The new 988 Suicide and Crisis Lifeline launched on July 16, 2022. With 988, it’s now easier than ever for anyone experiencing mental health-related distress–whether that is thoughts of suicide, a mental health or substance use crisis, or any other kind of emotional distress–to seek immediate help.

The new 988 dialing code operates through the existing National Suicide Prevention Lifeline (the Lifeline) network of over 200 locally operated and funded crisis centers across the U.S. People can now access a strengthened and expanded Lifeline via 988 or the existing 10-digit number (which will not go away).

In this post, we’ll continue the introduction of the new 988 Suicide and Crisis Lifeline and provide additional resources for you to learn more and be prepared if you or someone you know experiences a mental health crisis.

What is 988?

Beyond being an easy-to-remember number, 988 provides a direct connection to trained, compassionate and community-based crisis counselors for anyone experiencing mental health-related distress–whether that is thoughts of suicide, a mental health or substance use crisis, or any other kind of emotional distress.

Who can use 988?

988 services are confidential, free and available 24/7/365 for anyone experiencing a mental health, substance use or suicidal crisis. And 988 isn’t just for you. People can also dial 988 if they are worried about a loved one who may need crisis support.

How are 988 services accessed?

The 988-dialing code is available for call (multiple languages) or text (English only), and chat services (English only) can be accessed at 988Lifeline.org. 988 services are available through every landline, cell phone and voice-over-internet device in the U.S.

 How is 988 different from 911?

The focus of 988 is to provide easier access to the Lifeline network and related crisis resources, which are distinct from 911, where the focus is on dispatching Emergency Medical Services, fire and police, as needed.

Why was 988 created and where can I get more information?

Congress designated the new 988 dialing code in 2020 to improve access to crisis services in a way that meets our country’s growing suicide and mental health-related crisis care needs. The Substance Abuse and Mental Health Services Administration (SAMHSA) is the lead federal agency, along with Vibrant Emotional Health (operational home of the National Suicide Prevention Lifeline), in partnership with the Federal Communications Commission and Department of Veterans Affairs, to make 988 a reality in the U.S.

SAMHSA provides comprehensive resources for anyone to learn more about 988, suicide prevention and mental health crisis services at   SAMHSA.gov/988.

Is my state ready for 988?

States are at varying degrees of readiness for the volume increases expected from moving to the 3-digit code, 988. The federal government is responding to resource challenges with unprecedented levels of funding and an all-of-government approach to partner with state and local leaders to improve system capacity and performance.

Find additional information and materials on suicide prevention at MagellanHealthcare.com/Prevent-Suicide, and stay tuned for our September Suicide Prevention Awareness Month campaign and free webinar.

Sign up to receive updates a few times a month from Magellan on free behavioral health resources you can use and share with family, friends and colleagues here.

Sources: SAMHSA and the National Action Alliance for Suicide prevention

“Our obligation to act is not just medical—it’s moral.”
Vivek H. Murthy, M.D., M.B.A. Vice Admiral, U.S. Public Health Service, Surgeon General of the United States

 
To support the Surgeon General’s recent advisory related to protecting youth mental health issues exposed by the COVID-19 pandemic, Magellan Federal offers best practices for professionals specializing in behavioral issues to foster the wellbeing of our military families.

Magellan Federal directly supports the mental health and resiliency of military youth and families, serving over 4.5 million service members and families a year. Read more about risk factors and recommendations in our whitepaper here.

It was hard enough for kids without social media. Many of our older readers will remember… We compared ourselves to others, but it happened mostly in-person at school or events, or when we consumed one-way media like TV or magazines. While it could be hurtful, we still got a break at home, while riding in a car, or for much of the rest of the day, as we didn’t have smartphones. We became the subject of gossip, but we had the benefit of an imperfect “grapevine” that took longer to spread information, and likely, we didn’t even always hear about it. And we played the popularity contest, but we could never be sure just who were the winners and losers.

We’ll dive into these issues in this post and you can learn more by watching a recording of our webinar, “Addressing the impacts of social media on kids,” here.

Kids’ self-image and social media

Social media makes it easy—and even entertaining—to endlessly scroll through the latest and greatest images of our friends, celebrities, and perfect strangers. We get to see the best of everyone all the time. If any one of our friends isn’t posting their best on any given day, we’re seeing someone else who is posting their best. This can put undue pressure on our kids to attain perfection, as they are developing their self-image and self-esteem.

