- Lafayette Lens.

Minding Mental Health.

A special presentation by PBS 39 and Lafayette College - Things that used to make me happy were not making me happy anymore.

- I couldn't be my normal 20-year-old self trying to explore, trying to find my way.

- One of the best things we can do to get rid of the stigma around mental illness is simply to talk about it.

- Even before Covid-19 Americans faced a mental health crisis.

More than one in four adults in 2019 had a diagnosable mental disorder, according to the Johns Hopkins School of Medicine.

That increased by 40% during the 2020 pandemic.

Hello, I'm Taylor Madeiros.

- And I'm Callie Wortmann.

Welcome to Lafayette Lens.

We're coming to you from the PPL Public Media Center in Bethlehem, Pennsylvania.

Lafayette Lens is a partnership between PBS39 and Lafayette College's policy studies program, where students address real world issues and problems.

- During the 2021 spring semester, the staff at PBS39 worked with our class to collaborate on this project.

- My classmates and I decided to examine mental health, looking deeply into types of disorders, exploring the causes, and hearing from experts on promising treatments and remedies.

- We found wide gaps in access to mental health care as Americans of all ages confronted dual epidemics.

Epidemics intensified by coronavirus lockdowns, isolation, and disruptions in daily life.

It was a crisis affecting millions well before we've even heard of Covid-19.

Each of us set out to tell a story.

What lessons have we learned to guide a path forward?

What solutions are out there to help?

We begin with something that caused a seismic shift in culture and the way we communicate, how social media is affecting the mental health of young users.

- It's all around us, about 70% of people in the United States have a social media account.

By 2023, the number of expected social media users in America is estimated to top 257 million.

What would you say your average screentime daily is?

- Four to six hours, depending on how boring the day is.

- Probably right around seven to eight.

And, you know, it really depends.

Maybe on a weekend, it could be more.

- How much of that time do you feel is spent on social media such as Instagram, Twitter, Facebook?

- At least half.

- I spend about two hours a day on social media.

- I'm on social media a lot.

My friends call me Mark Zuckerberg, just because I'm on there so much.

- Did you see an increase in screen time during the pandemic?

- Not being able to see friends as much, you spend more time just on your phone.

- And would you consider the level of phone usage to be addicting?

- Not necessarily addicting, but there are times when I find myself using it when it's really inconvenient.

- Just the nature of having something in your hand, having something to always look at, having short bursts of content right in front of your face.

- It's no surprise that social media and screen time usage is on the rise among young people.

The pandemic has only added to it and poses potential concern about the lasting effects on mental health and well-being.

- Understanding the full effects of social media use in young people isn't easy.

But some studies suggest only a small percentage of adolescents face significant short-term and long-term mental health effects.

It's a growing focus of monitoring and study.

- While social media can be an effective resource to promote awareness of mental health, there are drawbacks, too.

It can paint false realities and spread misinformation that takes a toll on overall mental health.

Cameron Rogers is a Lafayette College graduate whose FreckledFoodie account on Instagram has 53,000 followers.

- My mission across all of my different platforms is to make healthy living approachable and to reassure you that, no matter the emotion you are feeling, you are not alone.

I do that by creating what I would like to think and what I'm told is approachable, honest and realistic content.

- Early on, Rogers' account focused on food and wellness.

- The more I share, the more I realize that a lot of people were going through similar things.

And I was getting all these messages like, "I thought I was so alone.

"You saying this makes me feel less alone.

"I feel seen."

So, my content has definitely evolved over the past especially two years, to focus way more on mental health and just making that a large topic of conversation.

A lot of people have faced mental health struggles this year that they never have before, whether that's because there's an overwhelming level of anxiety and unknown in the universe right now, or because you're spending more time isolated and with your own thoughts.

- Do you think that social media is a good place to talk about mental health, or does the whole concept of Instagram, Facebook, etc, Twitter only add to people's insecurities?

- For me, I find that it's created a space for an incredibly supportive and wonderful community, and for me to interact with amazing people that I would have never had the opportunity to interact with, and to share my story and connect with people, and hopefully help people.

That's what I am aiming to do, and what I aim to do every day.

- The overuse of social media may come at a cost, but it has also become a powerful tool for awareness and mental health.

- We are a user, it's an addiction.

But you really decide whose content you want to consume.

And so, really focusing on consuming people's content that makes you feel better about yourself and more encouraged, instead of worse or less-than.

- From Lafayette Lens, this is Callie Wortmann and Taylor Madeiros reporting.

All of us by now know the signs and symptoms of Covid-19.

But could it cause biological changes?

Ryan Mangini has this look at how the virus may affect the brain.

- Covid-19 is most commonly associated with respiratory illnesses like pneumonia that can cause lung complications.

And we know that SARS-CoV-2 can enter the brain through the blood supply in the lymphatic system, or through transfer by cells of the peripheral nervous system.

But is there a biological link between Covid-19 and brain disorders?

Chris Flores is vice president of neuroscience at Janssen Pharmaceutical companies of Johnson & Johnson.

He and his team are studying how the coronavirus that causes Covid-19 affects the brain.

- What happens once SARS-CoV-2 enters the brain is much less clear.

