‘SOCIAL PRESCIPTIONS’ BY DOCTORS COUNTERS LONLINESS AND ISOLATION.

 

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The growth of doctors prescribing greater social connections, known as ‘social prescriptions,’ is growing as a counter to growing feelings of isolation throughout the population. 

This is not just a case of physicians encouraging their patients to get out and see friends. Social medicine is more systematic and often involves encouraging the use of structured group interactions.  Social prescribing attempts to meet people in the community where they are, and links them to social support structures.

The New York Times recently discussed social prescription by doctors in a  thoughtful article discussing developments in the U.S. and the U.K.

Here are some passages from the article:

  • Loneliness is a big issue. Any way we can develop connections can help.
  • ‘Social prescriptions’ are already being written in Britain, where physicians can now direct patients to a “link worker,” a trained specialist who focuses on connecting patients to community groups and services for practical and emotional support. Link workers not only connect patients with existing groups but also help create new groups, working as needed with local partners.
  • It’s not just older adults who benefit. Young patients with other chronic conditions and people with mental health issues. There are no age barriers, no limits on what social prescribing can support people with.
  • What social prescribing reflects is a recognition that loneliness affects our health, and we have a universal need to connect with one another.
  • This development of promoting social perceptions by doctors is linked to a larger shift in medicine toward a more holistic approach. We have to remember people don’t come to doctors with a list of medical problems; they come with a life, and a life that may have medical issues but also social and emotional issues.  
  • Doctors say that social prescribing may become the norm in the United States sooner than later. The pandemic has really opened up the door for this kind of thing. Doctors have used structured support groups as part of community programs, for example, such programs have been designed to improve the cardiovascular health.
  • People recognize that it’s not that hard to log on to a virtual group meeting, and it can bring people together who wouldn’t have otherwise been able to.

“Doctors Are Prescribing Ways to Connect Socially for Those Feeling Isolated.” New York Times (May 25, 2021).

Anxiety, Mental Health and Young People — Exploding Crisis.

 

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Here are some excerpts from an outstanding article discussing the exploding issue of anxiety and mental health issues among young people.

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Nationally, young people across the nation increasingly are reporting rising rates of mental distress amid the global coronavirus pandemic.

While COVID-19 is a public health crisis, it’s created a parallel epidemic involving mental health — especially among younger people.

May is Mental Health Awareness Month, an annual observance to remind people of the importance of overall well-being. Mental health is just as important as physical health, and the pandemic calls attention to the need to nurture both.

Among children ages 12 to 17 years old, NAMI reported, there was a 31% spike in mental health emergency room visits in 2020.

The high school years can be a roller coaster of emotions and stresses in the best of times as students worry about grades, social acceptance and admission to college. But the uncertainty of a pandemic, political polarization and this past year’s racial unrest further exacerbated those tensions.

This extends to older teens and young adults as well.

A recent survey conducted by the Centers for Disease Control and Prevention (CDC) showed that 63% of 18- to-24-year-olds reported symptoms of anxiety or depression, with 25% acknowledging increased substance use to deal with that stress and 25% saying they seriously had considered suicide.

Nationally among all adults, according to the CDC, 2 in 5 Americans report symptoms of anxiety or a mental health disorder — an alarming increase from 1 in 5 before the pandemic.

In Virginia, mental health concerns among adults have soared during the pandemic, according to interim results from COVIDsmart, a digital health study. The study is sponsored by the Eastern Virginia Medical School-Sentara Healthcare Analytics and Delivery Science Institute (HADSI), George Mason University and Vibrent Health.

Of the more than 450 people who participated in the study in March, nearly 1 in 4 reported experiencing signs and symptoms of moderate to severe anxiety (22%) or moderate to severe depression (24%). That’s three times greater than before the pandemic, when in 2019 6% of adults in the U.S. reported moderate or severe anxiety and 7% reported moderate or severe depression, according to Dr. Sunita Dodani, director of HADSI and principal investigator of the study.

But remember, anxiety and depression strike all ages.

 

“Mental Health Week.” RICHMOND TIMES-DISPATCH (May 8, 2021).

College Students and Mental Health Crisis.

Here are some excerpts from an outstanding article discussing the exploding issue of anxiety and mental health issues on college campuses ………………………………..

Across the country, some school leaders and experts say the pandemic has brought new urgency to a mental health crisis that had been unraveling on college campuses for years. From social isolation to heightened feelings of inadequacy, students say it has made it harder to concentrate on school and put a strain on families and friendships.

