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Mental Health

From left, Legislator Stephanie Bontempi (3rd from left) and Legislator Manuel Esteban (center) at the forum. Photo courtesy of Leg. Bontempi's office
John Venza, one of the presenters, speaking to the audience. Photo from Leg. Bontempi’s office

The Northport Public Library recently collaborated with Suffolk. County Legislator Stephanie Bontempi (R-18th L.D.), Suffolk County Legislator Manuel Esteban (R-16th L.D.) and Suffolk County Legislator Robert Trotta (R-13th L.D.) to facilitate a timely discussion on addiction, mental health and today’s youth.  One of the objectives of the event, entitled “Breaking the Stigma,” was to encourage more frequent and honest dialogues on the topics in both public and private circles.

“The issues of addiction and mental health are too important to ignore or tiptoe around,” said Bontempi.  “These serious issues warrant our full attention, and part of the process leading to that is recognizing that they are simply part of the human condition.  We need to address our issues, not be ashamed of them.

“The night’s presenters included John Venza and Gordon Gooding who spoke respectively about concerns surrounding addiction and the stressors associated with everyday life.  The presentations made it clear that there are no shortage of challenges out there, but there are also many treatment options and preventative tools.

“If you are a parent or caregiver of children, staying up-to-date on the growing body of knowledge and resources in this arena is so important,” added Bontempi.

For those interested in exploring resources regarding addiction and mental health, visit: https://www.scnylegislature.us/171/Stephanie-Bontempi and click on “Behavioral Health Directory.” 

 

Left, Dr. Daniel Jamorabo, gastroenterologist at Stony Brook Medicine and assistant professor of medicine in the Division of Gastroenterology and Hepatology at Stony Brook University’s Renaissance School of Medicine. Right, Dr. David Purow, chairman of Medicine-Gastroenterology at Huntington Hospital. Left by Stony Brook Medicine/Jeanne Neville; right from Northwell Health

No one rushes to make a reservation at a pre-colonoscopy restaurant with a cleansing and well-reviewed special of the day. 

In fact, for most people, the preparation for a potentially lifesaving diagnostic procedure is somewhere between unpleasant and unpalatable.

That, however, may have changed as the U.S. Food and Drug Administration recently approved another incremental improvement in the colonoscopy preparation that could make the preparation and the procedure — which can detect early signs of cancer — less bothersome.

Manufactured by Sebela Pharmaceuticals, Suflave is a low-volume preparation that tastes like a lemon-lime sports drink. It should be available in August.

“Patients really like” Suflave, with about 80 percent finding it palatable, said Dr. Daniel Jamorabo, a gastroenterologist at Stony Brook Medicine and assistant professor of medicine in the Division of Gastroenterology and Hepatology at Stony Brook University’s Renaissance School of Medicine. 

Jamorabo called it a “wonderful addition to the bowel preparations that are out there.”

Jamorabo said the ingredients in most preparations are the same: the difference in the Suflave preparation seems connected to the flavor.

The thinking in the gastrointestinal community is that “we need to find a preparation” that is more pleasant, said Dr. David Purow, chairman of Medicine-Gastroenterology at Huntington Hospital. “That will capture more people who are somewhat reluctant to have a colonoscopy.”

Colonoscopies are a “necessary screening procedure,” Purow added, and health care professionals in the field don’t want the discomfort during preparation to discourage people from getting the procedure.

Indeed, doctors have a much higher success rate with patients when they detect evidence of colon cancer early.

Getting it right

Doctors suggested that the success of preparing for a colonoscopy varies.

Jamorabo estimated that around 10% of patients may not take all the steps necessary to have the screening.

In those circumstances, these patients have to reschedule the procedure and go through drinking fluids that clear out their systems more effectively.

Gastroenterologists urged people to ask questions if they don’t understand any of the steps they need to take to prepare.

For some patients, the COVID-19 pandemic delayed their routine colonoscopy visits, as people stayed away from hospitals and medical care facilities during periods of highest viral infection.

Jamorabo added that colon cancers have started to show up in younger people.

In 2018, the American Cancer Society recommended lowering the age for screenings from 50 to 45.

“It’s showing up more” in people under 50, said Jamorabo. “It may even go lower.”

Doctors discovered stage three colon cancer in late actor Chadwick Boseman before he was 40.

“We don’t know yet” why it’s causing cancer in younger people, Jamorabo added, but “it’s not rare. It’s been going on for a couple of years. We can’t write it off as some statistical anomaly.”