There's some evidence that it is able to indirectly affect brain cells or directly infect brain cells, including some but not all neurons, as well as glial cells, which are involved in the maintenance and function of nerve cells.

However, it is still somewhat controversial how this occurs.

- He says it could lead to neurological and/or psychological diseases in the brain.

There is a difference.

Neurology involves the structure and function of the nervous system.

Psychology refers to the mental, emotional, and behavioral expressions of the nervous system.

While we often think of them as being distinct, Flores says that the two are inextricably linked.

- One type of disease may lead to another.

So, I think it's important we start thinking of the nervous system in a more holistic sense, in the same way that we are realizing that the mind and the body are, in a way, inseparable.

What's also very interesting is that neuropsychiatric patients that can contract Covid-19 have a significantly worse prognosis, so the effects can go both ways.

- According to Flores, the effects from Covid-19 can be serious and include headaches, seizures, cognitive reduction, confusion, and also smell.

Viral infections also can cause blood clots and strokes that lead to nerve death and brain damage.

For evidence that the brain can experience biological changes, look no farther than our first responders, whose mental health has been put to the test and who have witnessed firsthand the tremendous sickness and death caused by the virus.

- This has had a serious impact on their psychological well-being.

Not only is this distressing acutely each time it occurs, but the repetitive negative impact on mental health from anxiety, depression, insomnia, etc, can have a significant, longer-lasting effect that bear many of the hallmarks of PTSD, or post-traumatic stress disorder.

Interestingly, some of these same conditions, such as PTSD and depression, have been observed in survivors of other coronaviruses such as SARS and MERS.

- Flores notes that changes in our social behavior, like isolation at home or constant Zoom meetings for work, are taking a toll on mental health.

- These are all added stresses of having to live our lives completely differently than we used to.

Indeed, our collective resilience is being tested in unprecedented ways.

And so, careful attention to our personal health and well-being, in terms of sleep and diet, and medical care and our social interactions, has never been more important.

- There is still much to be learned about how the virus affects the brain.

This much is clear.

Just like it attacks the lungs, Covid-19 can have an impact on our neurological and psychological health, as well.

For Lafayette Lens, this is Ryan Mangini reporting.

- Losing a job is never easy.

A person's whole world can be turned upside down.

Financial hardships, yes.

But have you ever considered the toll it can take on one's mental health?

Troy Fisher reports.

- From 2016 to the beginning of 2020, the United States had its lowest rates of unemployment in over two decades.

The pandemic and other factors changed that.

Unemployment skyrocketed.

Gladstone Hutchinson has witnessed the devastating effects of joblessness firsthand.

The economics professor at Lafayette College has seen it in his study and work in places such as Baltimore and Appalachia.

- We are in Baltimore after the Freddie Gray situation in 2015, and their continued decline where people are choosing to leave, where the population has fallen from one million to 600,000 over a 20-year period, because of people's sense that they are not able to achieve the kind of prosperous life, the life of dignity, the life of community wealth they would like, or they don't see them having the ability to exercise agency in transforming their circumstance.

- Hutchinson leads Lafayette's Economic Empowerment and Global Learning Project, a community redevelopment initiative.

He's seen it time and time again, how joblessness and economic despair can destroy personal agency, limiting a person's ability to influence their own outcomes and taking a toll on mental health.

- There's no mental health without agency.

What do I mean by this?

OK, we all grew up and we have heard the story of the fox who tries to get the grapes, and the fox can't get the grape, and the fox says the grape is sour.

Anyway, you have given up on the ability to pursue something because it is out of reach.

What does that have to do with mental health?

Well, if you have a poverty of food, then a child cannot learn because the child's intellectual bandwidth spends all of its days trying to search for food or imagine finding food.

So, they can't ever hear a teacher, they can't ever read a note.

- What is your main role whenever you come into these communities?

Like, how do you help?

- So it's a long answer to say we don't help.

We don't do paternalism, we don't do clientelism.

We are bringing our currency of our intellect and our commitment to buy our learned development, and they got to make sure that they get a fair return.

- He points to Appalshop, a non-profit arts and education center in eastern Kentucky.

It was founded over 50 years ago as a way to fight the war on poverty by providing vocational training in film.

Participants were able to document their lives and tell their own stories.

- It turns out that all of these stories that they had been making, these documentary films, their music, when we did the simple exercise of what you would do for an interlibrary loan to try and trace a book, and we put in the Appalachia copyright, and we looked.

We saw thousands and thousands, and thousands of things that they had created.

being held all over the world.

In Scotland, where they have coal mines, in Poland, where they have coal mines and are dealing with the same fly ash and big companies.

Everywhere that they had these crises, people are buying these things.

And that actually gave Appalachia an incredible confidence to know that their work was so valued.

- Today, Appalshop is an engine for community arts, operating a filmmaking institute and community development program in Whitesburg, Kentucky.

Hutchinson stresses the importance of agency, action that has become a great force for personal well-being and mental health.

He says those who have lost work can't lose hope.

- You can't build anything of value on hopelessness.

- From Lafayette Lens, I'm Troy Fisher.

- Next up are Alex Petrie and Nick Ross.

They found college students willing to share how the pandemic took them to places they didn't expect.

- Three college kids, one familiar struggle.

Like many amid the Covid-19 pandemic, these students had thought they'd never had and feelings they'd never felt.

