By EWA MATUSZEWSKI
Healthcare is not for the faint of heart. I’m not speaking of exposure to blood, trauma, distress, violence, and death – but there’s that, too.  Rather, I’m playing my violin for the healthcare warriors who are dealing with a new era of healthcare in a post-pandemic world. These are frontline nurses, physicians, phlebotomists, clerks, medical assistants, x-ray, ultrasound and med techs, midwives, social workers and behavioral health specialists. But they are also administrators, hiring managers and recruiters, payors, financial personnel and office managers.

This is not an exhaustive list; the healthcare world is simply too massive to capture every role in this column. The overarching commonality, though, is that healthcare professionals are facing a crisis of societal despair that is exhibited in increasing mental health problems in doctor’s offices, hospitals, community agencies, and school and university health clinics.

In speaking with a colleague recently, I opened up about some troubling statistics from our PO’s patient population regarding Emergency Department (ED) visits from January 2023 through September 2023. Out of 1,208 ED visits, 469 were due to substance use disorder and depression: alcohol (329), opioids (28), cocaine (29), general substance misuse (96) and depression (107). These numbers, significantly higher in most categories than pre-pandemic numbers, represent patients from across the spectrum in Southeast Michigan, from suburban, urban and semi-rural private practices to Federally Qualified Health Centers.

Substance use disorder and depression are agnostic when it comes to socio-economics – and they are rampant in the new era of healthcare. The widespread availability of NARCAN has been a godsend to first responders in saving lives. Yet, at the same time, it can be hard to track their use because of their availability in increasingly consumer channels, such as vending machines.

In the depression category – where there is no NARCAN equivalent – a report released last month by the National Center for Health Statistics revealed a record high number of suicides in 2022 – nearly 50,000. The number is incomprehensible, even when I look at the growing mental health visits in our own patient population.  Equally troubling, the rate was highest among men aged 75+. The mental health crisis among our youth is now well-known, with their active place in society via school, sports and friend groups making them more visible than the lives of old men, who may live alone, have limited connection with social groups and, for a variety of reasons, may not have strong family relationships.

For those of all ages who do seek help, there are challenges and roadblocks. Mental health parity often exists in name only, with commercial insurance often lagging the coverage available through government plans like Medicaid. Yes, telehealth continues to play a role in treatment – and online treatment communities are forming for group therapy of sorts – but the common denominator in treatment is behavioral health specialists. From limited license therapists, social workers, and nurse practitioners with a specialty in mental health to psychologists and psychiatrists – we simply don’t have enough of them. Increasingly, economics are coming into play, especially with social workers and therapists.  As demand goes up and supply stays low, the price increases. Understandable, but still a barrier to hiring for smaller healthcare/community organizations that can’t compete with industry-leading salaries. Sigh.

But there is hope, too. There is increased awareness, there is greater acceptance and there is more targeted attention being paid to the needs of a society where too many are experiencing mental anguish. Yes, the pandemic ushered in a new era in healthcare that can make one long for the good old days. But we must look to 2024 and the years to follow as opportunities for breakthrough treatments and healing that will be the domain of the next generation health professionals, strengthened by the gutsy leadership, compassion and expertise of those who served before them.