Mental health of young people worries experts as COVID-19 continues to grip Colorado

State’s mental health crisis hotline sees 30% increase in calls and texts since pandemic started

Dulce Trujillo, whose depression has worsened since the coronavirus pandemic began, stands for a portrait on a break from her job at McDonalds in Salida, Colo. She's worked there for four years now, saving money to attend college after serving a Mormon mission, but the pandemic has derailed and threatened those plans. (Eli Imadali for Colorado Newsline)

It’s been a “roller-coaster” couple of months for Dulce Trujillo as she’s tried her best to adjust to the reality of the coronavirus pandemic. 

For years, the 18-year-old from Salida has navigated depression and struggled with suicidal thoughts. When the pandemic hit, she already felt isolated from her friends after spending the first semester of her senior year in Mexico teaching English. 

After graduating in May from the Horizons Exploratory Academy, an alternative high school in Salida, she planned on embarking on a mission trip with her church before attending college. But the coronavirus pandemic sidelined her plans. She’s now trying to envision what her future looks like. “It’s just really hard sometimes. I find myself thinking about it while I’m on my break at work,” said Trujillo, who works full-time at McDonald’s, about dealing with the uncertainty and weight of the pandemic. 

“And I’ll just be like, ‘OK, so I’m supposed to help try to solve the world’s racism and flatten the curve on this pandemic,” she said. “And also go to college and figure out how to be a positive person in this world? It’s all just really overwhelming if I think about it like that.”

Dulce Trujillo’s work nametag, adorned with a hand-drawn smiley face and a piece of candy. (Eli Imadali for Colorado Newsline)

The coronavirus pandemic is impacting younger Coloradans in unprecedented ways. The crisis has led to the reimagining of the state’s education system. It’s turned daily routines upside down, led to skyrocketing stress levels among youth and put future plans on pause. The sweeping changes to day-to-day life have experts worried about the mental health impacts now and into the future.

“When parents are stressed, kiddos are stressed, too,” said Camille Harding, director of community behavioral health in Colorado’s Department of Human Services. “Parents and caregivers are feeling particularly strained by COVID. And then on top of that, thinking about the upcoming school year. Everything is just very unclear.”

Harding, who was a child and adolescent therapist for 15 years before joining the Office of Behavioral Health, said her staff has seen a 30% increase since the pandemic started in the number of calls and texts coming into Colorado Crisis Services, the state’s crisis hotline.

Harding said the coronavirus pandemic, and the social isolation that has come with it, has taken a unique toll on the mental health of younger Coloradans. She said she’s been hearing from providers and hospital systems that more adolescents are ending up in emergency rooms for substance use and mental health concerns. “We don’t have a lot of concrete data on that yet … but that’s certainly concerning,” she added.

Scott A. Simpson, director of Psychiatric Emergency Services at Denver Health Medical Center, said his center has not seen an increase in behavioral health visits among youth and adolescents but that it’s difficult to gauge because many patients coming to the emergency department for anxiety also present with somatic complaints, like pain. 

“So the actual volume changes are likely difficult to detect,” said Simpson, in an email, adding that there has been an increase in poison control cases, which includes substance abuse.

Simpson said the closing of school-based health centers has been a challenge because they are typically the most common partner for outpatient behavioral health. “With kids being out of school, I think this will be a challenge,” he added.

Pre-COVID mental health already appeared to be in decline

Dulce Trujillo stands for a portrait on a break from her job at McDonald’s in Salida, Colo., on July 18, 2020. (Eli Imadali for Colorado Newsline)

In 2019, 15.3% of Coloradans reported poor mental health, compared with 11.8% in 2017, according to a survey by the Colorado Health Institute. Though the increase could signal worsening mental health, it could also be pointing to an increased willingness to talk about it and to seek help.

Prior to the pandemic, Harding’s office launched the “Below the Surface” campaign to help teens get support from the state’s suicide prevention hotline. During the first year of the statewide campaign, the hotline answered 236% more texts from youth than the previous year. Launched in 2018, the campaign aims to raise teens’ awareness of Colorado’s Crisis Text Line — a free, confidential text line that connects youth with trained counselors any time of the day. To reach a councilor, you can text “TALK” to 38255.