- I consider myself to be a pretty positive person, you know, prior to the pandemic.

But, you know, just the stress you get from being cooped up indoors, you know, spending a lot more time alone.

There's also the fear of, like, contracting the virus and worrying about the safety of your friends and family.

And then, there's also like a lack of motivation to do your academic work.

You know, all those things add up and, you know, at some point, you start feeling a certain way, and then, you're like, "OK, yeah, this is different."

You know, "I'm feeling anxious.

I'm feeling stress."

And you probably feel like, "OK, that might be symptoms of depression.

- There was this estrangement and a lack of integration into my social communities and social groups.

That kind of led me to feeling kind of alone and isolated, and maybe even in my own head at some times.

- I knew that I needed to seek help when, for example, the things that used to make me happy were not making me happy anymore.

- Help doesn't necessarily mean you have to go to, like, a psychotherapist or a therapist.

You can consult your friends, you can talk to someone that you feel very close to.

- Dr. Lillian Tidler is medical director of psychiatric services in Arlington County, Virginia.

She says distinguishing between normal emotions and something more serious can be difficult.

- If you're not feeling quite right, if something in your gut is telling you, nagging you that this has gone on for too long, or, "I don't feel like this is something I should ignore."

- Dr. Tiddler suggests there are signs to be on the lookout for.

- We don't want to over-pathologize.

We don't want to say that normal reactions to stressful situations are illness.

It can be very natural for people to have a wide range of emotions.

If you see somebody whose use of substances is increasing, there are changes in their energy level, sleep patterns, a lot of negative thinking, blaming themselves, they're not worth anything, those two can be significant warning signs.

- Just adjusting is probably the biggest way that I have, my new perspectives out of this, and just always going forward and never really worrying about what's in front of you, just tackling it.

- I think you can find happiness in those people right around you.

Whether that was my family originally, once the pandemic hit, and then, coming back to campus with my roommates, I found the most control and happiness in the people right around me.

- For me, I think it created a whole new meaning to the term, the phrase "fishing in troubled waters," where it's a situation where, you know, in the midst of chaos, there is an opportunity for people to thrive.

- For Lafayette Lens, this is Alex Petri with Nick Ross reporting.

- College life can be stressful enough.

Shane Davis has more on students trying to cope.

- Isolation was, like, the first time that you're away from friends, you just kind of walk to the one place.

- It's a group that's suffered and faced anxiety or depression as much as any in the pandemic.

College students.

82% have dealt with anxiety, and 63% have battled depression because of Covid-19, according to a study by the Jed Foundation, a nonprofit that specializes in mental health of young people.

- The beginning of the pandemic really inspired me to go back to therapy.

It's just been such a strange time, to be 20 years old and be told to just stay in your house alone, when you're so used to socializing, being around people.

- Pracheta Trivedi is a licensed professional counselor and owner of Penn Counseling in Easton.

She's seen the mental strain firsthand.

- Having worked with college students in the past, working with college students currently, as a practitioner, I can feel and see the differences in what's happening.

- For the first time, I really thought about how my mental health was, and am I OK?

Like, not even just me, but like people around me started thinking about their mental health.

It really put a magnifying glass on mental health this year.

- I'm a very active person, so I like to explore and do a lot of different things.

And, you know, like everyone in the pandemic, you weren't really allowed to do that.

So, I felt very alone.

- Trivedi says it wasn't one thing.

A combination of factors contributed to the fears and anxieties of college students.

- A lot of students perhaps don't have the best home situations, aren't going back to environments that are healthy.

And so, college at times could have been a respite for many of them, a place for them to explore not only who they are, but their identity, make new friends, create these lasting relationships.

And that suddenly was taken away and told, "OK, now go home and deal."

And I think that, just from the get-go was very hard for a lot of students that I know.

- These Lafayette College students shared about the toll the last year has taken on their mental health.

- Our generation, you know, like, there's so much to focus on.

Like you were saying, Shane, with the normal college stress and what's going on after graduation.

And now, like, you don't even know if there's going to be a pandemic after graduation.

And like, trying to find internships, like, are they going to be in-person, or are they going to be online?

Like, can you find internships?

And, you know, can you talk to your friends before they go off into the world?

- I would say our age group took a significant blow from the pandemic, just from social to jobs, to trying to get a good education.

Because, as much as they do work to make Zoom classes good, it's still never going to be the same as being in person, as much as a job interview tries to make a Zoom interview OK.

It's never be the same as going and shaking a hand.

- Trivedi says the challenges of college students are reflected across the country.

It's important, she said, that they get the help and resources they need and realize that there is light at the end of the tunnel.

- There are a lot of students who are really struggling to juggle all of that.

So, I give them a lot of credit, because they're making it work, and they're doing the best that they can.

- For Lafayette Lens, I'm Shane Davis reporting.

- In our next segment, Huslen Dashpurev examines how culture and gender have influenced specific mental disorder and how treatment for it has evolved.

- Hysteria is defined in the Cambridge dictionary as "extreme emotion that cannot be controlled".

Some common symptoms include crazy, frenzied and mad.

However, the word has a more perverse connotation than many may realize, according to William Bissell, a professor of anthropology at Lafayette College.

- It comes from the Greek word for "womb," that is histeria.

