Briefing with Public Health experts including former fta commissioner dr. Scott gottlieb. Watch live at 3 00 eastern on orpan, online at cspan. Org, listen live on every cspan radio app app. Joshuaur next guest, dr. Gordon, the director of the National Institute of Mental Health. Thank you for joining us. Dr. Gordon nice to be here. Role what is the federal when it comes to Mental Health issues . Dr. Gordon the National Institute of Mental Health is the primary federal Agency Responsible for conducting Mental Health issues. Everything from neuroscience, novel treatments, and how to get those treatments to those who need them. Host in light of the pandemic, does this open up new avenues of study as far as how people are reacting to covid19 mentally . Dr. Gordon absolutely. We know from previous disasters what to expect, there are specifics relevant to this covid pandemic that we are very interested in studying. One area that we need more research in is the area of interventions to help reduce the Mental Health impacts of disasters and pandemics. That is something we are interested in pursuing in the coming weeks and months. We have gotten a lot of Fast Track Research proposals we are working on to try to encourage how best to respond. How do you gather that data and what are the questions to be asked . A lot of questions to be asked and a lot of ways to gath te of the things we are vey interested in doing is combining administrative databases with scientific and medical databases. Arenow already that there lots of different mitigation measures for the pandemic that are being tried in different localities, be they states, cities, or counties. We know those mitigation factors wee Different Levels of what call adherents, people are listening to them to different extents. Those can all be measured. They can be measured through lots of different sources. We would love to be able to combine that with studies of Mental Health outcomes to understand the impact of mitigation measures. Is other thing we want to do take interventions that have been shown to work for reducing the impact of traumatic events and reducing the impact of and deploydversity them. Especially in underserved areas. Orces like Rural Communities minority communities where there have been challenges in access to Mental Health care and study how to deploy them and how they work in the current circumstance. Those are just a couple of ideas but we want to encourage researchers to get on top of this quickly. We are trying to make resources available. Host does the research only extend to the average citizen . Workershose frontline factor into the research . Dr. Gordon we know from Prior Research that frontline workers are at tremendous risk. Particularly those who have been working in icus and have been witnessing people succumbing to the pandemic, they have been having to service conduits between those people in the icus and their families. They have been in for a rough time, they are working long hours and dont have a ton of time to build themselves back up before their next shift. We know from previous disasters that they are at high risk. What we are focused on is trying to understand how interventions help frontline workers. Healthto mention the care workers are the one everyone is most concerned about. There are other frontline workers in this pandemic that we also want to study. We are talking about grocery clerks, delivery folks who are delivering from restaurants and warehouses and companies who are maintaining some degree of opening. Are alsontline workers at risk and what we would like to understand is, what are the that affectors Mental Health. We know underrepresented communities are a target because they are being infected by the virus, higher rates of dying from the virus. Understand the particular Mental Health consequences in those communities. And again, test interventions in those communities that may help them weather the storm. Ast our guest can be asked question on three lines. In the central time zone, 202 7488000. Mountain and pacific time zones, 202 7488001. Mental Health Professionals you can call and ask your questions at 202 7488002. The Kaiser Family foundation put out statistics taking a look at this issue, saying 39 of americas have lost a job or income. Saying that covid19 stress is affecting their Mental Health. One in five saying there is a major negative impact. How is that manifesting itself among those dealing with this . Dr. Gordon if you are talking about Mental Health professionals, we are seeing greater demand for hotlines, greater demand for crisis talk line services. We are seeing people reach out more and more. A lot of our Mental Health professionals have made the transition rapidly to telehealth consultations. That has been a challenge for some but i think most are meeting that challenge. Host how is the average citizen dealing with this stress, what are they doing to cope . Dr. Gordon everyone is doing something different. One of the things we are seeing a lot of and that you are familiar with yourself is social connection at social distance. We are recognizing that the tools that have been developed over the past few years, a especially videoconferencing tools like facetime and the like, these are wonderful ways to stay in contact with each other. Arenow that social supports on incredible resilience factor. The more people connect with each other socially the more they are able to respond to the challenges of the pandemic. Tremendous confluence of risk factors that we are concerned about. You have mentioned them already, but the threat of the virus distancinghe social which can if we are not careful lead to social isolation, and the economic effect. What we have learned from past disasters is those at greatest risk for adverse Mental Health consequences are those who face multiple threats from various sources. People who have lost their homes oneobs or lost a loved coupled with preexisting conditions, coupled with exposure to specific traumatic events. These are the folks who are most at risk. Ins most everybody in the u. S. Is exposed to at least three things, the virus threat, social distancing, and the economic impact, we can anticipate a tremendous demand. Your institute gives us recommendations and things to look out for, signs of stress include a worry about the health of your your own health or the health of loved ones, worsening of Chronic Health , increased usage of alcohol, tobacco, and other drugs. Does suicide factor in it all at this phase . Dr. Gordon suicide can factor into it. We are not yet able to measure whether there is an increase in suicide rates. A Later Development when we look at the time course of events or traumatic events after economic downturns. Sometimes it is not that substantial an increase in the suicide rates, but a shift towards the effect of the pandemic as increasing rates. Athink we are worried about potential increase in suicide, but we