Early symptoms

People can and should be on the lookout for symptoms that might indicate colon cancer.

Unintentional weight loss, such as losing 10 pounds or more in three to four months without changing diet or exercise regimen, could indicate a problem.

Blood in the stool, changes in bowel habits and ongoing constipation could also require medical attention.

More subtle signs, such as fatigue, shortness of breath or decreased appetite, could indicate that people are losing blood in their stool.

As for the overlap between COVID and colon cancer, Jamorabo believes that the ongoing inflammation from the SARS-CoV2 virus could predispose people to cancer.

“I don’t think enough time has elapsed” to know if there’s a link between the virus and colon cancer, he added.

With anxiety building over big-picture issues like global warming and an intensely divided population, people are likely increasingly worried about the state of the world.

“Most gastroenterologists are probably busier than they’ve ever been,” Purow said. “Some of that is probably due to the times in which we are living.”

Stress and anxiety can cause gastrointestinal symptoms that manifest in different ways.

Even with less concern about the pandemic, doctors are still seeing more people with alcoholic liver disease, as some turned to alcohol to relieve their ongoing anxiety.

“We’re trying to expand our network of dietitians and mental health professionals that we’re working with,” said Purow.

Information is power

An important tool in preventing colon cancer involves tracking the colon’s health through colonoscopies.

Having Suflave on the market could “lower the dread” of having a colonoscopy, Jamorabo noted. “We need to make the logistics of the preparation easier.”

METRO photo

By Fr. Francis Pizzarelli

Father Frank Pizzarelli

These are polarizing times. The days of civil conversation around delicate issues are long gone. Social media is a blessing and a curse. As a graduate school educator, it is a blessing if you need to have evidenced-based research in an instant. It is a curse because so much of what is posted is opinion, at best masquerading like it is evidence-based research.

Critical thinking is a thing of the past. Too many people believe whatever they see online, especially if it supports their own position. What happened to the days of genuine give and take conversation? What happened to agreeing to respectfully disagree?

We are still reeling from the pandemic; especially our young people. Mental health and human relations have really been impaired.

No one was prepared for the pandemic’s aftermath. We are still not well equipped or trained to navigate into the future. This present generation of young people is profoundly wounded mentally, emotionally and spiritually. We are failing to prepare them to deal with the divisive world we have created and are living in. 

 Our schools are central to empowering the next generation to wellness and wholeness. Instead of always ripping at our schools and our teachers, we need to work harder at collaboration. We need to be committed to a holistic approach to learning — body, mind and spirit.

Our children should be exposed to evidence-based material in every subject area. We need to be more conscious of the impact, for better or for worse, of the smart phone. That little device can build people up or with the push of a button destroy someone.

At what age should children have a cell phone? What restrictions should be imposed? Should elementary and middle school students have cell phones in class? Should we create universal guidelines in this regard?

The other issue that needs to be addressed is how parents parent their small children with tablets to keep them busy. How and where do our children learn about human connections? How do they learn about their feelings and how to express them?

There has to be a partnership between parents, school and community. Together we need to foster positive human connections grounded in love, respect and radical inclusiveness which our nation is founded on. 

Father Francis Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

Canadian wildfire smoke reduced the amount of sunlight reaching the ground over Long Island. Photo by Terry Ballard from Wikimedia Commons

Brian Colle saw it coming, but the word didn’t get out quickly enough to capture the extent of the incoming smoke.

Dr. Jeffrey Wheeler, director of the emergency room at St. Charles Hospital in Port Jefferson. File photo from St. Charles Hospital

The smoke from raging wildfires in Quebec, Canada, last week looked like a “blob out of a movie” coming down from the north, said Colle, head of the atmospheric sciences division at Stony Brook University’s School of Marine and Atmospheric Sciences. As the morning progressed, Colle estimated the chance of the smoke arriving in New York and Long Island was “80 to 90 percent.”

Colle, among other scientists, saw the event unfolding and was disappointed at the speed with which the public learned information about the smoke, which contained particulate matter that could affect human health.

“There’s a false expectation in my personal view that social media is the savior in all this,” Colle said. The Stony Brook scientist urged developing a faster and more effective mechanism to create a more aggressive communication channel for air quality threats.

Scientists and doctors suggested smoke from wildfires, which could become more commonplace amid a warming climate, could create physical and mental health problems.

Physical risks

People in “some of the extremes of ages” are at risk when smoke filled with particulates enters an area, said Dr. Jeffrey Wheeler, director of the emergency room at St. Charles Hospital in Port Jefferson. People with cardiac conditions or chronic or advanced lung disease are “very much at risk.”

Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital. Photo from Stony Brook University

Dr. Robert Schwaner, medical director of the Department of Emergency Medicine and chief of the Division of Toxicology at Stony Brook University Hospital, believed the health effects of wildfire smoke could “trickle down for about a week” after the smoke was so thick that it reduced the amount of sunlight reaching the ground.

Amid smoky conditions, people who take medicine for their heart or lungs need to be “very adherent to their medication regimen,” Schwaner said.

Physical symptoms that can crop up after such an event could include wheezing, coughing, chest tightness or breathing difficulties, particularly for people who struggle with asthma or chronic obstructive pulmonary disease.

When patients come to Schwaner with these breathing problems, he asks them if what they are experiencing is “typical of previous exacerbations.” He follows up with questions about what has helped them in the past.

Schwaner is concerned about patients who have had lung damage from COVID-related illness.

The level of vulnerability of those patients, particularly amid future wildfires or air quality events, will “play out over the next couple of years,” he said. Should those who had lung damage from COVID develop symptoms, that population might “need to stay in contact with their physicians.”

It’s unclear whether vulnerabilities from COVID could cause problems for a few years or longer, doctors suggested, although it was worth monitoring to protect the population’s health amid threats from wildfire smoke.

Local doctors were also concerned about symptoms related to eye irritations.

Schwaner doesn’t believe HEPA filters or other air cleansing measures are necessary for the entire population.

People with chronic respiratory illness, however, would benefit from removing particulates from the air, he added.

Wildfire particulates

Dr. Mahdieh Danesh Yazdi, an air pollution expert and environmental epidemiologist from Stony Brook University’s Program in Public Health. Photo from Stony Brook University

Area physicians suggested the particulates from wildfires could be even more problematic than those generated from industrial sources.

Burning biomass releases a range of toxic species into the air, said Dr. Mahdieh Danesh Yazdi, an air pollution expert and environmental epidemiologist from Stony Brook University’s Program in Public Health.

The U.S. Environmental Protection Agency has done a “fairly decent job” of regulating industrial pollution over the last few decades “whereas wildfires have been increasing” amid drier conditions, Yazdi added.

In her research, Yazdi studies the specific particulate matter and gaseous pollutants that constitute air pollution, looking at the rates of cardiovascular and respiratory disease in response to these pollutants.

Mental health effects

Local health care providers recognized that a sudden and lasting orange glow, which blocked the sun and brought an acrid and unpleasant smell of fire, can lead to anxiety, which patients likely dealt with in interactions with therapists.

As for activity in the hospital, Dr. Poonam Gill, director of the Comprehensive Psychiatric Emergency Program at Stony Brook Hospital, said smoke from the wildfires did not cause any change or increase in the inpatient psychiatric patient population.

In addition to the eerie scene, which some suggested appeared apocalyptic, people contended with canceled outdoor events and, for some, the return of masks they thought they had jettisoned at the end of the pandemic.

“We had masks leftover” from the pandemic, and “we made the decision” to use them for an event for his son, said Schwaner.

When Schwaner contracted the delta variant of COVID-19, he was coughing for three to four months, which encouraged him to err on the side of caution with potential exposure to smoke and the suspended particulates that could irritate his lungs.

By Colleen Merlo, LMSW

Colleen Merlo

One need not look very far to know that we are facing a mental health crisis. CDC data shows that youth are reporting high rates of poor mental health and suicidal thoughts and behaviors, and a recently published report by the Surgeon General declared loneliness an epidemic.

For many Long Islanders, these findings are not merely statistics or verbiage. This crisis is affecting their daily lives. It may show up with a child pleased to not attend school, or through a decline in the cognitive health of an aging parent. Many of us are feeling a rawness that we cannot quite put to words, nevertheless we know it is there. For some of us it shows up as irritability and angst; others are walking around feeling exhausted.

Living through a pandemic has changed all of us and the way we think about mental health, and left us less resilient as a society. On the bright side, the pandemic has been a catalyst for increased discussion about mental health. We need to make sure this trend continues. In the past, when people thought about mental health, the topic took a myopic view that focused on illness.  While mental illnesses are common, widespread, and can affect anyone (around half of people in the U.S. will meet the criteria for a diagnosable mental health condition at some point in their life), this view left many people overlooking mental health and wellness, and the ways we can foster community mental health. 