And so, it is linked to notions of female physiology going back for a very long time.

So, it might be one of the oldest kinds of medical diagnoses.

Certainly up until the time of Freud in the 19th century, it was exclusively associated with women.

So, gender was obviously a very clear and compelling component from the beginning.

- Pinning down exactly what hysteria is and how it presents itself is difficult because of its abstract nature.

However, there is a common thread among those who were historically diagnosed and how.

- Hysteria is one of those kinds of "conditions", quote-unquote, that is difficult to put your fingers around.

It's often diagnosed in the sense of people who were seen as not conforming to regular, or normative kinds of functionality.

- Some examples of such people were witches and shamans, both of whom have long histories of being persecuted and ostracized.

We should also note, too, that for much of its history, this is not women in positions of power and medical authority looking at other women and diagnosing a condition.

So, who is discoursing about a condition?

Who has the power and perspective?

So, it is really key here.

- Hysteria is not just a relic of the past.

Its effects are still being felt today in what many suggest demonstrates a deep gender bias.

Susan Wenze is a professor of psychology at Lafayette College.

- There's all sorts of research in the medical field, for example, showing that, like, women's pain is less believed and less likely to be treated than men's pains.

They're actually like real, sort of, life-threatening repercussions to this kind of background idea that women's pain is, sort of, not real, or imagined, or exaggerated.

All of those things are true for women in general.

They are especially true for women of color.

- This dismissiveness not only present itself in the medical field, but in our day-to-day interactions, as well.

- In popular discourse, we often see women as being linked to their hormonal cycles in ways that we don't apply to men, even though men are equally hormonal kinds of creatures.

So, there's still that kind of lingering notion about women's physiology being somehow different and problematic.

- Many women, you know, probably will recognize the experience of being told to "calm down", right, if they get upset about something, or if they get angry, in a way that men maybe not, you know, are not as often experiencing.

We anticipate women are going to be more emotional.

And at the same time, we dismiss, you know, we may sometimes dismiss, like, real reasons for getting upset, particularly when women are the ones who are getting upset.

- Hysteria was removed from the Diagnostic and Statistical Manual of Mental Disorders in 1980.

It was replaced by "conversion disorder", a term coined by Sigmund Freud.

- This is a disease that has lasted for something like 4,000 years with different iterations.

There are all sorts of ways, I think, over that long history, we can see how notions of hysteria are linked to social, cultural, and historical conditions at the time.

- From Lafayette Lens, I'm Huslen Dashpurev reporting.

- Thank you, Huslen.

That was a specific example of a disorder, but when it comes to mental health, all sorts of misconceptions are out.

Rheya Jain explains.

- Mental health is a complicated topic.

And, like anything complex, there are misconceptions.

One is that people with mental health issues are always unpredictable, or even violent.

Dr. Shannon Stirman is a Stanford professor, and is on the board of directors for the American Psychology Association.

- The idea that people with mental health problems or mental health diagnoses are violent or unpredictable is really incorrect.

And in fact, people with severe mental illness are much more likely to be the victims of crime than they are to be the perpetrators.

- She says the association with violence or volatility hurts people suffering from mental illnesses.

- I think it can really affect the way the people interact with individuals with mental health diagnoses, that they might be treated differently or excluded in some ways from a lot of things that people typically enjoy in society, including employment opportunities, social opportunities, and social support.

- A second misconception is that people with mental illnesses can feel better if they just try hard enough.

- There are a lot of factors that contribute to a person's mental health.

And so, really making a change to experience relief from mental health problems and challenges often means addressing a number of factors.

It's a little more complex than just willing yourself out of it.

- Dr. Stirman says that some mental illness such as anxiety, depression, and PTSD can last a very long time.

- There's really a range, and it depends on the issue.

Depression tends to be cyclical.

PTSD tends to be longer-term if it's not treated.

And anxiety similarly can kind of increase and decrease depending on situations that people are in.

- Dr. Stirman says improving mental health requires putting in the work.

- I think a lot of times, we're sort of taught that you can think your way out of problems.

The reality is that, although the treatments do involve working to change some different patterns, some different building-up coping skills.

- According to the Mayo Clinic, for most types of therapies, treatment takes 3-4 months before a patient starts to feel relief.

Another misconception is that therapy is less effective than medicine.

- Part of it depends on the diagnosis.

But there have been studies comparing treatments for depression to medications that have found them to be of similar benefits.

And the combined treatments for more severe depression can be somewhat better.

A lot of the studies show that that some of the psychotherapies can be just as effective as medications.

There's been more of a legitimacy to the idea that mental health problems need to be treated, and that they can be treated.

And for some people, that's been very helpful to understand that there is there's sort of a physical connection to what they are experiencing psychologically.

And that's also led to people being encouraged to take medications that can help.

- According to the National Institute of Health, the success rate for psychotherapy alone is 80%, while the success rate for medication alone is 13%.

- From Lafayette Lens, I'm Rheya Jain reporting.

- Anxiety and depression are among the most common mental health diagnoses.

Student reporter Alex Mathis found the pandemic only added to that.

- In the first half of 2019, 11% of Americans experienced symptoms of depression or anxiety.

By December of last year, according to the Journal of the American Medical Association, that number had grown to 42%.

