Gruesome twosome: Amid suicide surge triggered by Covid-19, Guam is facing a shortage of mental heal

SN, a 56-year-old resident of Santa Rita, lately finds herself needing to talk to her counselor more often than she normally does. The combination of social isolation and the constant fear of getting infected by Covid-19— on top of “other tense, personal circumstances— heightens her anxiety and triggers her emotional meltdowns.

“Talking to someone helps me a great deal,” SN said.

SN was first diagnosed with major depressive disorder in 2012. “I had called an ambulance for myself, thinking I might have been having a heart attack. Turns out it was an anxiety attack. I stayed two nights and three days as an in-patient.”

She has since been seeing a doctor and a counselor regularly and taking prescribed meds for depression and anxiety. “I take them once or twice a day as needed,” she said.

Lurking behind the Covid-19 pandemic is an equally deadly crisis that has been relegated as a mere footnote to the main discourse on the coronavirus. In May, the World Health Organization warned of a looming mental illness crisis around the world resulting from the Covid-19 pandemic.

"Multiple lines of evidence indicate that the Covid-19 pandemic has profound psychological and social effects. The psychological sequelae of the pandemic will probably persist for months and years to come," according to a study published in the QJM International Journal of Medicine.

"Social isolation, anxiety, fear of contagion, uncertainty, chronic stress and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use and other psychiatric disorders in vulnerable populations including individuals with pre-existing psychiatric disorders and people who reside in high Covid-19 prevalence areas,” the study said.

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On Guam, treatment of mental health patients is a major challenge due to a shortage of mental health professionals, according to Theresa Arriola, director of Guam Behavioral Health and Wellness Center.

“There is a hiring delay due to an industry shortage of counselors/ substance abuse counselors, psychiatrists and psychologists. Funding is not an issue but rather shortage nationwide,” she said. “GBHWC gained (Health Resources and Services Administration) site designation last summer. It’s a recruitment tool. Individuals that work for us maybe eligible for student loan forgiveness.”

Even prior to the pandemic, Arriola said "the need for more mental health and substance abuse providers has always been an issue because of a nationwide shortage."

She said GBHWC is working with the Western Interstate Commission for Higher Education to establish a psychologist intern program to address shortage of psychologists. "Also recruitment tools like loan forgiveness program has helped as we have received interest to work at GBHWC as a result of it," Arriola said.

The Covid-19 pandemic’s toll on mental health is apparently beginning to show itself through an increased suicide rate on Guam during the first eight months of the coronavirus year. Numbers indicate that the mental sufferings caused by Covid-19 can be more fatal than the virus itself.

The Office of the Chief Medical Examiner has recorded 26 suicides from January to August, or an average of 3.25 a month. There were 15 suicides in the last three months alone– June (5), July (5), and August (5)– at the height of the Covid-19 outbreak that has sent people behind locked doors with no jobs to return to when the economy reopens.

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As Covid-19 rages on, the number of cases this year is expected to surpass the 31 suicides recorded in 2019. There were 44 suicides on Guam in 2018.

While the suicide rate went down between 2018 and 2019, Guam’s suicide rate continues to be significantly higher than that in the U.S. mainland, according to Guam Behavioral Health and Wellness Center.

The agency said suicide risks are seen highest among youth and young adults; half of those who died by suicide in the last 10 years occurred in individuals 30 years and younger. “The families of those who’ve died by suicide are left to grieve the loss of their loved one and begin to cope with that loss as best as they know how,” GBHWC stated in a release.

The crisis hotline (647-8833/8834), which is open 24/7, has been swamped with calls. Arriola said since the start of the pandemic, the number of callers has increased. “As of Aug. 31, we had 2,945 calls since March 15 from when the pandemic first started on Guam,” Arriola said.

The average number of calls per month has increased 1,667 percent. On average, Arriola the crisis hotline receives 500-plus calls per month. Before Covid-19 struck the island, the hotline received a monthly average of 30 calls.

Arriola said 95 to 99 percent of calls received during this time are related to coronavirus-triggered depression, with some people asking, “Is it worth living?”

Arriola said the decrease in the number of suicides from 2018 to 2019 was the results of openness in the community. People started speaking more about suicide, which was once considered a taboo subject talked about in whispers. People have become more open about their feelings and are willing to work through them.

In observance of the Suicide Awareness and Prevention Month in September, the University of Guam held a Suicide Prevention Forum. "We hope to open the conversation on these issues so people can understand it’s OK to talk about mental health, depression and suicide,"

Dreamstorm Productions public relations director Hannah Cho Iriarte stated in a press release. "That way those suffering can get the help they need.

Guam has programs that train people to help those with suicide tendencies, such as SafeTalk. These trainings are designed to help people identify the signs of suicide. “Assist and Connect are other programs that can help with suicide prevention training, and Guam Behavioral Health can provide these trainings, too,” Arriola said.

GBHWC receives federal assistance from the U.S. Substance Abuse and Mental Health Services Administration. The agency, former