Every day we have a chance to focus on emotional wellness and incorporate tools into our lives. We also have an opportunity to better recognize and respond to mental distress. An important first step is to learn common warning signs for mental health conditions or crises and how to respond.  Mental Health First Aid training takes the fear and hesitation out of starting conversations about mental health and substance use problems by improving understanding and providing an action plan that teaches people to safely and responsibly identify and address a potential mental illness or substance use disorder.

Understanding the risk factors for a mental health condition can be more difficult when it’s your own mental health. Take time to reflect on your thoughts, feelings, and behaviors to see if you see a pattern that may be caused by a mental health condition. Here are some questions to get you started:

• Have things that used to feel easy started feeling difficult?

• Does the idea of doing simple daily tasks now feel really, really hard?

• Have you lost interest in activities and hobbies you used to enjoy?

• Do you feel irritated, possibly to the point of lashing out at people you care about? 

• Have you withdrawn from family, friends, or society?

• Are you increasing your use of drugs or alcohol?

If you are concerned about your mental health, there are several options available. You are not alone — help is out there, and recovery is possible. It may be hard to talk about your concerns, but simply acknowledging to yourself that you’re struggling is a really big step.

Taking a screening at http://mhaw.org/get-involved/online-screening/ can help you to better understand what you are experiencing and get helpful resources. After that, consider talking to someone you trust about your results, and seek out a professional to find the support you need.  

A phone call to the Association for Mental Health and Wellness can help link you to support, services, workshops, and trainings. Call MHAW at 631-471-7242 ext. 2. While you may not need this information today, knowing the basics about mental health will mean you’re prepared if you ever need it.

Colleen Merlo, LMSW, is a  the Chief Executive Officer of the Association for Mental Health and Wellness in Ronkonkoma.

*This article first appeared in TBR News Media’s supplement Focus on Health on May 25, 2023.

Pixabay photo

By Daniel Dunaief

Daniel Dunaief

While for now, the pandemic is officially in the rearview mirror, according to the World Health Organization, it’s worth considering what we can and can’t blame on COVID-19. For starters, here are a few things that aren’t the fault of the pandemic.

— A favorite sports team’s defeat. Every team had to deal with COVID-19. The pandemic didn’t affect my team’s best athletes any more than any other team’s stars.

— The weather. It’s going to rain, and it’s going to be too hot and too cold. That happened before the pandemic, and it’s going to happen afterward. Global warming, if anything, might have slowed slightly as more people stayed home each day.

— Unrequited love. Authors throughout history have found this topic particularly appealing. A would-be romantic goes out into the world with a proverbial heart filled with affection and admiration. Cupid hits that person with an arrow, creating a wellspring of dedication and devotion toward someone who doesn’t return the favor. The pandemic might have made it harder to know where we stood with each other, but unrequited love will continue to cause problems and lead to sad-but-relatable romantic comedies.

— Bad grades. We all have moments when we don’t study enough, the right way, or even the right material. The pandemic might have made it harder to focus or to care about theorems or memorizing dates, but it’s not the fault of the virus. It might have been tougher to concentrate in those early days, with dogs barking, parents yelling into Zoom calls, and people dropping off food at our front door.

— Anger in Washington. This is one of the easiest to dispel. Did you pay any attention to the vitriol coming out of the nation’s capital before 2019? It’s not as if the parties suddenly decided fighting each other was more valuable than getting anything done or compromising. The words under the Washington DC license plate shouldn’t read “taxation without representation,” which refers to the fact that residents pay taxes but don’t have federal representation. Instead, it should read: “Grrrrrrrrrrr!”

— Biased journalism. As a member of the media, I understand the frustration with the written and spoken words on TV and in print. The left hates Trump; the right hates Biden and ne’er the ‘twain shall meet. The pandemic didn’t pour gasoline on that dumpster fire. Media organizations staked out their territory prior to the pandemic and have remained more faithful to their talking points than many people do to their own marriage vows.

Okay, now, what about the things we can blame on the pandemic.

— Mental health strain. While the pandemic may be gone, we haven’t wrapped our arms around the mental health impact. We spent way too much time on our phones, making us feel simultaneously connected and disconnected while the pool of frustration continues to get deeper.

— Educational gaps. Students will never get back those days and the lessons they missed during the pandemic. Classes condensed their syllabi, lowering requirements and expectations for each class and for graduation. Students of all ages missed lessons and assignments that might have inspired them and that would have helped them reach previous educational requirements.

— Social graces. A first-grade teacher recently told me that their school still can’t bring all the first-grade classes together. When they do, the students argue about resources and space. Prior to the pandemic, students from several classes could easily play together. Hopefully, that will change as the students age and fill in gaps in their ability to interact.

