If there is one area of competition with the world’s other wealthy nations where the United States clearly loses out, it’s life expectancy. The average American can expect to enjoy about five fewer years of life than residents of other developed countries.
It’s a statistic that breeds despair, and largely springs from it. The United States leads comparable nations in what are called “deaths of despair.” These are the suicides, drug overdoses and deaths due to alcohol abuse that are huge contributors to the nation’s poor longevity.
The crisis is deepening. Our response, although improving, still comes nowhere close to reflecting the urgency these skyrocketing deaths, and the problems of behavioral and mental health and addiction, demand. And our biggest failures involve meeting the mental-health needs of young people. For these sufferers, failure is compounded by the decades of anguish they may endure. Or worse, the decades of life they’ll miss, if they don’t get the treatment they need.
On July 16, the new national hotline number 988, the Suicide & Crisis Lifeline, debuted. It’s intended to first supplement, then replace the old 10-digit one. A few days earlier, The Wall Street Journal reported that 1.5 million of the 9.2 million calls received by the nation’s suicide hotlines between 2016 and 2021 had been abandoned by callers or disconnected before a counselor could respond.
CALL CENTERS NEED STAFFERS
Significant shortages of staffers and volunteers have bedeviled the nation’s 200-plus call centers dedicated to talking to people seeking help with suicidal impulses. Now $432 million in new state and federal funding to improve the crisis line will help to cut response times, but officials say progress in staffing up is slow and the system is still not where it needs to be. They must keep the focus on making it work.
Suicides in the United States are up 30% since 1999, and the 45,940 Americans who took their own lives in 2021 rank the nation a tragic 160th in the world at preventing such deaths.
And the suicide numbers are dwarfed by drug overdose fatalities — more than 100,000 in the United States in the 12 months from April 2020 to April 2021, a fourfold increase over the past 20 years.
The stress, isolation, depression and lack of structure that came with COVID-19 have helped problem drinking find a new gear, too. Liver disease from alcohol killed 29,502 people in the United States in 2020, a rate that doubled since 1999. Addiction professionals on Long Island say they are still seeing an explosion of problem drinking.
Resources simply aren’t in place to help people with all kinds of mental health and addiction needs, say addiction counselors and other mental health professionals. There is a particular shortage of services in New York and on Long Island to meet the mental health needs of young people who are particularly vulnerable to developing addictions and succumbing to suicidal fantasies.
Between 2014 and 2021, New York eliminated 32% of its state-run youth psychiatric hospital beds. That was part of a plan to move resources to community-based outpatient treatment. But the funding needed has mostly not materialized, and providers say they can’t afford to hire or retain enough staff. As a result, that change in policy has only made things worse.
Youth advocates say that while community-based outpatient treatment often is a better option for young people, in cases of extreme trouble it is not. There is now a monthslong wait for such beds for patients so troubled that intense treatment cannot be postponed without inviting dire results.
CHANGE IS POSSIBLE
Yet improvement may be possible. Funding for addiction services has been boosted significantly, both from federal and state governments. Lawsuits against drug companies will bring about $180 million to Suffolk County over the next 18 years, and a bit less to Nassau.
The Diagnostic, Assessment and Stabilization Hub, opened in Hauppauge in 2019 by the Family Service League, offers 24/7 stabilization, evaluation and a path to treatment for mental-health crises and addiction in its facility and via mobile units. Plans for a similar facility in Nassau are moving forward.
And attitudes toward addiction and mental illness are evolving, toward understanding that both mental illness and addiction are diseases that need to be viewed more like diabetes or cancer, and less like weakness or willfulness. They also need to be viewed and treated as parts of a whole, because they so often coexist. The separation between mental-health treatment and addiction treatment needs to narrow.
Both mental illness and addiction have historically been hidden and denied. Now the United States is increasingly finding the despair of heavy drug and alcohol use, along with suicidal depression, anxiety, eating and personality disorders, and a host of other mental and emotional maladies, to be among its greatest challenges.
It’s literally killing us, at rates unseen in the rest of the developed world. It’s past time we turned the engine of American ingenuity and perseverance to addressing the bodies and minds and families and communities and children who are being shattered by suicide, deadly substance abuse and mental illness.
MEMBERS OF THE EDITORIAL BOARD are experienced journalists who offer reasoned opinions, based on facts, to encourage informed debate about the issues facing our community.