- With the increase in anxiety, the depression, and stress, have you had a greater number of patients since the start of the pandemic?

- I have had an increase in patients.

And it's possible it is from the pandemic because, you know, like I said, it did create stress.

- Remote work and learning, isolation, losing the ability to spend time with family and friends, all can contribute to the most common recurring symptoms.

- Anxiety comes from uncertainty, right?

Uncertainty about, you know... Well, you know, there was uncertainty related to, were kids going back to school?

What was their schedule going to look like?

So, you know, any time there's a change, then there's other changes that come with that change.

- According to the Journal of the American Medical Association, people with lower incomes and who worked for small businesses were at greater risk of depression.

In your opinion, do you think that the stress has become more severe or less severe for those patients who have younger children at home?

- Thinking back to just in general, back to May, when we went into lockdown, people didn't know if their kids were going back to school.

You know, like there was more uncertainty where I think, I'm guessing, and this is just my personal opinion, but once schools went back or decided what they were going to do, some of that uncertainty decreased, and then, they adapted to it.

- With states around the country slowly reopening, what do you think is the biggest obstacle right now in order to...or facing the population and, kind of, getting over this pandemic, depression, anxiety, stress issue?

- We're all going to be different after this.

I mean, everybody's life has been impacted.

The impact is different on everybody.

It's going to take longer for some of us to work through what happened than others.

- With more vaccinations being given and fewer reported infections, the worst of the pandemic may be behind us.

Covid-19 restrictions are being lifted, but the pandemic's impact on mental health could be felt for a long time.

- From Lafayette Lens, I'm Alex Mathis reporting.

- If you're in need of help and want to talk, the National Suicide Prevention Lifeline is staffed 24/7.

Once again, the number is... - We continue this special presentation of Lafayette Lens, a collaboration between PBS39 and the Lafayette College Policy Studies Program.

Our focus this semester, mental health.

- Kids weren't considered high risk for Covid-19, but perhaps no group has felt the effects of the pandemic more.

Holden King and Katie Parnell spoke with a middle school counselor to learn more.

- By the end of the school year, this was a typical day for Ramon Rodriguez.

For much of the past year-and-a-half, though, it has been a different story.

- Last year at this time, when we shut down, our job mainly was just to make sure the kids had what they need, making sure that they were safe, making sure that they were able to log in, making sure they were stable enough at home to stay in a good routine.

And it was tough.

It was very hard.

- Rodriguez is a guidance counselor at Northeast Middle School in Bethlehem.

Remote and hybrid learning has affected more than students.

Teachers and counselors have felt it, too.

- Our mental health is affected because we worry so much about their mental health.

Just knowing how the struggle is and how the adjustment has been on them, two days a week is not enough for these kids.

I mean, we have kids that, when they come to school, this is their safe haven.

This is where they feel most comfortable.

This is where they're most productive.

The hardest part has been making sure these kids can stay on task at home, because there are a lot of kids that are by themselves, sixth graders by themselves at home.

Some have younger siblings that are doing this online stuff at home.

So, it can be very chaotic.

- Students in Bethlehem elementary schools returned to in-person classes four days a week in mid-April.

Middle school and high school students attend two days a week.

According to a Gallup poll, 45% of parents have reported declining mental health in their children since the pandemic began.

- Do kids struggle?

Absolutely.

But are kids successful?

Well, definitely.

I have kids that are straight A's online, but then, there are kids that, you know, especially our IEP students or learning support students who need that extra support.

I mean, they don't get that at home.

So, those kids are going to struggle.

- Plans are being made for a full return to all schools in the fall.

At least, that's the hope.

- We know that our students struggle.

We know that our kids need to be in school five days a week.

They don't have the normal middle school experience as if it were a normal schedule.

But, you know, I tell you what, our kids are resilient.

They adapted, they accommodated.

- Rodriguez says the school district has enlisted outside resources to help his students.

- St. Luke's is a big piece to this puzzle.

We also have different services that offer family therapy.

We have a program called Project Success, which is a mentorship program, we have a person come in, and she handles about 10-15 kids, and just making sure that they're on track.

They have what they need.

We have online tutoring.

We have more students that offer online tutoring for some of these kids, academic help, which kids log in via Zoom.

We also have our homework club here after school to a select few of the kids that have taken advantage of, you know, just stay up on other things.

From Lafayette Lens, this is Katharine Parnell and Holding King reporting.

- With more on the pandemic's toll on young people and mental health, here are Caleb Burr and Jesse Whittman with this story from the Lafayette College campus.

- The mental health of college students has taken a hit during the global pandemic.

Students' lives and independence suddenly were put on hold.

- We sat down with students and faculty from Lafayette College to get their accounts on how Covid-19 affected them.

- Definitely being home and not being at school had a big effect on my mental health.

And just worrying about, like, health concerns.

- I was afraid to even go out of my house when I was really down, I felt very alone.

Kind of, how I described it is I was in a room alone, and it was all black.

And, you know, there's a window and you can see everybody else, but they can't see you, and you can't even open the window.

- Just exhausted, like emotionally, mentally, and physically, just from my anxiety.

- And I couldn't be my normal 20-year-old self, trying to explore, trying to find my way in this world.

And that was very, very hard for me.