Even as we hope to move past the pandemic, we can’t ignore the difficult reality, forcing parents, teachers, children and members of society to relearn lessons about acting and interacting. No, we can’t take cues from Washington, but maybe we can overcome deficiencies exacerbated by the pandemic.

METRO photo

By Fr. Francis Pizzarelli

Father Frank Pizzarelli

What will it take for the country to push the pause button and then reset? We are a nation that is out of control. The pandemic has only underscored how out of control we are.

We are losing hundreds of young people every day due to fentanyl, heroin and suicide. The nation has declared that we have a national heroin epidemic but what is being done to address this tragic health concern that is killing more than 100,000 lives a year?

Yes, we are making Narcan more available but what about holistic residential treatment beds? There are no beds anywhere. Yes, a few for-profit programs have emerged in the midst of this crisis but what about the working class and working poor? How do they pay for evidence-based treatment for their children?

No one wants to challenge the insurance empire that is sentencing so many of our at- risk people to death. It is scandalous that an insurance gatekeeper with no training decides whether or not your son or daughter gets treatment! So many of these gatekeepers are clueless about addiction; our silence in this regard is deafening

How many more young people have to die before we say enough? If human life is such a priority, then challenge our paralyzed leadership to work together for systematic change in the treatment of substance use disorder and mental health.

Our social welfare system in Suffolk County needs to be overhauled department by department. Instead of empowering the broken and wounded to healing and change, our system is setting people up for failure. Your tax dollars are being wasted on a system that is inept and incapable of breaking the cycle of poverty and dependence among the people they are supposed to serve.

For more than 40 years in the trenches I have seen firsthand our destructive system at work I have seen countless homeless men set up for failure because we have no real transitional housing for them. We do not have enough case managers and social workers to assist them for so many of them are mentally ill and dependent.

The state is once again using fancy rhetoric to trick us with their new initiative to keep troubled youth at home. These troubled youth are young people between the ages of 12 and 17 who already have stolen cars, assaulted people and some are even in dangerous gangs. We have few to no mental health services in our local communities to support these young people and their families.

The few programs that do exist are being forced to close; soon we will have no help and no resources for families in need.

We are blessed to have a dynamic commissioner of social services in Suffolk County in the person of Frances Pierre. She is a talented and gifted professional who is being shackled by a legislature that lack the vision and commitment to the most vulnerable and broken among us. Our commissioner needs to be free to do her job. We need to raise our voices in support of her!

Father Francis Pizzarelli, SMM, LCSW-R, ACSW, DCSW, is the director of Hope House Ministries in Port Jefferson.

The holiday season can be a difficult time for many people, especially for those who lost a loved one recently. Stock photo

An important gift people can give each other this holiday season is a check-in call or visit.

That’s the advice of area mental health professionals, who say that the holidays in general can be stressful and that several factors, including grieving over the loss of family or friends, fear about ongoing health concerns, and uncertainty and overall anxiety, have created stressors to mental health.

“If you know someone is having a rough time, who will be without a loved one for the holidays, you can call and say, ‘I’m here,’” said Dr. Stacy Eagle, director of Psychiatry at Port Jefferson-based St. Charles Hospital. “Doing something that simple can be really helpful.”

Indeed, area mental health professionals said the health care system in general has been straining to meet the need for patients in a host of ages to provide timely services.

Signs

Dr. Adam Gonzalez, a licensed clinical psychologist, director of Behavioral Health at Stony Brook Medicine and founding director of the Stony Brook University Mind-Body Clinical Research Center at the Renaissance School of Medicine, suggested that people can look for signs among their friends, family members and coworkers.

“Be aware of behavioral and emotional changes like social withdrawal, increased alcohol or drug use, overeating/eating more unhealthy food, difficulty sleeping, difficulty concentrating or making decisions, difficulty with getting work done” irritability and sadness, Gonzalez explained in an email.

Broadly speaking, Eagle added that people should be aware of any change in normal functioning. An extrovert who is acting withdrawn can provide a clue about a daily struggle.

Solutions

When people notice these kinds of changes in themselves or others, doctors urged a host of responses, depending on the severity of the symptom.

People who are an imminent danger to themselves or to others can call 988, which is a suicide and crisis hotline phone number. They can also call 911 or go to an emergency room, where a psychiatrist can evaluate them and offer help.