For kids, and us all, there is tremendous value in limiting the time we spend on social media and understanding that what we see there isn’t usually the full picture. Social media can provide a great sense of connection with others, along with many other positive impacts, but life outside of it can be refreshing and cleansing when we focus on all that we have and want to do.

Social media and cyberbullying

It’s a lot easier to be mean to someone when you’re not doing it to their face. With social media, not only is it easy for a bully to target another child from behind the protection of their screen, but they can do so publicly for classmates and the world to see and weigh in with opinions, or even just a “like,” on the matter. This ruthlessness can be humiliating and overwhelming for the victim, and lead to serious mental health concerns.

As our kids’ gossip and squabbles naturally pervade and have the potential to be broadcasted instantaneously on social media for all to see, let’s talk to them about leaving the negativity off of social media and focusing on positive messages that will ultimately reflect better on us all. If your child is a victim of cyberbullying, find resources at https://www.stopbullying.gov/cyberbullying/prevention and learn more in our webinar on May 11.

Our kids’ popularity, quantified

Our kids’ popularity is now quantified and displayed on social media. They have a number of followers, and every time they post, it’s assigned a number of likes and comments. Is this environment creating additional pressure for our kids to be liked and drive up their social stats at the risk of harming their mental health in the process?

While we can’t make a direct correlation with kids’ use of social media, we know the prevalence of depression among adolescents aged 12–17 has steadily increased–and more than doubled–from 8% in 2010 to 17% in 2020, and that certain demographic groups have been disproportionately affected, including girls, of which the prevalence of depression has increased from 11.9% in 2010 (4.4% among boys) to 25.2% in 2020 (9.2% among boys).[1]

We know our kids are much more than the number of likes they receive on a social media post. It’s important that we talk to our kids about what is really important and build up their self-worth through meaningful activities that stimulate their learning and interests, and help others.

On May 11 Magellan Healthcare hosted a webinar, “Addressing the effects of social media on kids,” for Mental Health Month with former Magellan child psychiatrists, Dr. Keith Brown and Dr. LaShondra Washington, and Senior Director Children’s Healthcare Barbara Dunn, and Creator of Magellan Youth Leaders Inspiring Future Empowerment Greg Dicharry. Watch a recording of the webinar at https://www.magellanhealthcare.com/event/addressing-the-effects-of-social-media-on-kids/.

[1] SAMHSA 2020 National Survey of Drug Use and Health, Youth Mental Health Trend Tables

Total wellbeing means that you feel fulfilled in all aspects of your life. Your mental health is a big part of your wellbeing. It is important to be aware of the signs or symptoms of mental stress so you can seek help or recognize when someone you care about may need help.

5 reasons why it is important to pay attention to your mental health and wellbeing

1. Mental illness is more common than you think. Mental illness does not discriminate, it affects people of all ages, genders, and ethnicities. One in five U.S. adults experience mental illness, 1 in 20 U.S. adults experience serious mental illness, and 17% of youth aged 6 – 17 experience a mental health condition. Unfortunately, too many don’t seek help.
2. Mental illness affects your physical health. Your brain is part of your body. Mental and physical health are connected. In fact, mental illness can be the root of many physical symptoms. For example, if you are suffering from insomnia, heart palpitations, or fatigue, your doctor may want to rule out depression, anxiety, or other mental health conditions as a potential cause.
3. Diseases or injuries can increase your risk. Just as mental illness can cause physical symptoms in your body, physical diseases, like cancer, multiple sclerosis, diabetes, and trauma such as head injuries, can raise your risk of mental illness. It is important that you are honest about your experiences when speaking with your doctor.
4. It runs in families. Mental illnesses tend to run in families due to both genetic factors and family cultural issues. Remember to include things like depression, bipolar disorder, and attention deficit hyperactivity disorder in your family health history along with information about heart disease, cancer, and other conditions.
5. Early detection makes a difference. Like medical conditions, getting diagnosed early generally leads to better outcomes. Getting the help you need can prevent symptoms of mental illness from getting worse and causing negative effects on your life, including strained relationships and difficulty managing work and finances.

Visit our 2022 Mental Health Month web page to discover more tools to address and spread awareness about mental health, wellbeing, and specific conditions as we recover from the pandemic and deal with civil, economic, and global unrest.

