BISMARCK, N.D. -- North Dakotans are on the front end of a long winter during a pandemic. But a mental health expert says it doesn't have to mean months of unhealthy isolation. He says people can tap into some reminders, as well as new advice, on how to protect their mental well-being.

A Kaiser Family Foundation poll says 53% of U.S. adults feel their mental health has suffered during the crisis. That's up more than 20% from the beginning of the pandemic. Paul Nussbaum is a neuropsychologist at the University of Pittsburgh School of medicine. He said it shows the effect the situation is having on much of the population.

"When we have a sense of loss of control and we're not able to sort of express ourselves in ways and cope in ways that we need to cope, there's almost a learned helplessness that begins to emerge," Nussbaum said.

He said tips offered back in the spring, such as establishing a routine and staying active, are still helpful. But he also said expressing what you're going through to a friend or loved one can be therapeutic.

Nussbaum will be the featured guest at a wellness event hosted by AARP North Dakota at 3 p.m. Central time Wednesday afternoon. It will be streamed on the group's Facebook and YouTube pages.

Nussbaum said added financial stress for many residents is bringing even more anxiety. Be he said those who are struggling need to remind themselves that the crisis isn't their fault, and that showing some vulnerability by talking it out can work wonders.

"It's not rocket science, it's not fancy. But it's still foundational for how we can begin to heal," he said.

He said sharing these feelings can help people recognize they're not the only ones dealing with these problems. He added it might prompt others to suggest helpful solutions they have discovered during the crisis.

A study by New Mexico State University shows the number of suicides among U.S. Hispanics is on the rise, in part because they are buying more guns.

Jagdish Khubchandani, public health sciences professor at New Mexico State and the study's co-author, said suicides by Hispanic adults in the group increased by more than 70% between 2010 and 2020, while their population grew only 25% over the same period.

"I wanted to see what's happening with Hispanic middle-age people 20 to 64 years," Khubchandani explained. "Because this is a unique population given their upbringing, their acculturation, experiences in the United States."

He pointed out Hispanics are using fewer passive, and instead more lethal suicide methods, noting during the study period, firearms were most commonly used among non-elderly Hispanic adults. Researchers analyzed a decade of mortality data from the Centers for Disease Control and Prevention. For those in crisis, the National Suicide Prevention Lifeline is now accessible at 988.

Khubchandani stressed among all the racial groups, Hispanics were the most likely to acquire multiple guns during the pandemic, citing a need to protect themselves or prevent themselves from being victimized.

"But as I wrote in the study, most of the time these guns will be used to kill household members and not be used for protection from bullies and racists," Khubchandani stated.

Khubhandani reported in the U.S., approximately 100 people die of suicide each day, or 45,000 per year. He added the mortality rate for HIV is 15,000 people per year, and he believes suicide needs the same research attention afforded the immune disorder.

"And all drug companies want to sponsor trials and studies and government wants to fund studies," Khubhandani observed. "I have not seen many studies funded by the government on suicide prevention for white, nonwhite, male, female; nothing."

The study also found southern and western regions of the U.S. had the highest suicide rates for non-elderly Hispanic adults in 2020. Colorado had the highest rate, with New Mexico second highest at a rate of about 24 per 100,000 people.

Nonprofit social workers in New York are seeing a shortage of people coming into the field, abdicating it for telehealth work.

Early in the COVID-19 pandemic, telehealth began to fill the gaps for in-person visits. However, the shift to a semi-virtual landscape has left some nonprofits without applicants to fill open positions. According to the Centers for Disease Control and Prevention, telehealth visits increased by 154% in 2020.

Angela Piccininni, associate director of clinical services at YES Community Counseling Center, is concerned about the kind of hands-on experience new social workers are getting.

"Prior to COVID, they would have internships in nonprofits and agency-based work at hospitals, similar to ours, which would lead to an exposure of the real missions of social work," Piccininni recounted. "And after training, we would begin to employ these new graduates."

One way she feels people could be drawn to in-person work is a re-evaluation of nonprofit- and agency-based social work, with hopes of incentivizing employees. Although it has become widely used, she said it could be a mismatch for people with more severe mental-health problems.

Telehealth marks a turning point for how people receive mental-health treatment, and it could be here to stay. According to a 2021 study by the Substance Abuse and Mental Health Services Administration, many clients saw a reduction in their symptoms of mental illnesses when they used telehealth, or a hybrid model.

Piccininni thinks the approach can be limiting, adding there are some things a person might not be able to notice on a computer screen.

"Much of what we do as therapists is observing, and working through nonverbal communication," Piccininni noted. "You cannot detect that when you're seeing someone's head or their shoulders. We're often finding individuals coming to session, that are in virtual treatment, that are in their car, that are driving or in public settings."

Social work may be shifting into a virtual environment, but it is not slowing down the growth of the field. According to the Bureau of Labor Statistics, employment of social workers is expected to grow by 9% nationally during the next decade. New York is expected to see a 6.6% growth in social workers over the same period.

School districts across the state of New York are facing a shortage of social workers.

According to an audit by the state comptroller's office, New York City schools are not providing enough social workers per school.

The report showed 423 schools are without social workers, while most of the schools with at least one social worker do not meet the recommended ratio of one social worker to every 250 students. Rural school districts are seeing a retention problem since they cannot afford to compete with their urban counterparts.

Martha Shultz, northeast division director of the National Association of Social Workers New York State Chapter, said a primary issue is noncompetitive salaries, since district leadership might not understand what a school social worker does.

"That stems from this kind of misunderstanding, or lack of understanding, or desire to learn about really what is social work and what can they offer," Shultz contended. "In schools, there's been a push for every building to have a school social worker. But, that doesn't necessarily mean that school leadership or even the school board knows what a social worker does at a school. They just know they have to have one."

Schultz pointed out another part of the problem is a pipeline issue, because many rural colleges and universities do not offer graduate-level social work programs. She has seen numerous empty positions without applicants, with a lack of education by district leadership being a deterrent.

Schultz added social workers might start at the bottom in school districts, despite many years of experience in other areas of social work. The issue of social-worker shortages goes beyond schools and has reached the state's Office for Mental Health.

Samantha Fletcher, executive director of the National Association of Social Workers New York State Chapter, said social workers are bearing the brunt of the shortage. One challenge she found is the growth in caseloads social workers have to deal with, arguing high caseloads contribute to faster burnout.

"They don't want to work in a situation where they know they're in a lose-lose position; that they know they can't give their clients what they need," Fletcher explained. "If you're seeing eight or more clients a day, how do you have time to do a suicide evaluation for another client or deal with a crisis from another client."

In 2021, two bills were introduced in the state Legislature to address caseload caps for social workers and for child protective service workers. Both are still in committee.