- These students were not alone in their feelings of isolation and struggle.

- Professor John Shaw is a psychology professor at Lafayette College.

- Dr. Julie Amato is a school sports psychologist.

Both are well-versed in the importance of mental health, and have witnessed students' struggles during this public health crisis.

- And I've noticed that the pandemic has had just an unbelievably devastating effect on many students, not just students with mental health issues, but all students.

I've noticed that students are more depressed, they're more anxious, and they're just plain sadder than they used to be during this.

I notice a lot of sadness.

- Yeah, I think this global pandemic has done a number on all of us in some ways, with respect to our mental health and wellness.

You know, we're dealing with a tremendous amount of uncertainty.

And so, the beginning stages and impact has been around grief, grief and loss.

- In spite of the difficulties, many have found healthy ways to guide themselves through the storm.

- I found myself talking to my friends, being like, "OK, I feel this way, too," or just talking to my parents and just like letting people know how I feel because then they can help.

- I knew I needed to step away from my work, and then, do things I really enjoyed and really loved.

- We wanted to know more about coping mechanisms to help students, so we asked for advice.

- This is something that's totally new for so many of us.

But, you know, we as psychologists are used to helping people through grief and through loss.

So, some of this is just around teaching self-compassion.

- Let me start with something that seems obvious, but is really important.

And that is engaging in healthy behaviors.

I'm talking about eating well, getting lots of sleep, getting exercise.

- The pandemic has led to a disruption in connection with people, so we're really trying to encourage our athletes to stay as connected as possible.

It's really important to establish and maintain social relationships.

It gives you an opportunity to make the human connections that we need so much.

It also gives people an opportunity to talk about what's bothering them.

- Student athletes have the added burden of their seasons disrupted or cut short.

- A lot of the coaches here, and myself included, have really pushed athletes to use this time to be introspective, to write or journal about their experience.

You know, it's helped them to really examine their non-negotiables, like, what are the things that are really important in your life?

- Another thing is doing something fun.

And I'm going to put this under the broad umbrella of-self care.

We're all tending to be too hard on ourselves.

And I'm this way, too, none of us are perfect.

We have to give ourselves some breathing room.

We can't expect perfection of ourselves or from anybody else.

- The pandemic has had a devastating effect on life for young people, but it has also cultivated resiliency and growth, something these students wanted to make clear.

- I feel like I really looked inward on myself and my mental health.

When I feel myself starting to get really anxious or, like, starting to get really emotionally tired, just finding ways or tools that I can use to, like, help myself.

- It taught me a lot about myself and how to be a stronger individual.

- Also, the conversation around mental health, like, definitely like picked up during the pandemic, because so many people were struggling with their mental health.

- It's OK if you're struggling.

Trust me, it's OK.

It's important to ask for help.

It's important to go get those resources.

Even if you're at a really low point in your life, it's very temporary.

-The students' main message, we can grow from our struggles to become stronger versions of ourselves.

- From Lafayette Lens, we are Jesse Whittman and Caleb Burr reporting.

- Another hard-hit group, those already battling addiction.

Here's Logan Kunz with the challenges faced at one Lehigh Valley Recovery Center.

- The Covid-19 pandemic's effect on mental health is widespread, especially on those already prone to mental illness.

According to county drug death data, drug overdoses have risen around 19% in the Lehigh Valley since the pandemic began, and coronavirus restrictions across Pennsylvania have limited the effects of addiction recovery centers.

Kevin O'Connor is the director of Change on Third Street, an addiction recovery clinic in Houston.

- The whole sense of isolation and the whole sense of social disruption, a lot more people went through behavioral distress.

More and more addicts were suffering.

The number of overdoses were growing.

- Betsy Martellucci is with Mid-Atlantic Rehabilitation Services, a drug and alcohol rehab center in Bethlehem that provides treatment options.

- In our treatment, we haven't seen a decrease in our numbers, but we've seen an incredible increase in disengagement.

So, people signing up for services and not following through or not feeling connected.

So, while we're getting a lot of referrals, our biggest challenge has been really getting people linked into treatment, feeling connected and supported.

Also, this constant cycle of people not really being able to connect and get the support that they need.

- The magic of recovery, as we know it, is just two drunks or two addicts, keeping each other sober one day at a time.

So, what happens here is we host 30 meetings or so a week, and that enables people to make individual personal contact.

- Taking small daily steps are an important part of Change on Third Street's recovery process.

- In the 12-step recovery programs, you know, when somebody comes into a meeting for the first time, they get a 24-hour coin or tag, or some memento to remind them that you only have to quit one day at a time.

And over the last two weeks, I've run out of 24-hour tokens.

- O'Connor says the scale of addiction problems remain great as difficulties with the recovery efforts in the pandemic persist.

- We've been able to do it for the last several months, and it's been remarkable.

I mean, we've, you know, we probably host 16 or 1,700 meeting attendees a quarter.

- Treatment providers say the goal is to take some of the lessons of the pandemic and incorporate them into treatment options used long after the pandemic ends.

- My hope is that we'll be able to really expand on some of those hybrid experiences, being able to access, provide access of service to people that don't have the capacity or ability, or motivation to come in.

- From Lafayette Lens, I'm Logan Kunz reporting.

- When it comes to treating mental health, resources may be limited.

