COVID-19 is drawing attention to other pandemics in Northeast Indiana: Suicide and domestic violence

Parkview Health’s SOS navigator team from left are Amber Janes, Nikki Laux, Heather Henry (Program Manager), Caitlin Golden and Anna Belot.

More than a year ago, the global COVID-19 pandemic caused a dramatic shift in nearly every aspect of life, and the stress it’s placed on people’s relationships and mental health is only beginning to be realized.

As a Senior Research Scientist with the Mirro Center for Research and Innovation at Parkview Health, Michelle Drouin, Ph.D., might not be considered a frontline care worker. But she’s witnessed the lethal effects of the pandemic firsthand. Drouin

“In general, I’ve seen people turning away from each other in a world where we really survive by the fact that we turn toward each other,” Drouin says.

While COVID-19 safety measures like a national shutdown, closed schools, and work-from-home policies have helped to prevent the spread of a highly contagious virus, they’ve also contributed to a rise in other dangerous and life-threatening conditions that thrive in isolated environments: Suicide and domestic violence.

Drouin says that because at-risk residents for suicide and domestic violence have fewer opportunities to escape their homes during COVID-19, these pre-existing challenges are worsening across the U.S. and specifically in Indiana—where suicide rates have long outpaced national averages.

According to data from the Centers for Disease Control & Prevention, Indiana’s suicide rate has been on a steep upward trend, increasing from 13.5 suicide deaths per 100,000 people in 2012 to 16.9 in 2019. This rate is higher than the national increase (12.4 to 14.5) in the same period.

Since the pandemic began, the Informatics Team at the Parkview Mirro Center for Research & Innovation has conducted two community surveys in Northeast Indiana to examine the impact of the pandemic on various aspects of residents’ physical and mental health.

“The surveys revealed that pandemic-related sanctions are having a negative effect on mental health for respondents (55 percent) and their families (38 percent),” a news release on Parkview’s website says.

With these statistics in mind, Drouin and Connie Kerrigan, Director of Community and Support Services at Parkview, applied for a COVID-19 Emergency Response for Suicide Prevention grant from the national Substance Abuse Mental Health Services Administration (SAMHSA) on Parkview’s behalf.

When Parkview was awarded a $772,000 grant from SAMHSA, it allowed them to hire a project coordinator and four Suicide and Obviation Support (SOS) navigators to begin what they’re calling the SOS navigator program.

“SOS navigators will be embedded in hospital emergency departments and connected to resources within the Parkview Behavioral Health Institute, as well as domestic violence organizations and emergency shelters,” a news release says.

SOS navigators Caitlin Golden and Heather Henry (Program Manager) were hired thanks to Parkview's grant from SAMHSA.

Launched in November 2020, the program covers eight of Northeast Indiana’s 11 counties, including Allen, DeKalb, Huntington, Kosciusko, LaGrange, Noble, Wabash, and Whitley.

It’s a critical part of meeting the “essential” and ongoing needs of Northeast Indiana residents during the pandemic, Kerrigan points out.

“Mental health is foundational to every other aspect of health,” she says. “You can’t have the physical without mental health. Mental health impacts every area of our lives. It impacts our spiritual; it impacts our relationships; it impacts just about everything.”

Providing ‘at-elbow’ support

While COVID-19 has quickly become a well-recognized lethal force in the U.S., suicide is another dangerous, yet often silent killer in American society.

Before the pandemic, 57.8 million Americans were living with a mental and/or substance use disorder, according to a 2018 National Survey on Drug Use and Health.

Currently, suicide is the 10th leading cause of death in our nation, SAMHSA reports. Realizing early on that the pandemic would only increase national rates of depression, anxiety, trauma, grief, isolation, financial instability, and other challenges, SAMHSA created its COVID-19 Emergency Response for Suicide Prevention grants to support communities in their efforts to reduce suicide attempts among adults age 25 and older.

In Northeast Indiana, older residents are prone to loneliness and at increased risk for suicide, too, Drouin says.

Prior to the pandemic, approximately 25 percent of seniors, ages 65 and older were considered “socially isolated,” and 30 percent of people more than 45-years-old said they “feel lonely,” according to the Center for Disease Control and Prevention.

Drouin says that since the SAMHSA grant Parkview received is designed to target people who have been hospitalized for suicide specifically, the SOS navigator program provides these residents with critical “at-elbow” support they might not find elsewhere during the pandemic.

SOS navigators provide "at-elbow" support for residents after they've been hospitalized for a suicide attempt.