have not been able to measure it. Concernedare always that an increase in Mental Health risk factors and increase in Mental Illnesses that we can predict from the pandemic will eventually lead to increases in suicide rates. Suicide rates in the u. S. Are already high. We are preparing for that possibility and trying to get the word out to organizations, whether they are Health Care Organizations or federal agencies that this is something we need to watch for and have resources ready for and be able to rapidly expand Mental Health care access. Ant we have already had issue in this country with opioid abuse. Thateasurable increase in or concerns about increases as further data comes in . Dr. Gordon i would say it is the same as with suicide. We have reason to believe that there may be increases in rates in addiction. We have reasons to believe that may be leading to increases in overdose deaths. The data may not be coming in so rapidly. It takes a couple of weeks to months to be able to get that information. There is a special factor in regards to many Addiction Treatment regimes. Thef the mainstay most effective treatments for isstance use disorders facetoface treatment, including facetoface delivery of medication. Medication is the most effective way to combat opiate addiction. It is the most effective way to combat alcohol addiction and other addictions. Some of those medications require either daily or weekly observed therapies. Challenging when we are engaging social distancing. We are very concerned that many people who rely on these forms of treatment may have challenges obtaining them during the pandemic. I know my colleague of the National Institute of drug abuse is very active in terms of trying to make sure that those treatment programs are available and there are evidencebased ways of delivering the medication safely. Gordon is dr. Joshua joining us from the National Institute of Mental Health. Here to take your questions about Mental Health and issues related during the pandemic. For those of you in the eastern and central time zone 202 7488000. 202 7488001 in the mountain and pacific time zones. 202 7488002 if you are a Mental Health professional. In about 15 minutes we will go to the house of representatives for their pro forma session and continue on with our conversation with dr. Gordon on this topic. Of, you mentioned the idea telehealth and telemedicine. I read an article yesterday about apps offering those types of services. Would you put those in the same category of telemedicine or telehealth . Dr. Gordon they are within the category of what we might call Remote Health care delivery or assistance in delivering health care remotely. Digital apps have taken off in the last several years in the Mental Health space. While there is plenty of evidence they can be outstanding adjuncts to a Mental Health treatment delivered by professionals, there are a lot of concerns about many of the apps out there, not necessarily because we know much about them, but because we dont know a lot about them. There are a number of apps which are marketed as Mental Wellness apps that dont have to go through the usual fda testing for software as a medical device. The efficacy for this is unknown. Many of these apps collect information about those people who participate in using those apps. The uses of that information are not always made clear and if they are made clear they are varied as is often the case buried in a long disclaimer notice when you signup for use of the app. Individualsourage interested in using these apps to work with their Health Care Providers to find an app that has been tested and shown to be efficacious and treat the user information with the privacy that is deserve it of health care information. The fda does approve software as a medical device and there are some of Mental Health apps that have gained the fda seal. There are some minimal standards of efficacy that are required and you must adhere to some privacy rules. Recommend the fda supported apps and devices. Consumers can find information at various places on the web about apps in terms of which ones are approved and which ones are shown to be efficacious and which ones are treating their data with privacy. I encourage consumers to do the research but Health Care Providers can be a source of information on this. Prussia,g of pennsylvania, and Mental Health professional. Dr. Are on with joshua gordon. Caller yes, hello. Are you talking to linda . Host you are on with our guest. Caller i am a frequent viewer of cspan. I want to give a kind of recognition. Licensed professional counselor, i am a therapist. We have been working really hard. Itcaseload is as full as ever was because people need a lot. Different styles of therapy that are effective in general. One of my favorites is muscle relaxation and meditative breathing. I see that some Large Insurance Companies are doing 30 second spots on tv and other places. Sometimes it is good to get a sense of what the client wants. If i ask the doctor what kind of therapeutic intervention do you think is most helpful, thank you for the call. Dr. Gordon thank you, for the question and the reminder that there are many forms of treatment which can be useful to help individuals who are suffering in the context of the pandemic. The methods, especially to help with anxiety and worry can be meditative relaxation and either staying in the moment and or relaxation. Youpecially appreciate that point out that it is important to listen to your patients. The data on different kinds of psychosocial interventions is really interesting. There are some interventions that have been shown to be particularly efficacious for a particular variety of mental distress. For example, obsessivecompulsive disorder. There is one particular psychosocial intervention that has shown to be superior than even medication for ocd. For patients with ocd that is the standard of treatment, but not every patient can tolerate that form of therapy. That may be other things benefit some patients with ocd. With generalized anxiety or with depression there are several forms of therapy that have been proven to work and there is not good evidence of superiority of one over the other. We recommend that therapists use evidencebased therapy like the hot Cognitive Behavioral Therapy or supportive psych of supportive psychotherapy, interpersonal psychotherapy, its a good idea to discuss with the patient the requirements of these kinds of therapies and form a line with the patient informs of what they think might work fast. Eventsagain any clear that one is better than any other. Host alex in los angeles, california. Before i ask my question let me talk about a reminder. If you remember at the beginning of the coronavirus outbreak, [indiscernible] ownsnated and he everything behind the scenes who, how, and for what purpose has created through the virus to shake hands
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