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How New Mexico invested in mental health

Columbus resident Lievano Ramirez said the stress of isolating in his home and the uncertainty of living amid a pandemic affected his mental health.
Reyes Mata III
Columbus resident Lievano Ramirez said the stress of isolating in his home and the uncertainty of living amid a pandemic affected his mental health.

When Atanacia Salazar, a resident of Anthony, New Mexico, caught COVID, it didn’t just make her physically sick. A year later, she’s still struggling with the effects on her mental health. She was hospitalized, and remembers the moments where she believed she would die.

“I just remember a lot of people running around, the nurses, everyone. No one was answering me, they put me face down. I remember feeling very tired, like I could not breathe,” she said. “My breathing was getting faster and faster. I was asking God to help control my breathing because I could no longer do it.”

“Then slowly, bit by bit, my breathing started to get better. After a while, they placed me on my back again. The nurse that was there said that it looked like I had given up, like I just wanted to die. How could they think that?” Salazar asked, then she thought for a moment and added: “Yes, maybe at that time I did want to just give up, to just die, because it was so hard.”

The physical trauma remains, she said, including bone-chilling sensations from the slightest breeze since her recovery. But most troubling to her is the remaining emotional toll of COVID, she said.

“Right now, what is left of me is different from who I was before. The person I was before never wanted to be at home, never. I wanted to be out. I was very outgoing,” she said. “I don't know what happened to me. A part of me is so different now.” She is afraid of getting sick and of the uncertainty of the pandemic. But she also no longer enjoys the things she once did, and rarely feels like leaving the house – a common symptom of depression.

If you or a loved one in New Mexico is struggling with a mental health crisis, help is available. Call New Mexico Crisis and Access at 1-855-662-7474 (toll free). Not in crisis but still need to talk to someone? Call or text New Mexico Peer to Peer support at 1-855-466-7100 (toll free).

Jagdish Khubchandani, who was the lead author of a study published in the Journal of Public Health that tracked depression and anxiety during the pandemic[1] , is not surprised by symptoms like those exhibited by Salazar.

“Anyone who has had COVID, it affects your brain,” said Khubchandani. In addition to the possible impacts of the infection, there’s the persistent fear for yourself and those around you: Will you survive? Will you sicken others?

Khubchandani and others say the pandemic will stay with us for a long time to come, both in infections and the ongoing mental health impacts. Southern New Mexico is particularly vulnerable, due to its demographics, and leaders are working to ensure the region and state have the resources they need to support people still struggling with the psychological impacts of the past two and a half years.

A History of Underfunding

Years ago, when Khubchandani was attending medical school in India, he asked one of his supervisors why so many mental health facilities were understaffed and underfunded.

“The supervisor said no one wants to invest in mentally ill people. He said, ‘What does society gain by investing in them?’” he recalled.

Khubchandani, now a public health sciences professor in the College of Health and Social Services at New Mexico State University, said the anxious time of COVID has proved his former supervisor wrong: Supporting mental health facilities is, in fact, essential to society.

Before the pandemic about 20 percent of the world’s population, including Americans, had some diagnosable mental health problem, according to his research[2] . “But now in the United States we estimate from a fifth of the people, to at least a third of the people, have serious mental health problems. The rates of depression and anxiety have shot up,” said Khubchandani.

Even before the pandemic, economically disadvantaged states like New Mexico often struggled to provide adequate mental health care. But state officials say that, since the start of the pandemic, the state has invested more in mental health and substance abuse treatment.

“The state received an additional $16.4 million in federal pandemic aid through ARPA for mental health and substance abuse treatment services,” Charles Sallee, deputy director of the New Mexico Legislative Finance Committee, stated in an email.

He said that the legislature also increased state funds for behavioral health this past session through Medicaid and other pools of money, and implemented a requirement to “not to remove anyone from Medicaid,” which is the state’s biggest payor for mental health services[3] .

Other mental health funding includes:

  • $20 million to build out the network of providers for “evidence-based behavioral health and child welfare services”

  • $50 million appropriated by the state legislature to expand the teaching capacity at New Mexico State University and New Mexico Highlands University for increasing the number of graduates in social work

  • $8.7 million from the Community Mental Services Block Grant[4] 

  • $7.7 million from the Substance Abuse Prevention and Treatment Block Grant [5] 

A March 22 New Mexico Legislative Finance Committee report[6] reflects that a total of $49.1 million in federal pandemic stimulus funding was allocated for substance use and mental health grants in the state.

For people like Columbus resident Lievano Ramirez, mental health treatment proved essential to surviving the pandemic. Ramirez said the stress of isolating in his home and the uncertainty of living amid a pandemic troubled him every day.

Everyone in his house was sick, he recalled, and his wife and his sister-in-law were “in bed, looking like they were unconscious,” he said. “They would have wet towels on their heads because of the fevers, horrible fevers.”

The anxiety of catching COVID – and an unexpected bout with meningitis – finally overwhelmed him.

“They even put me in a psychiatric ward. It was very hard. They committed me because I was going crazy. All the craziness from COVID-19, staying inside the house, just having to stay there. I don't know what was going through my head.”

He stayed at a mental health facility for three weeks for his anxiety, he said.

