New Mexico braces for surge in behavioral health needs as COVID-19 trends upward

ALBUQUERQUE - New Mexico health officials said Tuesday that the state is bracing for a surge in demand for behavioral health services in October related to the personal stresses and economic consequences of COVID-19.

New Mexico Human Services Secretary David Scrase gave an update on COVID-19 data and epidemiological modeling for the state on Tuesday via video conference, which was livestreamed on the department's Facebook page. 

Despite increasing spread of the disease, which Scrase attributed to factors including Labor Day weekend gatherings and daily travel, the National Safety Council recently rated New Mexico among 12 states on track for further reopening based on guidance for workplaces, testing rates, rapid contact tracing and access to treatments for substance abuse and behavior health via telehealth or telephonic services.

In fact, New Mexico was among the five highest-rating states, along with New York, California, Rhode Island and Washington. 

Nevertheless, Scrase said, "Our case counts are drifting up," and data indicating a decline in screening and dental services warned of possible increases in other health care needs as the COVID-19 emergency continues into flu season. 

It mirrors a national trend, as the federal Centers for Medicare and Medicaid Services reveals that from March to May, vaccinations for children ages 2 and under were down 22 percent over the same period in 2019; child wellness screenings were down 44 percent; and dental services had declined 69 percent. 

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Those national trends increase risk for outbreaks of infectious disease. As well, Scrase said that reduced dental care correlates with other health problems, including heart disease. 

New Mexico's Medicaid program, which serves 40 percent of all New Mexicans and 56 percent of the state's children, reported that vaccination compliance was down by 17 percent among its beneficiaries.

Additionally, 45 percent of U.S. adults reported negative mental health impacts from the pandemic, per federal data, while children have been presenting with higher rates of anxiety, depression and post-traumatic symptoms.

Forty percent of adults reported they were struggling with mental health or substance abuse issues in June, and 11 percent reported seriously considering suicide. 

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Patients diagnosed with substance abuse disorder presented a higher risk for COVID-19 infection, per a study of 7.5 million substance abuse patients. They also showed a higher prevalence of other illnesses such as chronic disease of the kidney, liver, or heart, type 2 diabetes, obesity and cancer. 

Further, among those patients, Black Americans were at higher risk of COVID-19 and negative outcomes than white counterparts. 

New Mexico, which presented the highest rate of suicide in 2018, had a prevalence of 22.9 deaths by suicide per 100,000 population from 2000, higher the national rate of 13.

Behavioral Health Services Division Director Neal Bowen cited a study during Tuesday's conference that found 20 percent of suicides worldwide are attributable to unemployment.

Business closures and public health orders reducing social and economic activity to curb COVID-19 have led to spikes in unemployment nationwide and in New Mexico, which reported an official unemployment rate of 11.3 percent in August.

Bowen said that increased use of telephonic or telehealth services, allowing patients to interact with providers from their home or car, was showing some positive results: Fewer "no shows" related to transportation problems or anxiety about seeing a clinician, and even indications that clients were more open in communicating their problems with providers. 

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It also allowed New Mexicans to be routed to providers in other parts of the state as needed, without adding to transportation times and obstacles, Scrase and Bowen reported. 

Lowering barriers to using telehealth services, training more crisis counselors and promoting a "treat first" methodology prioritizing care over lengthy intake procedures had all enhanced outcomes for patients.

Still, Bowen acknowledged that a "workforce numerical deficiency," or a need for more personnel and licensed professionals in particular, remained a challenge. 

Trends going the wrong way

The upward trend was most marked in the metro region, with Bernalillo County leading with 445 new cases confirmed from Sept. 15 to 28.

In the south, Doña Ana County confirmed 327 cases in the same span of time, as neighboring El Paso County in Texas has seen a recent surge as well. 

Southeastern counties near the Texas border, especially Chaves, Eddy and Lea, also saw increasing rates of transmission turn up in test results. 

Based on 10-day rolling averages, New Mexico's spread rate was 1.25 as of Monday, exceeding its target of 1.05 or less. Scrase said officials expected that in coming days the state would also exceed its target of no more than 168 daily cases based on seven-day rolling averages. 

Hospitalizations have also been trending upward, with 80 individuals hospitalized in the state as of Tuesday, 14 of whom required ventilators. 

The state Department of Health reported 178 new cases Tuesday, bringing the total over 29,000 since the first cases were identified in New Mexico on March 11. Statewide, 875 deaths have been associated with the disease.

The DOH had designated 16,565 cases as having recovered.

25% of New Mexicans have been tested

As of Tuesday, 914,986 tests had been processed with results reported to state health officials. 

The state also unveiled new data reporting the percentage of persons tested for the SARS-CoV-2 coronavirus, which causes COVID-19 disease, per county. The estimates, corrected for individuals who have been tested multiple times, indicate that 25.5 percent of New Mexico residents had been tested as of last Sunday. 

The counties with the highest testing rates were Guadalupe (38 percent), McKinley (37 percent) and the southwestern county of Hidalgo (34.7 percent). 

Along with urging New Mexicans to get tested, and preferably at state Department of Health offices, Scrase pointed to recent literature indicating that personal protective equipment and masks, even non-medical grade cloth face coverings that securely cover face and mouth, are showing efficacy in slowing community spread of the illness.

Antibody tests were not yet shown in clinical evaluations to be reliable, and for that reason Scrase did not recommend them as an alternative to nasal swab testing processed by state labs reporting data to the Department of Health.

The two activities most frequently cited by individuals testing positive for COVID-19, Scrase said, were traveling and being part of large gatherings within the previous 14 days. 

Mobility rates, measured by geographic mobile phone metadata, have been consistently flat since April but Scrase said the last two weeks of data suggest a recent increase. 

The rate of COVID-19 transmission in the state, he said, is driven by everyday behaviors, especially in wearing cloth face-coverings in public, washing their hands regularly, avoiding gatherings of 10 or more people and maintaining at least six feet of distance from others. 

More: Here are the Doña Ana County businesses investigated for coronavirus

"I would prefer not to live on this roller coaster" of trending up and down, Scrase remarked, expressing confidence that current emergency health orders and executive orders presented a map for producing a "very sharp dropoff" in new cases within "a couple of weeks."

"Let's work together to shorten the length of time it takes to get through this," Scrase urged the public.

Algernon D'Ammassa can be reached at 575-541-5451, adammassa@lcsun-news.com or @AlgernonWrites on Twitter.