Trujillo is one of approximately 40 student leaders for the campaign. In this role, she’s helped educate her peers and spread awareness about the campaign and the mental health resources that are available. She said she got involved because she wanted to be an ally for other people with depression and to learn how to identify warning signs for suicide. 

Marisa Westbrook, a part-time instructor at the University of Colorado Denver, said she can see the toll the pandemic is taking on her students’ mental health. She’s currently teaching an undergraduate summer course.

“I feel like the things I’m hearing from my students, and the things that they are experiencing, are a microcosm of what we’re seeing as a larger society and community,” said Westbrook, who is a Ph.D. student in health and behavioral sciences at CU Denver. “We are seeing a lot of students who are struggling.”

She said some of her students are having to take care of parents who have lost their jobs or are sick with the coronavirus. Others are caring for younger siblings who are out of school while having to work full-time to help make ends meet.

“And those scenarios are not necessarily new scenarios for many families and students, but they’re far more intense now than they were before,” Westbrook said.

Dulce Trujillo shows her rings, the one at left from Ireland and the one at right from Mexico, in Salida, Colo. Since looking forward has been difficult during the pandemic, Trujillo says she’s found comfort in looking back at her Mexican and Irish heritage. (Eli Imadali for Colorado Newsline)

With many schools going remote in the fall, Harding is working with the Department of Psychiatry at the University of Colorado and Colorado Children’s Hospital to find new ways to support parents and students during these unprecedented times. Details are pending, but Harding said her department and other partners are brainstorming a webinar to help parents assess what is best for their family’s well-being and health when it comes to going back to school.

“We are in discussions on how we can best support parents during this time,” Harding said. “… Because when parents are stressed, that trickles down.”

For Trujillo, the first few weeks of the pandemic were the hardest. “I have a big family, and we’re Hispanic, so our culture is very much, like, we’re all up in each other’s faces all the time,” she said.

“And now I feel this super strong need to get away from home and my parents,” said Trujillo. “Which is really hard for me right now, because how am I supposed to plan a future and figure out how to support myself financially and emotionally in the middle of a global crisis?” 

After a month in quarantine, she said her mental health started to decline. “I started using marijuana again, which I’ve used periodically throughout my teenage years, and it affects my mental health poorly,” she said.

In the last few months, she said she’s found comfort in connecting with her heritage. “I’ve been reaching back a lot and trying to connect to my ancestry, as a way to contribute to the BLM movement, too,” Trujillo, who is half Mexican and Irish, said in a text. “I’ve been working on healing my own generational trauma and helping others to do the same.”

Nature of school safety hotline tips change during COVID-19

A person holds a phone with the Colorado Safe2Tell mobile app pulled up on July 16, 2020. Earlier this month, Gov. Jared Polis signed a bill into law that allows Safe2Tell reports related to mental health or substance use to be directed to Colorado’s statewide crisis response system instead of law enforcement. (Moe Clark/Colorado Newsline)

Colorado’s Safe2Tell program — the state’s anonymous school safety hotline — received 689 tips throughout June, according to the program’s monthly report, a 2% increase compared to the same month in 2019. Typically, the number of calls and text decline during the summer months. But they’ve remained relatively steady this year.

Typically, suicide threats, drug use and in-person bullying are the top categories reported to the Safe2Tell hotline, according to Essi Ellis, the director of the Safe2Tell program, which is run out of the Colorado attorney general’s office. But during the coronavirus pandemic, welfare checks and cyberbullying also elevated to the top of the list. 

In June, the hotline received 133 reports of suicide threats, 48 tips that required welfare checks and 43 related to cyberbullying. Between Aug. 1, 2019, and June 30, the Safe2Tell program has received a total of 20,249 tips related to school safety.

Earlier this month, Gov. Jared Polis signed a bill into law that allows Safe2Tell reports related to mental health or substance use to be directed to Colorado’s statewide crisis response system instead of law enforcement. This will help direct resources faster and more efficiently, say mental health advocates.

“We are pretty excited about that,” Harding said. “… We want to make sure that we’re really digging in and tailoring services to children and adolescents and thinking about the type of response that’s best when someone is in distress.”