“They gave me pills to help to rehabilitate me, and I got better and I was released. But it had a very strong impact on me, this whole pandemic.” He never caught the disease.

Researchers say that New Mexico’s demographics meant it was vulnerable to mental health impacts when the pandemic hit.

“We have seen in our research that people from lower-income households have been more likely to report negative mental health impacts” during the pandemic, said Nirmita Panchal, senior policy analyst with the Kaiser Family Foundation, a health policy think tank.

The southern region is poorer – with $7,000 less median income than the state average – and is less educated, with about eight percent less of its population having at least a bachelor’s degree than the state average.

The 13 southernmost counties of New Mexico are also nearly half Hispanic, according to the latest U.S. Census figures. A county-by-county analysis of U.S. Census data conducted by the Southern New Mexico Journalism Collaborative also shows that 12.7 percent of the 617,000 Southern New Mexico residents are immigrants, compared with 7.8 percent of the 1.4 million residents in Northern New Mexico.

Black and Hispanic communities have reported higher-level symptoms of anxiety and depression throughout the pandemic. This is also coming at a time when these communities have also experienced higher rates of COVID and COVID-related deaths,” Panchal said, and added that “the most recent data continues to show that Hispanic adults are more likely to report anxiety and depression compared to White adults[7] .”

With an unemployment rate of 5.3 – the nation’s second highest[8] – New Mexico is at a further disadvantage, Panchal said.

Even with the state’s recent investments in behavioral health, New Mexico is still struggling to build a mental health system that can adequately provide service for its population.

The 2021 New Mexico Health Care Workforce Committee Report, which was highlighted in June by Searchlight New Mexico[9] , shows that New Mexico’s mental health system has an average of only one independent psychotherapy provider for every thousand residents.

Unexpected Successes

Despite that, the people in the state surprised some experts during the trying times of COVID.

“We were at the bottom, ranked in terms of education, the economy and healthcare,” said Khubchandani. “And despite that, kudos to people of New Mexico who have shown so much resilience.”

He said that national indicators had prepared him to expect New Mexico to have been “the worst state for income, economy and health,” during the pandemic. “But that didn't happen … we are not the worst performers during COVID,” he said.

For example, the Federal Reserve Bank of Dallas, which maintains a database of economic indicators for Southern New Mexico, reports that the economy of Las Cruces – the region’s largest population center – expanded in its most recent reporting period[10] .

Two years into the pandemic, the report stated, “Las Cruces payrolls are completely recovered.”

The report also shows that multiple sectors have experienced net job gains, including trade, transportation and utilities at 490 jobs, leisure and hospitality with 335 jobs, manufacturing with 298, and education and health services with 80 net gain jobs.

The impact of mental health is sometimes beyond the measure of economic indicators. It’s the private stress within a family, engulfed in the seclusion of COVID isolation, and struggling to cope with the possibility of losing a loved one or leaving your family behind.

For Esau Salido, a 51-year-old Sunland Park resident who nearly died from COVID earlier this year, his mental health was at its worst when he realized his loved ones might have to cope with the hardship of losing his income, which sustained his entire family.

“I was thinking of my family, how would they make it with me gone?” he recalled. “If you are the head of the household, and you are not there, how will they survive? You know they will struggle,” he said in Spanish.

Salido said he never looked for professional mental health support.

That worries Khubchandani, but he also attributes New Mexico’s better-than-expected pandemic performance to its deep connectedness and community unity.

“Overall, New Mexico people have been less divided along religious, political and social beliefs. And that has helped a lot,” he said. “New Mexico just happens to be a nice part of the world where you don't see people fighting with each other much.”

He also cautioned that the need for that kind of community resilience – and mental health support – hasn’t faded.

“We are approaching another tough time. With gas prices, inflation and elections. It will not be an easy time for people in the United States, or worldwide this year,” he said.

In a society that undervalues mental health, he said the current emotional crises will continue to grow and more people will succumb to debilitating mental conditions like depression, anxiety, and drug dependency.

“Unless we have great global actions, people essentially have to take care of themselves,” he said. So what can people do? “People have to find ways to exercise, to eat healthy food, to disconnect from social media for some time, to have a positive routine – a healthy routine – and lie low as the storm comes and goes.”

https://academic.oup.com/jpubhealth/article/43/2/246/6078709

https://news.nmsu.edu/2021/02/nmsu-researcher-links-pandemic-to-skyrocketing-depression,-anxiety-rates.html

https://www.nmlegis.gov/Entity/LFC/Documents/Session_Publications/Post_Session_Fiscal_Reviews/April%202022.pdf

https://www.samhsa.gov/coronavirus

https://www.samhsa.gov/coronavirus

https://www.nmlegis.gov/Handouts/ALFC%20042722%20Item%203%20Federal%20Relief%20Funds%20Brief%20April%202022%20Final.pdf

The Implications of COVID-19 for Mental Health and Substance Use

https://www.bls.gov/web/laus/laumstrk.htm

https://searchlightnm.org/burned-out-ill-paid-overburdened/

https://www.dallasfed.org/research/indicators/snm/2022/snm2201

Reyes Mata III is a freelance Journalist working in southern New Mexico and the borderlands.