Young adults between the ages of 18 and 24 for years have struggled disproportionally with mental illness compared to older groups, and experts cite such underlying factors as high expectations, social media and financial pressures. Now, evidence shows college students experienced higher rates of anxiety, depression and suicidal ideation in 2020 than in 2019.

Despite the promises of vaccines and a return to normal in the fall, students are still stressed, overwhelming campus counseling centers with requests for treatment. Unable to see most students in person, school counselors have responded by developing self-help tools and hosting virtual therapy sessions.

Many students, whether they’ve contracted the virus or not, are reeling from the last year of uncertainty and wonder when they’ll recover.

The perils of isolation.

AU reopened some residence halls this month but many students had tried to replicate communal living in nearby apartment buildings, houses and even hotels — forming friendships in the process.

Counselors at AU have offered services to students including anonymous mental health screenings, virtual workshops and group therapy sessions. But, wary about pursuing counseling,

‘It’s demoralizing’

Students also are supporting each other through traumatic events via text, instead of face-to-face. It has made a tense year even more strenuous, as students of color deal with waves of violence and social upheaval. Black students made similar sacrifices last summer as the world reacted to the police killing of George Floyd and demands for justice for Breonna Taylor and Ahmaud Arbery.

Moving through crisis

On campuses across the country, counseling center staff are “busier than ever.,”

The pandemic also introduced the unique challenge of delivering mental health care across state lines. When students scattered to their homes across the country, on-campus health providers suddenly faced a hodgepodge of licensure laws that determined where they could and couldn’t practice. Dozens of states have relaxed their restrictions, but 60 percent of students still say the pandemic has made it more difficult to access mental health care, surveys show.

To fill in the gaps, counselors are producing self-help videos, sharing advice on social media and using computer-assisted therapy programs that can be just as effective as in-person treatment.

Officials also scattered mental health days throughout the semester, when classes are canceled and professors are discouraged from assigning work.

“It’s really important for us to provide resources and tools for students so they don’t get to that point where we’re in crisis.” “The pandemic has really extenuated the pressures we feel to help students with mental health.

“College Anxiety and College Crisis,” Washington Post (April 6, 2021).

Post-Pandemic Social Gatherings.

Here’s a short excerpt of some very interesting suggestions concerning relearning how to socialize after the pandemic. From a recent New York Times article …………

 

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Though you may be chafing at the confines of the lockdown, remember that it’s still not entirely safe to resume social activities as before. Across most of the country, the risk of coronavirus transmission is still high. Here are some suggestions:

 

  • Though the past month has seen a spate of reopenings across the country, some scenarios might still set off a siren in your head. And because these facilities are open, doesn’t mean you need to go.
  • “Assess your own risk level and comfort,” “So you’re very clear about what you would and would not like to do.” This will also provide you with a clear document of how your comfort levels are changing over time as you readjust.

Brace for tough conversations.

  • This empathy and candor will also be an asset if you find that your friends and peers have developed the tendency to over share, either out of anxiety or being starved for conversation. (You may be doing it yourself, too.) If a conversation subject makes you uncomfortable or anxious, say so.
  • It’s OK if you don’t feel ready to see people socially again. Through the challenges of the lockdown period, you may have found that “your mental health is served best when you have time for calm and rest and introspection,” Dr. McBride said.
  • So pace yourself while considering the benefits of getting back out there: Even casual interactions have shown to foster a sense of belonging and community. “Social interaction is critical to our existence,” 
  • “If you’re comfortable going to a dinner at a small family restaurant, you can do that.” “If you want to wait a month or two, that’s OK, too.”

“Prepare Yourself for Gatherings.” New York Times (March 29, 2021).

Family Counseling and the Pandemic — Tips for You.

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     Good information for mental health for families and individuals. From the World Health Organization ……….. World Health Organization (Your Mental Health) (2021).
   
      The new realities of working from home, temporary unemployment, home-schooling of children, and lack of physical contact with other family members, friends and colleagues take time to get used to. Fortunately, there are lots of things that we can do to look after our own mental health. Here are tips and advice that we hope you will find useful.