Sources: health.clevelandclinic.org, nami.org, nih.org

Finding solutions that allow individuals to improve their overall wellbeing has been Sara Pierce’s primary focus with the recent launch of eMbrace on April 1, 2022. As senior vice president of strategy and execution, Pierce has worked closely on the collaboration between Gallup and Magellan Health and the creation of the Magellan-Gallup Wellbeing Project. With over 10 years of experience working at Magellan, Pierce is a leader on the Growth Team where she’s responsible for the team’s Go-To Market strategy (GTM) and leads individuals on the sales operations, the sales training, and customer experience teams. Pierce, who is based in Connecticut, discusses her ongoing work with Gallup on projects including eMbrace, and how Magellan’s culture has been instrumental in its success.

What sort of innovative projects are you currently working on?

I think the most innovative and fun project I’m working on right now is related to our collaboration with Gallup. We’ve created the Magellan-Gallup Wellbeing Project, joining  forces to combine Magellan’s 50 years of behavioral health experience with Gallup’s industry-leading insights and research to understand how we can better meet the needs of individuals and improve their overall wellbeing. Gallup’s State of the Global Workplace Report tells us that roughly seven in 10 employees are struggling or suffering in their overall lives, with negative emotions at an all-time high. As an employer and a human this is deeply troubling to me.

eMbrace is a fully integrated, evidence-based solution for supporting members’ total wellbeing. We’re incorporating Gallup’s wellbeing assessment and then introducing different solutions or opportunities for employees to engage at all levels across the continuum depending on where they are in the six elements of wellbeing. In essence, we are breaking the silo that has until now separated employee assistance and clinical care, shifting an individual from coaching to employee assistance to clinical counseling based on what is happening in their life.

Do you have any other projects still in the planning phase?

We’re still in the thick of the recent eMbrace launch and it’s exciting that our own Magellan associates will be one of our first customers to utilize eMbrace. This provides us a valuable opportunity to “walk the walk” and to continuously learn from ourselves and our own team. At the same time, we are exploring how we can bring this important work to our health plan, public and Federals markets as well. This is only the beginning!

Why is Magellan Health the best place to do this project?

I think we are the perfect place to do this because of our over 50 years of deep clinical behavioral health experience. Our customers, whether they are employers, health plans, public or federal markets, all have one thing in common – they all have people who are struggling and suffering. The way I think about it, is if not us then who?

What are your thoughts on the culture here at Magellan Health? How has the culture at Magellan impacted your project?

I think one of the things that’s truly unique about Magellan’s culture is that everyone is singularly focused on our mission to help people. We take that very seriously. I think that’s a big part of who we are and why we do what we do and that it’s palpable. When you’re working on trying to solve big problems, it helps to bring it down to the individual level and understand that what we’re doing matters to a person, a family, and an employer. That culture informs everything we do.

What are some exciting trends you’ve noticed in the healthcare industry? What direction do you see healthcare going? What lessons are there to learn in other industries that can be applied to healthcare?

We are in unprecedented times in terms of the rise in unmet need. More and more, as an industry, we are coming up with unique ways to try and meet those needs. One example of that is by addressing people earlier on in the continuum so that we can intervene to prevent exacerbation of illness. Offering digital assessment tools and interventions is one way to try and address the unmet needs. But of course, we can’t make the mistake of letting the pendulum swing too far in any one direction. I believe that our customers want us to balance digital and in-person. The right tools to the right people at the right time.

I think one of the problems in healthcare is that the industry has not designed solutions with the user experience in mind. Meanwhile in all other aspects of our lives, our tolerance for bad experiences is getting smaller every day. Our cell phones are continuously upgraded to improve our user experience. Products and services are marketed directly to us based on knowledge of our preferences, and we have countless choices in entertainment, retail, and restaurants. User experience is king in everything other than healthcare. For too long consumers of healthcare have been trapped with few choices. The good news is that every day I see more evidence that this is changing but we have miles to go before we rest.

Learn more about the dimensions of wellness here.

Obstructive sleep apnea (OSA) has been linked to an increased risk of physical health problems, including high blood pressure, heart disease, stroke, and diabetes. But how does OSA affect your ability to think clearly, learn and remember, and your emotional psychological, and social wellbeing?

