The first two years of the COVID-19 pandemic created significant stress for Pierce County residents, and many young people, in particular, are still dealing with the effects, according to a recent report from the Tacoma-Pierce County Health Department.
In the report, titled “Pierce County Mental Health: A data-informed perspective,” the health department’s findings are drawn from its review of data from 2020 and 2021. TPCHD examined rates of local emergency-room visits for ailments such as anxiety and depression, crisis hot-line calls, school behaviors and drug overdoses, among other criteria.
“This mental health analysis revealed increased levels of stress and anxiety, but also showed encouraging signs of resiliency,” the report said. “As societal events and COVID-19 restrictions became more disruptive and people began losing control over aspects of their lives, residents turned to several outlets to try to regain some sense of control.”
Elizabeth Allen, behavioral health policy coordinator with TPCHD, said the report stemmed from officials wanting to dig deeper into how the public health crisis and other events between 2020 and 2021, such as political strife and an uproar over racial injustice in policing, had affected locals.
“We wanted to be able to say, at the end of the day, that Pierce County is struggling and we know why,” Allen said in an interview.
Barriers to mental health care access worsened during the pandemic for low-income families, older people and those living in rural areas, according to the 48-page report published in February, which said that data suggested people of color might bear a greater mental health burden than others.
The public health crisis also de-stigmatized mental health to some extent as more people opened up about their struggles, according to Allen. Although the report indicated that Pierce County residents have shown resiliency, Allen was clear that each person has been affected differently.
“Everybody has some weight of the pandemic that they might carry for the rest of their lives emotionally,” she said.
Hospital visits, youth stress and drugs
The report found that hospital visits related to concerns of self-harm, anxiety or depression increased in spring 2020, aligning with the onset of the public health crisis. After declining for much of 2021, rates jumped again that fall, which the report suggested might have been connected to the emergence of the Delta variant and talks about a “double pandemic” stemming from COVID-19 and flu.
Emergency-room or urgent-care visits related to anxiety or depression saw the highest rates among whites, American Indians/Alaskan Natives and people who identified as more than one race. Overall, rates at the end of 2021 were lower than in 2020 but still higher than in 2019.
Hospital visits related to concerns of self harm, which consisted largely of people between 18 to 44 years old, fell back to or below 2019 rates in 2021, the report showed.
Few indicators of negative mental or behavioral health improved for children and teens, however.
The number of youth referred for service through mobile crisis responses nosedived at the beginning of the pandemic but sharply increased in spring 2021 to levels well above the two years prior, the report showed.
Primary-care visits related to eating disorders rose during the first two years of the public health crisis. In the first quarter of 2021, the highest rate belonged to girls aged 12 to 17, the report said, adding that some people might binge or restrict food as a coping mechanism or to regain control.
The report also acknowledged the role that major shifts in education played in stirring anxieties, with newfound stress on students, parents and school staff as learning was disrupted. The report cited national statistics that indicated safety was a concern among many educators.
A Healthy Youth Survey in 2021 showed that 18% of Pierce County 10th graders reported that they did not feel safe at school, while 13% said they were bullied in school or online.
“While we don’t yet know the longer-term effects of the pandemic and related societal events, the data suggests many Pierce County youth are still dealing with the events of the last two years,” the report said.
It’s one of the reasons that TPCHD recommended closely monitoring youth suicide rates moving forward because it’s a mental health indicator that takes time to develop.
Overall, there were slightly more calls with suicide concerns to the county’s crisis line in 2021 than in 2020, but due to a change in 2020 to how that data is captured, TPCHD said it could not compare figures to 2019. Neither suicides nor emergency-room visits for suicidal ideation increased during the pandemic.
Drug overdoses did spike. Deaths from fentanyl and stimulants such as methamphetamine increased dramatically in 2020 and 2021, according to the report. Adults aged 20 to 30 have been particularly impacted by fentanyl.
Much like with access to mental health care, the report said that barriers to drug treatment, counseling and support worsened during the pandemic.
The report also noted its own limitations. For instance, the LGBTQ community and people with disabilities were uncounted in existing data sets and researchers could not pull race and ethnicity from all data.
In the future, TPCHD said it plans to include mental health indicators such as climate, housing and economics.