But there is help right here in the Lehigh Valley.

Andrew Schukraft has that story.

- Bethlehem shop owner Kate Fetzer has faced mental health challenges for years.

The Covid-19 pandemic added to the strain.

- As a person with a diagnosis living in recovery, I have a certain formula that I've developed over the years of the things that keep me well.

And some of those things on that list have been compromised, one of which is socialization.

- Last June, a CDC study found 40% of Americans had at least one adverse mental or behavioral condition related to the pandemic.

Maggie Murphy is executive director of the Lehigh Valley branch of NAMI, the National Alliance on Mental Illness.

- I think that statistic is pretty consistent with what we're seeing here in the Valley.

Certainly calls to my office have increased, and not only has the volume of calls increased, but the complexity of issues that people are facing as a result of Covid-19 and the impact on their mental health.

- The pandemic has placed an emphasis and a greater awareness on mental illness.

- There is certainly less stigma with respect to anxiety and depression.

Definitely.

I think... And through no fault of one's own, if they've never had a close experience with it, it's hard to understand.

I don't wish that this is the way that people became aware that they were having these feelings themselves.

But that's what we're living in right now.

- Softening the stigma also has come as celebrities such as Olympic swimmer Michael Phelps have shared their own struggles with mental health.

- One of the best things we can do to get rid of the stigma around mental illness is simply to talk about it, so that people understand that this is something that can affect anyone, any age group, any demographic group you can think of.

They're experiencing mental health issues.

- In the Lehigh Valley, addressing mental health comes in many forms.

- The first are support groups, and we have those both for individuals who are living with mental illness, and for their family members.

And, since the start of the pandemic, we've switched all our services to online on Zoom.

- Murphy says providing resources is a collaborative effort.

Information and services can be found on the NAMI website at... - We're lucky in the Lehigh Valley, because we have a number of really wonderful agencies that are providing a variety of services, from help with employment to housing, to all of the other issues that can be impacted by mental illness.

- Murphy says, despite the attention, access to mental health professionals remains limited.

- Unfortunately, access wasn't good even before Covid hit, and now, it's even tougher.

We have a shortage of mental health professionals across the spectrum, psychiatrists, psychologists, social workers, counselors, peer providers.

We just need more.

- Despite the lack of mental health professionals in the medical field, Murphy left us with an important note regarding resources and their effectiveness.

- There are so many good treatments these days that can be really effective.

And at NAMI, we believe that the most effective treatment is holistic in the sense that it brings in a number of different things, may or may not include medication, counseling, physical wellness, things like meditation and journaling are helpful.

- Kate Fetzer has been there.

She's grateful for NAMI's help, and she has a clear message for anyone who's struggling.

- Reach out.

Tell somebody.

Tell somebody, please.

Even if at first, you can only bear to tell your best friends or a neighbor that you're close with, or call a crisis line or a warm line.

Tell a stranger who's trained to help you with these feelings because that keeps them from going to a darker place, is to talk about these feelings and bring them out into the light.

And the sooner people are treated, statistically, the better outcomes are had with recovery, - From Lafayette Lens, I'm Andrew Schukraft reporting.

- There's one place where getting mental health treatment is especially difficult, in our nation's prisons.

Nicholas Davatzes explores this issue.

- The pandemic has sparked a national conversation on mental health and the insufficient resources dedicated to it.

For advocates of the imprisoned, it's a discussion they say is long overdue.

- Approximately 15-20% of people who are incarcerated do suffer from mental health issues.

- Su Ming Yeh is the executive director of the Pennsylvania Institutional Law Project, a nonprofit group that monitors conditions and advocates for the state's imprisoned.

Is there a PA baseline policy on mental health services in prison?

And if so, what is required?

The answer is yes and no.

There is a baseline based on the US Constitution.

The Constitution provides that everyone who is incarcerated is entitled to proper and adequate medical care and mental health care.

However, there are no specific rules or regulations that say you must get, you know, meet with the psychiatrist twice a week or anything along those lines.

- About 47,000 men and women are incarcerated in the state prison system, thousands more are in county jails.

The proportion of those with mental illness is greater inside than on the outside.

- This, of course, is a huge challenge for prisons and jails, but also for the people who are incarcerated because prison is really a terrible place to be if you do have mental illness.

- For years, studies have suggested a worsening mental health crisis behind bars.

A Bureau of Justice Statistics report from the last decade showed 26% of people in jails and 14% in prison experienced serious psychological distress in the past 30 days.

On the outside, that rate was 4%.

- At the heart, it stems to inadequate treatment and support out in the community.

And then, what we do is we will blame people for their actions, when in fact, it's actually a manifestation of their psychiatric disability.

So, rather than having compassion and offering the support and treatment that's required, instead, we criminalize certain behaviors, blame that individual and, as a result, they unfortunately end up in the criminal legal system and, at the worst, incarcerated.

- The Pennsylvania Institutional Law Project is calling for more than greater investment in mental health resources, it seeks a culture and policy shift regarding the approach to and goals of incarceration.

Alexandra Morgan-Kurtz is the project's managing editor.

- There's a lot that's said out in society about prison is to rehabilitate people, and this and that.

When you're actually on the ground in the prisons and jails, the reaction you get from basically anything that happens is going to be punishment, discipline, and ramping that up.