If you have ever worked a 24-hour shift or experienced back-to-back days of poor sleep, it probably comes as no surprise to hear that OSA has been linked to cognitive and mental health issues. OSA causes frequent breathing interruptions, or apneas, while you sleep—as many as 30 per hour. OSA is associated with:

1. Trouble concentrating—OSA can lead to significant changes in two important brain chemicals, gamma-aminobutyric acid (known as GABA) and glutamate. Together, these two chemicals help maintain balance. People with OSA may have decreased levels of GABA and elevated levels of glutamate. GABA is a chemical messenger that acts as an inhibitor in the brain. It slows things down and helps you remain calm. Glutamate, on the other hand, speeds things up. When your glutamate levels are high, your brain is working in a state of stress and does not function as effectively.[1] Glutamate in high amounts has also been shown to contribute to brain damage.
2. Memory problems—Throughout the night your body fluctuates through different sleep stages, allowing your brain to process and sort out all the information it has gathered throughout the day. OSA stops the flow of oxygen to your brain or completely cuts it off multiple times during the night, robbing your ability to reach deep and restorative sleep These frequent disruptions can contribute to memory loss and have a negative impact on overall brain performance.[2]
3. Poor decision-making—Sleep is essential in maintaining brain health and contributes to your ability to learn and recall information. A lack of sleep caused by OSA can cause frequent problems with attention and concentration. If you suffer from OSA, you may have trouble focusing at work or school, being creative, solving problems, and making decisions.[3]
4. Depression and stress—OSA can cause hundreds of interruptions in your breathing during the night, which can set off a constant fight-or-flight response. You may wake up suddenly with your heart racing, sweating, and a feeling of doom. This can carry over into the daytime, causing you to feel run-down and sleepy and your body to be without the energy it needs to protect you against depression and stress.[4]

The good news about obstructive sleep apnea’s impacts on cognitive and mental health

While OSA can negatively impact your day-to-day life, there is hope. The harmful cognitive and mental health effects of OSA can be reversed with treatment. For some, this may mean lifestyle changes. For others, it may mean continuous positive airway pressure, or CPAP—a machine that helps you sleep easier.

Want to learn more about obstructive sleep apnea?

Find the recording of our webinar, “Obstructive sleep apnea: Impacts, diagnosis and treatment,” to hear board-certified somnologist and neurologist, Dr. Karen Jablonski, physician clinical reviewer, Magellan Healthcare, and I discuss the mental and physical health impacts of OSA, and OSA diagnosis and treatment here.

[1] https://newsroom.ucla.edu/releases/sleep-apnea-takes-a-toll-on-brain-function#:~:text=They%20found%20that%20people%20with,calm%20%E2%80%94%20like%20a%20brake%20pedal.

[2] https://goodsomnia.com/blog/snoring-sleep-apnea/can-sleep-apnea-cause-memory-problems/

[3] https://www.sleephealthsolutionsohio.com/blog/sleep-apnea-and-brain-health/

[4] https://www.everydayhealth.com/sleep/sleep-apnea-link-depression-anxiety/

In the midst of a national children’s mental health crisis, families are doing the best they can to assess how well their children are coping with increased stressors from the pandemic and figure out what to do if it seems they are having difficulty. Psychotropic medication is among the options to consider when indicated. However, over the years, children and adolescents with behavioral health challenges have generally been prescribed an alarming number of medications. This high prescription rate, paired with questions about the appropriateness of the diagnoses used to justify the drugs’ use, has raised many concerns among families, practitioners, and youth advocates alike. Prescribing medication to treat children’s mental health conditions can be appropriate, but parents, caregivers, and practitioners need to fully understand the risks and monitor their use.

In this post, we will contemplate these issues and draw on knowledge from Magellan Healthcare’s recently updated clinical monograph, Appropriate Use of Psychotropic Drugs in Children and Adolescents, which highlights evidence-based research on the use of psychotherapeutic agents in children and principles for optimal children’s psychopharmacotherapy practice.

Considerations for treatment with medication for children’s mental health

When families consider medication as an option to treat a child’s mental health condition, Magellan’s monograph offers the following to contemplate:

The practice of evidence-based medicine for children and adolescents requires health professionals and child welfare advocates to engage in a careful assessment of the risks and benefits of using psychopharmacological treatments while addressing serious concerns of over-diagnosis and overtreatment in this vulnerable population. As attention to these issues has grown, a strong undercurrent of anxiety and confusion exists about whether the use of psychotropic agents to remove undesirable impulses and behaviors of children may affect their neurological development, personality, character, and temperament. Suspicions exist that over-diagnosis and overtreatment are driven by a supply-induced demand created by pharmaceutical companies and medical providers.