SOS navigators help at-risk residents cope with out-patient life in Northeast Indiana, ensuring they have access to care, transportation services, and even temporary housing, if needed.

“After people are released from the hospital following a suicide attempt, they might still have dark days,” Drouin says. “Our SOS navigators help people with all of the different types of community connections they need to get services for support.”

While many services for suicide prevention exist in Northeast Indiana’s community, SOS navigators help fill gaps in the system by providing residents with connections to these resources. They also offer patients a “suicidality prevention plan” to help them identify where they are mentally, and what actions they should take to prevent their mental state from worsening, depending upon their current condition.

Kerrigan compares this prevention plan to the Asthma Action Plan, which is rooted in the correlation between a person’s symptoms and the appropriate level of response they should take, ranging from “yellow zone” medications or care at home, to “red zone” medical emergencies.

“A suicidality prevention plan really looks at helping people identify: Am I in a good place today?” Kerrigan says. “And if I’m not: What do I need to do? Where am I trending? If I’m trending into another place, what level of care do I need? Do I need to seek a therapist? Call my coach? It provides people with strategies to cope and understand, ‘If I’m in the red zone, what do I need to do?’”

Heather Henry is Program Manager of Parkview's SOS navigator team.

Prior to COVID-19, mental health has not been historically prioritized in the U.S. A report by Mental Health America shows 23.6 percent of adults with mental illness and 60 percent of youth with severe depression in 2017-2018 say they had not received the mental health services they needed.

Parkview’s SOS navigator program helps redirect focus to the importance of mental health—which could generate innovation in the future by helping residents and caregivers be more aware of suicide symptoms and responses.

Kerrigan says Parkview’s own awareness of suicidal thoughts is more robust than it was before the pandemic, as professionals are being trained to identify specific symptoms in patients. Prior to the SOS navigator program, there were other outreach programs focused on issues, such as addiction, but with COVID-19 came an increased awareness around the higher numbers of suicide and domestic violence cases across the country.  

Since the SOS navigator program launched in Northeast Indiana, Kerrigan says she’s witnessed firsthand how it is already helping those struggling with mental health issues. Many patients have not only been able to identify their stage in their illness through these safety plans, but also have expressed a great appreciation for having easy access to resources as simple as a phone call for support.

“Northeast Indiana has a critical need for suicide prevention efforts, and the effects of the pandemic have heightened that need,” Kerrigan says in a press release. “For those at risk for suicide, we know there is a disconnect between seeing a healthcare provider and then following up with treatment or other services. The SOS navigators will help bridge this gap and ensure continuity of care.”

Supporting victims of domestic violence

In addition to helping those who have attempted suicide or struggle with depression, 25 percent of Parkview’s SAMHSA grant also focuses on supporting the victims of domestic violence.

“Under normal circumstances, domestic violence can lead to situations of increased stress, anxiety, depression, and trauma,” SAMHSA reports. “These are all contributing factors to risk for suicide if unaddressed.”

Drouin affirms that people who are in domestic violence situations are also at risk for suicide, and there is some overlap in the needs of these populations.

Prior to the pandemic, the New England Journal of Medicine reports that one in 4 women and one in 10 men in the U.S. experience Intimate Partner Violence (IPV). This violence can take various forms from physical, to emotional, sexual, or psychological. 

“People of all races, cultures, genders, sexual orientations, socioeconomic classes, and religions experience IPV,” the Journal reports. “However, such violence has a disproportionate effect on communities of color and other marginalized groups. Economic instability, unsafe housing, neighborhood violence, and lack of safe and stable childcare and social support can worsen already tenuous situations.”

As a result, the shelter-at-home orders during the COVID-19 pandemic had a disproportionately negative effect on already marginalized populations. Along with suicide rates, domestic violence has been increasing as more at-risk people are stuck at home with stress and unemployment rise.

Even so, the full implications of the pandemic on domestic violence are yet to be realized in many ways. As domestic violence hotlines across the U.S. braced for an increase in demand at the onset of the pandemic in 2020, many organizations experienced the opposite, the New England Journal of Medicine reports.

“In some regions, the number of calls dropped by more than 50 percent,” it says. “Experts in the field knew that rates of IPV had not decreased, but rather that victims were unable to safely connect with services.”

Drouin says Northeast Indiana is following national trends in experiencing an increase in domestic violence here, and while specific information is yet unknown, she can point to a few indicators of the rise.