There is not a focus on rehabilitating someone.

There's always this recognition of you're here because you did something and, because you did something, I don't have to care about what you say.

- The Pennsylvania Institutional Law Project stresses the importance of preventative measures, instead of reactionary ones.

- Admittedly, it might be difficult to provide those services, but it is really critical because that's the only way we are going to be able to support those who are in greatest need.

Almost everyone who enters prison or jail is going to come out, and they are going to be coming back to our community, our society.

It's in our best interest, as well as the most humane thing to do, to provide the adequate mental health care for those who are incarcerated.

From Lafayette Lens, I'm Nicholas Davatzes reporting.

- More and more, psychologists are treating mental illness with a focus on the trauma behind it.

But what is trauma, and how can it affect the brain?

Here's Pooja Kumar.

- Trauma doesn't have to be life-altering.

According to the National Institute of Mental Health, half of all people in the US will experience a diagnosable trauma.

Cecilia Rodriguez is a trauma therapist for Questa Health Center in Albuquerque, New Mexico.

- The broadest definition is exposure to violence, whether it's a war, an accident, abandonment, domestic violence, neglect and childhood physical, emotional, and sexual abuse.

Like, if you grew up in poverty, if you grew up being subjected to racism and discrimination, you're more likely to suffer trauma.

It can also be migration, for example, or incarceration that causes the trauma.

And, as long as there's violence in the culture, there will be trauma.

- Mental health researchers say that many mental illnesses, such as anxiety and depression, are responses to trauma.

It's the brain's way of coping, of adapting to protect us.

- The most common denominator of people who've gone through trauma, they don't feel safe.

So they can't relax.

They can't open themselves to an experience.

It's very difficult for them to enter new situations and interact with new people.

- These symptoms of trauma often manifest as mental illnesses, and that makes them susceptible to mistreatment, according to researchers.

Trauma therapy focuses on what causes the illness, rather than symptoms.

Rodriguez says trauma-oriented therapy can help patients get better faster.

- When you first interview the person, you don't automatically have them relive the trauma.

Deep breathing or other techniques, being gentle and being... Compassionate is a big factor in helping someone who's having difficulty with the trauma, getting them to feel like they're masters of their emotions.

- According to recent research, mistreatment comes in using medication as the only way to treat mental illness, rather than focusing on the root causes.

A study by the World Health Organization showed that in Third World countries, where medications are not widely available, recovery rates are actually higher because medication is not the focus of treatment.

Rodriguez suggests medication does help to alleviate some symptoms of many mental illnesses, but it should not be the end of treatment.

- And so, therapists need to have different tools to approach it.

And they also need to meet the person where they're at.

Then you've got to deal with what's upfront, and then, work your way backward.

- She says that people who have experienced trauma can get better.

- Yes, you can recover to the point where it doesn't intrude or disrupt your life.

And second, you do need to continue to take care of yourself.

- From Lafayette Lens, I'm Pooja Kumar reporting.

- Companies are increasingly monitoring employee mental health, and they're using technology to do it.

Rich Magnus has a story of one company doing both, and how they're helping others along the way.

- The Trevor Project is a national organization that serves at-risk LGBTQ youth.

When it needed help improving its mental health hotline, it turned to Twilio, a Cloud communications company.

The change led to a 22% increase in crisis contacts in the first six months.

- And, when they switched each of the conversations that they were having ten minutes faster.

And ten minutes faster, when people are on really the brink of self-harm, means all the difference.

- Erin Reilly is Twilio's chief social impact officer.

Based in San Francisco, the company is seeing greater demand on the mental health front, an area that relies heavily on communication to remedy crisis situations.

- There is such an increase in demand for mental health support right now.

And what Twilio technology can really do is help with scalability, which is basically reaching more people, but also helping to reach those people in the ways that they are really used to communicating.

- Riley says social impact is deeply ingrained in the company's culture.

That includes ensuring their own workforce has the mental health resources they need.

- During this time of Covid, the mental health crisis affects everybody, including Twilio employees.

And we have found a couple of things have been really essential to help employees right now.

One is we rolled out free counseling that's confidential, and services for employees who need mental health support, emotional support.

- Twilio helps connect companies and organizations through all sorts of communications.

Whether it's text, voice, video, or WhatsApp, its technology touches more than 250 million people a year.

- We want to make sure that our technology is even more accessible to those organizations that are taking on some of the biggest challenges.

- Twilio is supporting global Covid-19 vaccine distribution with ten million in grants, and the company says its social impact arm, Twilio.org, has helped 6,000 nonprofits.

Nonprofits like The Trevor Project that provide crisis intervention and suicide prevention services.

- At Twilio, we are seeing over and over that the right communication at the right time can really change a person's life.

And so, to be able to provide the technology that could get people the type of support they need right when they need it, was not only an opportunity, but our responsibility to help when we possibly could.

- From Lafayette Lens, I'm Rich Magnus reporting.

- That's our look at mental health as we enter a post-pandemic world.

For Lafayette Lens, I'm Taylor Madeiros.

- And I'm Callie Wortmann.

On behalf of Professor Mark Crane, the policy studies program at Lafayette College, and our partners at PBS39, thank you for joining us.