Addressing the shortage of children’s mental health professionals

Another consideration for parents and families is the shortage of professionals providing specialized mental healthcare services for children. Mental healthcare for children is often initiated at the pediatrician’s office, Magellan’s monograph provides the following insights:

Given the significant national shortage of child psychiatrists, there remains a realistic need to rely on primary care clinicians to perform screenings of children for mental health disorders and treat uncomplicated ADHD, anxiety, or depression. However, the problem of follow-up care and ongoing monitoring of mental health problems in pediatric primary care is a matter that must be addressed.

Principles for optimal use of medication to treat children’s mental health

The American Academy of Child and Adolescent Psychiatry published the Practice Parameter on the Use of Psychotropic Medication in Children and Adolescents to promote the appropriate and safe use of medication to treat children’s mental health by emphasizing the best practice principles that underlie medication prescribing. These principles, as highlighted in the monograph, are as follows:

Principle 1: Before initiating pharmacotherapy, a psychiatric evaluation is completed.

Principle 2: Before initiating pharmacotherapy, a medical history is obtained, and a medical evaluation is considered when appropriate.

Principle 3: The prescriber is advised to communicate with other professionals involved with the child to obtain collateral history and set the stage for monitoring outcomes and side effects during the medication trial.

Principle 4: The prescriber develops a psychosocial and psychopharmacological treatment plan based on the best available evidence.

Principle 5: The prescriber develops a plan to monitor the patient, short and long-term. Clinicians should use standardized, objective measures to measure the efficacy of pharmacologic interventions.

Principle 6: Prescribers should be cautious when implementing a treatment plan that cannot be appropriately monitored.

Principle 7: The prescriber provides feedback about the diagnosis and educates the patient and family regarding the child’s disorder and the treatment and monitoring plan.

Principle 8: The child’s assent and parent’s consent are completed and documented before initiating, and at important points during, medication treatment

Principle 9: The assent and consent discussion is focused on the risks and benefits of the proposed and alternative treatments.

Principle 10: Medication trials are implemented using an adequate dose and for an adequate duration of treatment.

Principle 11: The prescriber reassesses the patient if the child does not respond to the initial medication trial as expected.

Principle 12: The prescriber needs a clear rationale for using medication combinations.

Principle 13: Discontinuing medication in children requires a specific plan.

We encourage you to learn more about medication to treat children’s mental health in the full clinical monograph and Understanding and Meeting the Needs of Children and Adolescents at High Risk: Foundations of a Model, which highlights evidence-based prevention and treatment approaches for problematic behaviors and various types of behavioral health challenges in children and adolescents, here. Both provide valuable insights and information to support the critical behavioral health needs of our nation’s children.

This article is part two of our discussion about the impacts on mental health and the war in Ukraine. Click here to read our tips for adults. 

Information on the war is continually changing. The youngest viewers, children, are watching and may experience the fear and stress associated with images from the war in Ukraine.

To add to the stress and concern, this global crisis comes on the heels of being exhausted and socially isolated by the pandemic. The following are some tips to help children that are impacted or stressed by the Ukraine situation.

Listen to children. Children hear and see things. This can be especially frightening if they have a parent deployed. It is important not to force them to talk. Find alternative ways to communicate with children such as drawing or playing with toys.

Calm conversation. It is important for parents to be calm when talking to their children about Ukraine. Parents need to be careful not to be the source of a child’s anxiety. Parents are encouraged to check-in and ask their children how they are doing.

Answer children’s questions. Support and acknowledge what your child is saying and their potential fears. Reassure your child but do not make unrealistic promises. Answer questions and help in separating fact from fiction.

Provide support. Do not let children watch the images of violence on television. Children who have experienced trauma may need extra attention. Some children may not want to talk about the event. It is okay if they would rather play or be outside.

Limit exposure to media and social media. Limit the exposure to graphic violence on media. For older children, watch the news with the child and then talk about how the child is reacting to what they are seeing.

Maintain a normal routine. Encourage the daily routines such as homework, sports, activities to continue.

Watch for changes in mood. Some children show their reactions in nonverbal ways. Watch for anger, physical symptoms, mood changes, or withdrawing from usual activities and conversations.