Cari Faith Besserman, director in the Division of Community Mental Hygiene Services with the Suffolk County Department of Health, said residents can take classes such as Mental Health First Aid, which teaches laypeople to increase their awareness by recognizing signs of emotional and mental distress, how to respond safely, and educates on symptoms of illness to decrease the stigma and mystery of mental health and various stages of wellness.

Suffolk County residents also can turn to the Diagnostic Assessment and Stabilization Hub, also known as DASH, program, which provides 24/7 access to behavioral health professionals and provides somewhere to go for those experiencing a crisis. The DASH number is 631-952-3333.

For less severe but problematic or ongoing symptoms, doctors urged some restorative measures.

Eagle suggested getting proper rest, ensuring a sufficient and balanced diet and staying hydrated. Activities such as exercise, which helps increase the release of serotonin, can help reduce anxiety and improve mood.

She added that unplugging from social media, especially for adolescents and children, can improve overall mental health.

Gonzalez also urged those who are offering support to remain fully present and nonjudgmental, and listen actively when someone shares concerns or anxieties.

“Be sure to ask what they need from you,” Gonzalez urged. “For some, it may be just listening; for others, it may be advice/ feedback or helping to connect them to professional support services. It’s easy for many to slip into problem-solving mode; however, sometimes others just want to be heard and validated.”

Gonzalez added that group-based treatments are just as effective as individual therapy and encouraged patients to try skills-based groups to learn coping methods for managing stress, anxiety and depression symptoms.

Stony Brook offers a COVID-19 support group for people who have or have had COVID, especially those with long COVID symptoms. Stony Brook also offers a comprehensive mind-body treatment program called the Stress Management and Resilience Training program.

The SMART program is helpful for people who are managing co-occurring mental and physical health problems and for those who would like to enhance their overall resilience.

Overwhelming demand

On the whole, hospitals and mental health facilities are struggling to keep up with the need for help.

“Currently, the demand for psychotherapy services is overwhelming,” Gonzalez explained in an email.

Eagle added that the weeks leading up to the holidays have often been a stressful period.

This year, some groups in particular are struggling. Parents of children born in 2022 are especially concerned about respiratory syncytial virus, which is “higher than normal,” Eagle said.

Seasonal affective disorder, which occurs during the darker, colder winter months, also affects about 0.5 to 3% of the population, Eagle said.

SAD can be harder for people if they have depression or anxiety, Eagle said. “These things are definitely an issue.”

Doctors added that those who are grieving over a loss can find the holidays difficult.

“Grief can be more of an issue” around the holidays, Eagle said.

Eagle urges the continuation of traditions that families found meaningful and helpful.

Gonzalez added that people can cope with grief by keeping a picture of a person who is no longer present close by, offering a prayer in their honor, sharing positive memories, or writing them a note.

Grieving families can also consider starting new traditions that may help them move forward with their lives, Eagle suggested.

Good news

Even amid all the concerns this year, doctors said people can appreciate some good news.

“Happily, we are out of the severe hospitalizations for COVID,” Eagle said.

Communities can also celebrate resilience “as individuals and as a country,” she added.

In hospitals, visitors are able to offer comfort and spend quality time with their friends and family, which is a considerable improvement from the days when patients couldn’t have visitors.

Eagle said she is following her own advice with her friends and family.

She will try to reach out to those she knows have had a particularly bad time this year to “make sure that they are aware that someone is thinking about them,” she said.

Dr. Farquharson suggests showing a person experiencing a mental health emergency your hands with the palms open to show you are not a threat to the person. Stock photo

Long Island residents have taken CPR classes and learned lifesaving basics to help others with injuries through programs like “Stop the Bleed.”

But what about mental health emergencies?

Those may be more difficult to diagnose or understand, particularly for people who may not know the person in emotional distress.

While Suffolk County Police Department officers with specialized training, support service organizations like Diagnostics, Assessment and Stabilization Hub (known as DASH) and Family Service League, and mental health care workers are available to help, doctors offered suggestions for people who would like to provide assistance for a friend, coworker or relative while awaiting professional assistance.

Dr. Wilfred Farquharson IV, a licensed psychologist and director of the Child and Adolescent Psychiatry Outpatient Clinic at Stony Brook Medicine, helped create a two-page patient education sheet titled “Mental Health Emergency Response Guidance Sheet — Knowing Your Options.”

The guide provides suggestions on how to respond to a variety of emergencies, starting with lower level crises, which could include a change in mood or side effects from a medication that is not dangerous to a person’s health.

The options in that case are to contact a mental health provider to schedule an appointment, to use a safety plan or to schedule an urgent visit with a primary doctor.

