Others have long waiting lists.  The Washington Post asked mental health professionals what advice they would give people who are struggling to find a therapist. About 300 experts from across the country responded with advice on getting an appointment — and tips on what people can do in the meantime to try to help themselves. Here are their recommendations. ”

4 emotional workouts to help you feel empowered and promote resilience, by Juli Fraga, The Washington Post, Sep 28 2022.

“Self-care tools can be helpful, especially when barriers such as high-deductible insurance plans, high co-pays and living in remote areas can make mental health care difficult to afford or access. And while the pandemic isn’t solely to blame for the lack of therapists, it’s certainly made things worse, says Vaile Wright, the senior director of health-care innovation at the American Psychological Association.  With too few mental health resources, we need innovative ways to make psychological care more accessible, she says. If you’re waiting to see a therapist, can’t afford mental health care or have recently finished therapy, emotional exercises are one way to strengthen your psychological muscles. While these workouts aren’t meant to replace individual or group therapy, Anhalt says they can promote resilience and help you feel empowered. ”

Confronting Health Worker Burnout and Well-Being, by Vivek H. Murthy, M.D., M.B.A., New England Journal of Medicine, Aug 18 2022.

“Expressions of gratitude have too often been replaced by hostility, anger, and even death threats toward health workers, as health misinformation has exploded, eroding trust in science and public health experts. Yet doctors, nurses, pharmacists, social workers, respiratory therapists, hospital security officers, and staff members of health care and public health organizations continue showing up to battle the pandemic and its sequelae — long Covid, mental health strain, widening health disparities, and 2 years’ worth of deferred care for myriad conditions.  The toll on our health workers is alarming. Thousands of them have died from Covid. More than half of health workers report symptoms of burnout,1 and many are contending with insomnia, depression, anxiety, post-traumatic stress disorder, or other mental health challenges.2  ”

How the U.S. Can Solve a Shortage of Mental-Health Professionals, by Lisa Ward, The Wall Street Journal, Aug 14 2022.

“Many sufferers of mental-health issues can’t find the help they need. Often there just aren’t enough providers.  More than a third of the U.S. population, about 130 million people, live in areas that have a dearth of mental-health workers. Residents of underserved areas have roughly a quarter of the providers they need, in aggregate, the Kaiser Family Foundation says. The shortage is even more acute in rural areas. About 80% of rural counties lack access to a single psychiatrist, according to a report by the U.S. Senate Committee on Finance, citing data from the Health Resources and Services Administration.  The pandemic brought the shortage of mental-health services into sharp focus as more adults sought help to deal with the stress and disruption of their daily lives. Children suffered immensely, too, as prolonged school closures weren’t only psychologically damaging, but also caused many children’s mental-health conditions to go unnoticed because teachers and school psychologists are a primary source of referrals. ”

The new 988 mental health hotline is live. Here's what to know, by Rhitu Chatterjee, NPR, Jul 16 2022.

“People experiencing a mental health crisis have a new way to reach out for help in the U.S. Starting Saturday, they can simply call or text the numbers 9-8-8.  Modeled after 911, the new three-digit 988 Suicide & Crisis Lifeline is designed to be a memorable and quick number that connects people who are suicidal or in any other mental health crisis to a trained mental health professional.  "If you are willing to turn to someone in your moment of crisis, 988 will be there," said Xavier Becerra, the secretary of the federal Department of Health and Human Services, at a recent press briefing. "988 won't be a busy signal, and 988 won't put you on hold. You will get help." ”

Grief-induced anxiety: Calming the fears that follow loss, by Jessica DuLong, CNN, Jul 18 2021.

“Millions of Americans are grieving loved ones taken by Covid-19. Yet even outside of a pandemic — with its staggering losses of lives, homes, economic security and normalcy — grief is hard work.  “The funny thing about grief is that no one ever feels like they’re doing it the right way,” said therapist Claire Bidwell Smith, author of “Anxiety: The Missing Stage of Grief.” But there is no right way, she insisted. The only “wrong” way is to not do it.  What often trips people up is misattributing the sensations of grief-related anxiety to some unrelated cause. “Probably 70% of my clients have gone into the hospital for a panic attack following a big loss,” Smith said. ”

How men hurt and grieve over miscarriage, too, by Matt Villano, CNN, Jul 15 2021.

“What scientists do know: About 10% to 20% of known pregnancies end in miscarriage, at least according to the Mayo Clinic. Many obstetricians and other experts say this number likely is even higher, since many miscarriages occur so early in a woman's pregnancy that some women don't realize they are pregnant at all.  Typically, because women are the ones carrying the fetus, miscarriages are perceived to be biopsychosocial in nature — that is, they affect moms biologically, psychologically and socially.  But fathers experience acute loss as well, said Kate Kripke, founder and director of the Postpartum Wellness Center in Boulder, Colorado. Theirs is psychosocial, without the biology. ”

Even with insurance, getting mental health treatment is a struggle in Mass., study says, by Liz Kowalczyk, Boston Globe, Dec 11 2018.

“Massachusetts residents who need health care are colliding with a hard reality: Having medical insurance doesn’t guarantee you can get treatment, particularly for psychiatric problems. More than half of adults who sought mental health or addiction treatment in recent months had difficulty getting that care, according to a survey of 2,201 residents by the Blue Cross Blue Shield of Massachusetts Foundation in Boston...The obstacle wasn’t a lack of insurance; the vast majority of patients were insured. Rather, the problem was that providers either did not accept their insurance or their practices were closed to new patients. ”

States may now broaden mental health treatment under Medicaid, by Michael Nedelman, CNN, Nov 13 2018.

“The Centers for Medicare and Medicaid Services may now allow for states to pursue Medicaid reimbursements for short-term inpatient treatment in mental health facilities despite a decades-old exclusion, Health and Human Services Secretary Alex Azar announced Tuesday. In a letter to state Medicaid directors, CMS detailed a new Medicaid waiver opportunity through which states may bypass longstanding reimbursement restrictions on inpatient psychiatric treatment, which apply to mental health facilities with more than 16 beds. Azar said the original policy has posed a "significant barrier" to people getting the treatments they need. ”

Losing a spouse late in life linked to cognitive decline, by Carolyn Crist, Reuters, Apr 20 2018.

“Older adults who lose a spouse may be more vulnerable to cognitive decline in subsequent years and require extra support and monitoring, researchers say. In the study of nearly 7,000 middle aged and older men and women, cognitive functioning declined over time for everyone, but it degraded slightly more and slightly faster for those who had been widowed, regardless of whether they remarried. ”

Helping Yourself Heal When Someone You Care About Dies of a Drug Overdose, by Alan D. Wolfelt, Ph.D., Jan 12 2017.

“A friend or family member has died of a drug overdose. Death and grief are always hard, but when someone dies from drug use, understanding your feelings and knowing what to think and say about the death can be especially difficult. This article offers compassionate guidance for coping with your own grief as well as helping others affected by the loss.   ”

Something Very Bad Happened: A Toddler's Guide to Understanding Death, by Bonnie Zucker, PsyD, Aug 2016.

The Grieving Process, by American Cancer Society, Jun 6 2016.

“Many people think of grief as a single instance or short time of pain or sadness in response to a loss – like the tears shed at a loved one’s funeral. But grieving includes the entire emotional process of coping with a loss, and it can last a long time. Normal grieving allows us to let a loved one go and keep on living in a healthy way. ”

Developmental Grief Resources, The Dougy Center, 2016.

“The Dougy Center describes children's grief responses according to age range. ”