“What I can say is that the normal places we’ve had for children and people to check in—school, work—these are not available to a lot of people right now,” she says. “So the times and places where people were once able to escape their abuser by leaving the house are no longer available in a situation where we have everyone on lockdown. So sometimes people are at home with the people they’re most in danger of being hurt by, and that’s a really sad thing.”

The SOS navigators program not only provides assistance to victims of domestic violence in finding temporary housing or transportation to escape their abusers and seek help, but also assists them in identifying potential struggles they, as victims, might be facing with their mental health.

SOS navigators like Caitlin Golden help people at-risk for suicide better understand their symptoms and appropriate responses during the pandemic.

While Parkview’s SOS navigator program was created in response to COVID-19, Kerrigan says the support it’s bringing residents struggling with domestic violence and mental illness doesn’t end when the pandemic is over—or when the grant money runs out.

“I believe that this program is very important in that we will continue to find innovative ways to serve individuals regardless of grant funding that we may or may not have,” she says.

Overall, she sees the program as a critical first step in helping mental health take a more “front-row seat” among the region’s—and nation’s—health concerns, drawing attention to the often-silent pandemics that pre-date COVID-19.

“People are beginning to realize the foundational impact of mental health and what that means for our community,” Kerrigan says. “This momentum has grown over the past several years, and people are more open to talking about mental health. We’re only going to get better from here.”

Learn more
To be connected to mental health resources anytime, 24 hours a day, call the Parkview Behavioral Health HelpLine at 260-373-7500 or 1-800-284-8439, or call the National Suicide Prevention Lifeline at 1-800-273-8255.

This story was made possible by support from Parkview Health.
Connie Kerrigan
Connie Kerrigan
Director of Community & Support Services
Parkview Health

IFW: What led you to your current role as the Director of Community and Support Services at Parkview Health?

I had been in the community, managing Parkview’s Community Nursing Team, for about eight years prior to this, and I really felt like a lot of the objectives I personally wanted to make an impact on were well underway. Then the opportunity presented itself to step into a role to be able to bring some of that outreach and education support to our regional communities from a mental health perspective, and so I took that opportunity to begin to build out more resources for our mental health community.

IFW: How has your outlook on your job changed during the last year since COVID-19 began?

I have felt extremely connected and directed to this work because the need is so significant. The work we’re doing has obviously always been impactful, but it feels even more impactful right now because there is such a great need out there.

IFW: What are things you encourage people to practice for stress management during the pandemic that they can do on their own?

I think one of the things I’ve seen be extremely helpful and valuable is really trying to focus on the positives. If you think of three positive things, write them down in a given day or three things that you’re grateful for. Review that list, and do that for 21 days. It has really been shown to pull up your perspective, from feeling negative and stressed to feeling more focused on positive, solutions-based thinking, and seeing what’s really good in life.

Sometimes, we get focused on what’s not going well in our lives or the world, and taking that opportunity to think about what’s going well and focus on that aspect of our lives can really help. The other thing I think is extremely helpful is that Parkview has purchased the Calm App for our coworkers to utilize during this pandemic—when so many members of our teams are exhausting our mental health reserves to serve others. So that helps us manage stress, and it might help you, too.

IFW: How can local residents be an ally to those who might be struggling with mental health challenges during COVID-19?

I think the most important thing is to talk to people, and really listen to them. Also, ask them directly how they’re feeling. Don’t assume that someone is not struggling because they seem fine. Reach out, and ask them, “How are you doing? I mean, really, how are you doing? Is there anything I can do to help you?”

If you know someone is struggling, and they are isolated, make it a point just like you would any other appointment on your schedule to really connect with them, either virtually or on the phone because connection is a key component of life that many residents are missing right now.

We need our neighborhoods and communities in Northeast Indiana to provide that fundamental support for other people who might need it.

IFW: Across the nation, we’re seeing heightened levels of domestic violence. If someone who is suffering from domestic violence were to read this article, what are recommendations or resources you would want to let them know are available to them?

I would say there are a lot of resources that are available in our community and in our health system to help. Please don’t think that you’re alone, and there’s nothing for you, or that there’s no one to help. Reach out. Find out what options you have and really prepare for what your plan of action will be with the people who can help you with that situation.

If you are in immediate danger, get out right away. I think what happens sometimes is people don’t know the steps to leave, and there are people who can help put those steps in place for you.

Learn more
To be connected to mental health resources anytime, 24 hours a day, call the Parkview Behavioral Health HelpLine at 260-373-7500 or 1-800-284-8439, or call the National Suicide Prevention Lifeline at 1-800-273-8255.