In situations in which a person is destroying property, is threatening physical injury and is not in a position for a safe transport, the guide suggests calling 911.

To ensure effective help from emergency responders, the guide urges people to go to Smart911 to complete a profile for the household.

Additionally, people who call 911 should indicate that there is a mental health emergency. The person making the call should be prepared to offer the person’s name and location, the reason for the call, the person’s diagnosis (if known), things that upset the person, such as yelling at them or getting too close, things that might help soothe the person, and special considerations.

While people are waiting for first responders, they can try to deescalate the situation, using tools similar to the ones professionals practice.

“A lot of what we do is give the person space,” Farquharson said. “We show them our hands, with open palms, and let them know we’re not trying to be a threat. We don’t say too much. We allow the person to talk, as long as they’re being safe. We allow them to yell.”

Neutral tone

Dr. Adnan Sarcevic, chairman of the Psychiatry Department at Huntington Hospital, also urges people to provide “as much privacy as possible” for someone in distress.

Sarcevic recommended that supportive family, friends or community members be empathetic without being judgmental.

“Keep your tone and your body language neutral,” Sarcevic said. He urges people to remain calm and friendly.

People can help deescalate situations by acknowledging that someone else’s feelings are important and indicating that crying or being angry is okay.

Taking a cue from the person in distress can also help. If a person stops talking, “let him or her be there in silence. Let them reflect,” Sarcevic said.

Additionally, the Huntington Hospital doctor urged people to respect the personal space of someone who is struggling.

As far as his list of “don’ts,” Sarcevic said people shouldn’t use judgmental language or wag their fingers.

“Don’t ask, ‘Why’ or ‘How could you do that?’” Sarcevic advised.

Other resources

The Suffolk County Police Department implemented a 911 call diversion pilot program in 2021 which allows Emergency Complaint Operators to divert crisis calls, when considered safe, to the Crisis Hotline at Family Service League.

The SCPD collaborates with Family Service League on a 24-hour crisis hotline as well as a mobile crisis team of mental health professionals that can be deployed 24/7, officials from the SCPD explained in an email.

Additionally, the department said about 20% of SCPD officers are Crisis Intervention Team trained. Someone with that training is always on patrol. 

In addition to 911, people can reach out to DASH, which is the Diagnostic, Assessment and Stabilization Hub. A community crisis program with a Mobile Crisis Team for Suffolk residents, DASH is open every hour of every day and offers services for people who have mental health and substance abuse disorders.

For situations in which there are no safety risks, Stony Brook Medicine suggested that DASH is a good option. Residents can call the hotline at 631-952-3333.

Additionally, residents can call the Suicide and Crisis Hotline at 988 at any time.

Dr. Stacy Eagle, director of Psychiatry at St. Charles Hospital, cautioned that what deescalates one person might be different from what helps someone else.

Offering physical comfort to some people may help, while others might prefer to have their own space.

All three mental health professionals said the pandemic has contributed to higher levels of anxiety and depression among the population.

“The pandemic has increased the level of distress for those patients,” Eagle said. The pandemic could be the “stressful hit” that triggers discomfort or a mental health episode.

Farquharson has noticed an increase in the acuity of symptoms for some residents.

The mental health practitioners said the response to a crisis depends on the person involved and the type of problem he or she
is experiencing.

“You have to use [your] judgment”
when dealing with various circumstances, Sarcevic said.

Mental health professionals urged people to develop a plan that includes having phone numbers nearby, for 911, 988, DASH and the Family Service League, among others.

Additionally, doctors suggested people can help by being supportive and being prepared.

Farquharson said people should learn what to do if someone is not feeling well emotionally or mentally when a doctor’s office might be closed.

The second in a two-part series, this article highlights the strain COVID-19 has placed on a mental health care system that was already resource-constrained. Mental health care workers, from social workers to psychologists, psychiatrists and emergency medical teams, have responded to the increasing need for their services, cutting back on vacation times and dealing with patients who threaten violence against themselves and others. During the pandemic, health care workers who focused on the emotional well-being of patients also sought balance in their own lives. To borrow from the TV show “Law & Order,” these are their stories.

For some, running half marathons, spending time with family, meditating and communing with nature helps. For others, staying connected and reaching out to the kinds of services they themselves provide also offsets the growing strains in their work.

Health care workers have shouldered the burden of the COVID-19 pandemic for more than two years, reaching out well beyond their job description to help patients amid a period of intense uncertainty that threatened their physical and emotional health.

