The pandemic has had a devastating impact on people across the country. For people with disabilities, who already face a lot of social isolation to begin with, COVID-19 has only exacerbated mental-health challenges.

A recent study found adults with disabilities report experiencing more mental distress than those without disabilities.

Dr. Sharon McLennon-Wier, executive director of the Center for Independence of the Disabled-New York, said during Mental Health Awareness Month, it is important to recognize the barriers to receiving mental-health treatment people with disabilities face.

"For a person with a disability, who has issues with transportation and traveling, may feel stuck that they can't physically go out and seek services," McLennon-Wier explained. "Because of their limited incomes, may feel that they can't afford mental-health services."

McLennon-Wier added mental-health resources are available through telehealth for people who may face transportation challenges. In New York, psychologists, social workers, mental-health counselors and marriage and family therapists are permitted to deliver services virtually.

The American Academy of Physical Medicine and Rehabilitation estimates 22 million people nationwide may identify as a person with a disability as a result of complications from long COVID.

McLennon-Wier said the major life change may be difficult for people to grapple with, but they should know they are not alone.

"That person who is newly disabled is going to have a lot of different emotions tied to the diagnosis," McLennon-Wier noted. "So it takes time to adapt and to rethink how you typically have done things that you're unable to do the same way."

According to the U.S. Department of Health and Human Services, long COVID can be considered a disability under the Americans with Disabilities Act if it significantly impacts major life activities.

In New York, Mount Sinai's Center for Post-COVID Care offers resources to manage anxiety and depression, post-traumatic stress syndrome, and other emotional issues as a result of lingering symptoms.

Advocates for mental health in Maine say the stigma of suicide often prevents those most at risk from getting the help they need. The CDC reports despite a decline in suicide deaths for those younger than 25 last year, total suicide deaths increased to nearly 50,000.

Joyce Morrissette, clinical suicide-prevention specialist with NAMI Maine, said suicide is a preventable tragedy and that talking to someone in distress about suicide does not trigger them to act but, instead, starts a conversation.

"In order to have a public health approach to suicide, we need to be able to acknowledge it and talk openly about suicide," she said.

Morrissette added NAMI Maine offers professional training, which describes how to have those discussions. Prevention works, she said, if people are willing to learn.

All public school personnel in Maine are required to undergo suicide-prevention awareness training, and health-care professionals also learn the best way to approach their patients. Research shows nearly half the people who die by suicide interact with the health-care system in the month before their death. That provides a critical window in which to utilize the advice from professionals that can save lives, Morrissette said.

"It's important for people to receive training and increase their awareness so that they're able to respond in systems such as schools and health care as well as in communities," she explained.

Morrissette added it is also important to remember that help is always available at the 988 Suicide and Crisis Lifeline or online at 988lifeline.org.

Data from last year show a growing percentage of Kentucky children and teens report struggling with depression or anxiety, largely driven by social media use. A new online toolkit from Mental Health America aims to provide information, tips and resources for young people, caregivers and school personnel on how to protect kids' mental health in a digital world.

Marcie Timmerman, Mental Health America Kentucky's executive director, said having resources to spot early warning signs can help families get off to a good start this school year, when many households are adjusting to new patterns and habits.

"I think one of the biggest early warning signs, especially related to social media use, is that they suddenly stop wanting to use it, or they are on it all the time," she explained. "There's an extreme change in their behavior and maybe their attitude as well toward the media platform."

The U.S. Preventive Services Task Force now recommends screening for anxiety in children and adolescents ages 8 to 18 years, even if they are not showing recognized signs or symptoms of anxiety. Over the past decade, feelings of persistent sadness and hopelessness, along with suicidal thoughts and behaviors, increased by about 40% among young people, according to the CDC.

Hannah Hallen, a Kentucky college student and mental-health advocate, believes traditional approaches to mental health have not kept up with the needs of her generation.

"I feel like they are trying their best with potentially old resources or things that used to work," she said. "But with the changes in this generation that are so niche to this era, there are a lot of differences."

In addition to social media, more young people report feeling distressed about mass shootings, climate change, and the growing political divide.

In rural states such as North Dakota, accessing mental-health care can be extremely difficult. Federal officials say it's even worse when someone's benefits for such care are improperly denied.

They're ramping up enforcement under a law aimed to address the issue.

The Mental Health Parity and Addiction Equity Act, in place since 2008, requires most health plans - offering coverage for behavioral health or substance use disorders - to not make those benefits more restrictive than those for standard medical care.

Lisa Gomez, assistant secretary for the Employee Benefits Security Administration, said their investigations have found that providers are still falling short in providing equal access.

"For example," said Gomez, "there were plans that were excluding coverage for nutritional counseling, if you were seeking that coverage for an eating disorder."

However, the plan in question was not restricting coverage for those seeking that type of counseling for help with a physical health issue such as diabetes.

In fiscal year 2022, Gomez's agency investigated nearly 150 plans and found almost two dozen violations.

An EBSA report suggests correcting these situations is significant because in some cases, hundreds of plan participants were affected by a single provision not in compliance.

Report authors say forcing the provider to make good on the claim can be a life-changer for those struggling with a mental-health issue.

Gomez said for underserved populations, such as rural areas, getting rid of obstacles helps that individual make their situation more manageable.

She added that the last they need is to have to wait for something like a co-pay error to be sorted out.

"We've seen what mental-health conditions and substance-use disorders can do to a person, to a family," said Gomez. "And so, it's really important that we try to use the tools that we have available to us and work together to try to address these issues."

Gomez acknowledged that while there is progress, it isn't moving fast enough to remove these specific coverage hurdles.

Various federal agencies are trying to finalize proposed rules that would strengthen provisions under the law.

Outside of benefits roadblocks, Kaiser Family Foundation data show that in North Dakota, only 19% of mental-health care patients' needs are being met due to provider shortages.




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