Young children in these 2 Maine counties are at greater risk for poor mental health

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Complex emotions among middle school students are nothing new, but the sadness and hopelessness of students in two of Maine’s poorest counties before the COVID-19 pandemic has public health officials and juvenile advocates concerned.

In Piscataquis County, 30 percent of middle school students felt so sad or hopeless that they stopped their usual activities for more than two weeks in a row, compared to the statewide rate of 24.8 percent, according to the 2022 Maine Shared Community Health Needs Assessment. The report includes statistics from 2019, before the pandemic forced students into social isolation. Since 2017, the county’s rate has increased nearly 10 percent.

In the same student population, 24.5 percent seriously considered suicide, compared to the national average of 19.8 percent. The county’s assessment — along with Washington County — finds that the overall rates are significantly worse than in Maine.

Other rural counties like Somerset — the poorest in Maine, according to 2020 data in Maine Department of Labor district profiles — didn’t have such alarming rates in the same mental health categories among middle school students. Aroostook, Hancock and Oxford counties also recorded lower percentages than Piscataquis and Washington.

The numbers are staggering, according to county officials, who plan to discuss solutions with parents and seek means that would bring more mental health resources to students and families. Health experts and advocates expect new data will be even worse, meaning middle school students in Piscataquis and Washington could be at greater risk than in other parts of Maine.

“Having someone to go to is absolutely critical,” said Sue Mackey Andrews, presenter of Helping Hands with Heart and chair of the Penquis District Public Health Council. “We all need people. Forty percent of our families here [in Piscataquis] have more than one job. About 15 percent work more than two jobs.

“If you do that, you’re not home. You earn your living. At the end of the week, when there’s not enough money to pay the bills, your kids see and hear that.”

Helping Hands with Heart is a Piscataquis coalition catering to food, emergency fuel and other needs in the area.

The 2022 Maine Shared Community Health Needs Assessment, released every three years, identifies access to care, mental health, social determinants of health, and substance use as priorities statewide. It is a collaboration between the Maine Center for Disease Control and Prevention, Northern Light Health, Central Maine Healthcare, MaineGeneral Health and MaineHealth.

Adolescent mental health statistics are from the biannual Maine Integrated Adolescent Health Survey of fifth through twelfth graders conducted by the Maine Department of Health and Human Services and the Maine Department of Education. It monitors alcohol use, substance use, diet and more.

In Washington County, 35 percent of middle school students said they felt sad or hopeless in 2019, up from 19.4 percent in 2017, the assessment said. Like Piscataquis, the county’s students face a decline in mental health that is above the national average. Almost 23 percent seriously considered suicide.

County-level data from the 2021 Maine Integrated Youth Health Survey that would reflect how students were feeling during the pandemic is expected to be available in the coming days, said Robert Long, spokesman for the CDC in Maine.

The assessments for Piscataquis and Washington counties raised concerns about the impact of the COVID-19 pandemic on youth, including the stress of home schooling and being in potentially unsafe situations with less school support.

Officials in both counties made it clear that adolescent mental health is complex and the worrisome rates are likely due to a combination of factors. An important one is Piscataquis’ status as the poorest or one of the poorest counties in Maine over the years, Andrews said. Washington also passed in this category.

This intergenerational poverty impacts children in a variety of ways, not the least of which is access to health care, healthy food, warmth, appropriate clothing and getting back to school while unprepared for success, Andrews said.

“This is only to continue the cycle of poverty in our region,” she said.

Hillary Starbird, director of public relations at Mayo and CA Dean Hospitals in Dover-Foxcroft and Greenville, pointed to the lack of transportation and other resources in rural communities.

As a parent, and not a health professional, Starbird suspects that the constant presence of cellphones and social media has also made mental health issues worse. A student’s most embarrassing moment could easily be filmed and shared online, she said.

Starbird also noted that in communities with many “extended families,” grandparents may not be aware of the pressure and cyberbullying their grandchildren face online.

Anecdotally, hospitals are seeing more youth in crisis situations than they have in the last two to three years, and finding suitable positions for them has become more difficult, said Dr. Dave McDermott, chief medical officer and vice president of medical affairs at Mayo and CA Dean.

Mainers under the age of 19 had an annual rate of 210.8 cases of suicidal intent per 10,000 emergency room visits, according to data from the Maine Department of Health and Human Services. This data — including intentional drug overdoses, suicidal thoughts, and suicide attempts — reflects visits since 2017. Piscataquis County had a rate of 223 per 10,000 and Washington County had a rate of 172.

Made with Flourish

“For every young person, there’s a different story and there’s a different tomorrow and a different family and family culture and community culture,” said Julie Redding, clinical director of the Community Caring Collaborative. “This is part of our ongoing work – how do we actually create opportunities not just to interview young people, but to follow them up?”

The organization is a partnership of more than 45 agencies along with nonprofit organizations and community members focused on improving the health and well-being of Washington County residents.

Redding mentioned “traditional advocates” in the region who have made mental health interventions accessible to children, including the Aroostook Mental Health Center, Sunrise Opportunities and Community Health and Counseling Services, and programs that give families hope for improvement, like Family Futures Downeast. The program offers college courses for parents and educational programs for their children.

Calais Community Hospital and Down East Community Hospital in Machias are using the assessment to develop a three-year action plan to bring about positive change, according to a joint statement from their spokespersons.

Starbird’s team is using the data to inform strategies at Piscataquis hospitals, she said. Northern Light Health is organizing a community forum for parents in Guilford in late November or early December — including a guest speaker from the National Alliance on Mental Health — to discuss the statistics.

The plan is to invite parents to form a community advisory coalition, and the hospital system wants to offer similar forums in Dexter, Dover-Foxcroft and Milo because the data would be specific to school districts, Starbird said.

Mayo Hospital runs positive action teams in Piscataquis schools, where a group of middle and high school students work together to spread positivity and address bullying and drug prevention, among other issues. The effort began in Guilford in 2017 and has expanded to other districts

Helping Hands with Heart is seeking a planning grant to purchase more mental health resources and is pending an additional half million dollars of congressional funding to create a regional mentoring program for middle and high school students, Andrews said.

The organization will host a presentation on the data from the 2021 Integrated Youth Health Survey in Maine at its December 16 meeting.

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