The cost to health care workers, including those who work in behavioral or mental health, has been considerable, as time at the hospital and speaking with patients remotely cut into their personal lives and threatened their own sense of balance.

“It was very difficult to be a doctor through the storms of COVID,” said Dr. Stacy Eagle, director of Psychiatry at Port Jefferson-based St. Charles Hospital. Health care workers had to “deal with a lot of mental health issues” during the last few years.

Indeed, hospitals throughout the area offered varying levels of support while their staff were on-site, including meditation rooms and aroma therapy. They also suggested personal health checks and provided on-call services for employees who might be struggling amid concerns about their health and the well-being of family members and their patients.

While the general public has tried to push COVID into the back of their minds, attending sporting events and movies, going to restaurants and returning to patterns and activities that are reminiscent of life in 2019, health care workers have increasingly needed mental health support.

Employee Assistance

Over the last several months, Stony Brook University, which has an Employee Assistance Program, has seen a rise in the number of staff reaching out for help.

During the pandemic, Stony Brook launched an employee helpline for those who need mental health support, including psychotherapy and/or medication management. Compared to last year, Stony Brook is seeing a two-folded increase, or triple, the number of employees reaching out for services, according to Dr. Adam Gonzalez, director of Behavioral Health and associate professor of Psychiatry & Behavioral Health at Stony University Renaissance School of Medicine.

“There are high concerns about employee burnout, resignations and departures from health care,” Gonzalez wrote in an email. “Most concerning is the risk for suicide — the ultimate consequence of burnout.”

Stony Brook has an employee support team that implements wellness initiatives, including daily mindfulness meditation sessions, yoga and stretching, and confidential one-on-one support by a faculty and staff care team and employee assistance program.

Dr. Poonamdeep Gill, director of the Comprehensive Psychiatric Emergency Program at Stony Brook Hospital, said the mental health team is “seeing more patients who are sicker from a mental health standpoint. People are really struggling. It does take a toll on you.”

Gill said Stony Brook is proactive with staff, making sure they can access services. The university also encourages staff to check in with their leadership team if they are feeling burned out or struggling.

Dr. Michel Khlat, director of St. Catherine of Siena in Smithtown, said he has seen some of the same health care fatigue that has beset hospitals and other health care facilities throughout the country.

“Staff members have gotten overwhelmed with the volumes,” Khlat said. “Some are altering their occupations to see more outpatients. Some are reverting to part-time and per diem work.” He has had a few friends in Florida who are seeing the same phenomenon, with health care workers quitting or cutting back on hospital time and going into private practices.

Bounce forward

The Northwell Health System has been working on the support of all health care workers, including in mental health, said Dr. Vera Feuer, associate vice president in School Mental Health. Northwell has adopted a stress first aid response, peer support, and a resilience model to recover from stress and trauma.

The military developed stress first aid to deal with situations like the pandemic, in which there is ongoing stress with an uncertain ending. That, Feuer said, differs from a single event, like 9/11, where something traumatic occurs and survivors build back from it.

The pandemic has involved over two years of continuous stress and this feeling of uncertainty, she added.

Stress first aid teaches people to support each other in resilience and to “bounce forward,” Feuer said. “It is difficult to maintain in a busy, stressful environment.”

Finding balance

Doctors suggested they engaged in a wide range of activities to help with their own mental health.

A believer in the value of nutraceuticals and supplements, Dr. Jeffrey Wheeler, the director of the Emergency Room at St. Charles Hospital said he also works on focused breathing.

Eagle, his colleague at St. Charles, urges people to pursue some of their hobbies, such as reading or painting. She also recommends staying off of or limiting social media, particularly for younger children who might find the information and the reaction to postings unnerving.

Stony Brook’s Gill believes in physical activity and exercise. She ran a half marathon a few weeks ago on Long Island.

“I make sure I stay active,” she said. “We need to take care of ourselves before we can take care of other people.”

Stony Brook’s Gonzalez stays closely connected to family, friends and work colleagues.

“I also try to stay active and explore nature,” Gonzalez said. “I regularly practice mindfulness [which is] tuning into the present moment in a nonjudgmental way.”

Gonzalez enjoys a good TV show or movie to disconnect and unwind as well.

Northwell’s Feuer said she’s worked harder than she ever had, but, at the same time, she feels fulfilled by the hope and meaning in her work.

For Feuer, the silver lining is the attention to mental health, which “we know has been a problem for a long time. I’m hoping the right resources and interventions” will help those who need it.

To read the first of this two-part series, “Mental health strain for Long Islanders,” visit tbrnewsmedia.com.