 

  • Keep informed. Listen to advice and recommendations from your national and local authorities. Follow trusted news channels.
  • Get up and go to bed at similar times every day.
  • Keep up with personal hygiene.
  • Eat healthy meals at regular times.
  • Exercise regularly.
  • Allocate time for working and time for resting.
  • Make time for doing things you enjoy.
  • Minimize newsfeeds. Try to reduce how much you watch, read or listen to news that makes you feel anxious or distressed. Seek the latest information at specific times of the day, once or twice a day if needed. 
  • Social contact is important. If your movements are restricted, keep in regular contact with people close to you by telephone and online channels.
  • Alcohol and drug use. Limit the amount of alcohol you drink or don’t drink alcohol at all.
World Health Organization (Your Mental Health) (2021).

KEEPING IN TOUCH — REALLY ESSENTIAL FOR GRANDPARENTS.

Here are a few suggestions for keeping in contact with your grandchildren:

  • Zoom cooking sessions. Food is always a great connector.
  • If grandkids live nearby, taking nature walks. Bring a surprise snack. Gives you great time together.
  • Zoom (or Facetime or Skype) a favorite story. Everyone loves story hour.
  • Playing online or by cell phone various word games.  Just pick a theme and see where that goes. Kids love it.
  • Talk about the future and specifically what the kids would like to do when covid is over and when they get a bit older.

It’s really important to stay in touch — for both the grandparent and for the grandchild.

Sadness and What to Do — 5 Simple Strategies.

   

                         

 

 This year has been emotionally hard for many people. The following strategies have been shown to help people keep their low moods from overwhelming them or turning into a major depression. The following suggestions are contained in a new article published recently.

 

           1. Reduce overthinking.

            2. Move around and socialize, even if you don’t feel like it.

             3. Increase self-compassion.

             4. Sideline thoughts of helplessness and hopelessness.

             5. Notice when you feel well and build on that.

“How to keep your sadness from turning into depression.” Washington Post (December 1, 2020).

                           

Emerging Teletherapy — Good for the Client and the Therapist.

                           

Good piece on the emerging field of teletherapy. Here’s three statements from it:

  • In addition to being driven by the pandemic and the availability of technology, the proliferation of teletherapy in recent months has been aided by policy changes that have increased accessibility to services in many areas of the country. One of the modifications to existing regulations is the expansion of insurance to better cover more methods of teletherapy, including phone sessions. 
  • Conducting teletherapy sessions from home can benefit providers as well as patients. One therapist says, “There were things that I learned about people that I had not known until I saw them in their home. It was amazing what insight I was able to gather just by looking inside their home as a session was conducted.”
  • The convenience of being able to hop on a video call with a therapist from home is one of the main reasons many are planning to continue with teletherapy, even if there is an option to be seen in person.

    Here’s the link to the full article. I highly recommend it. “Emerging Teletherapy.” Washington Post  (Nov. 19, 2020).

TeleCounseling — Here to Stay.

Good article discussing telemedicine –specifically,  virtual counseling. It concludes: “The coronavirus pandemic has forced medical centers around the world to  adopt telemedicine.  Some patients are not comfortable with the technology, or can’t afford it; others need services that cannot be provided entirely online.” But the conclusion is that this is generally good. Such counseling crosses state lines. But the federal government has changed its rule to allow it. My observation is that much of this is here to stay.

The Psychiatrist Will See You Online Now.” NEW YORK TIMES (Sept. 1, 2020).

Microaggression — Ready a Response.

 Good article in the New York Times today about how to respond to micro aggressions. Here are some observations from that article:

 

  • For many of us, microaggressions are so commonplace that it seems impossible to tackle them one at a time. Psychologists often compare them to death by a thousand cuts.

  • The first step to addressing a microaggression is to recognize that one has occurred and dissect what message it may be sending.

  • Discrimination — no matter how subtle — has consequences.

  • Even once you have decided that you can respond to a microaggression, knowing what to say or how to behave can be nerve-racking.

  • While your response will vary by situation, context and relationship, one recommendation is to memorize one tactic from a list of prepared statements. For example, ask for more clarification.  

  • Learning to draw boundaries and find support among allies is one of the most important steps in dealing with microaggressions.

My suggestion — In confronting microaggressions,remember it is the aggressor that has the problem, not you. Be prepared with a response beforehand. Unfortunately, some (many?) micro aggressors are serial aggressors. Just be prepared when you meet this person again. It’s not going to change, unfortunately.

 

“Microaggressions: Death by a Thousand Cuts.” New York Times (June 15, 2020).