COVID-19 exacerbates Wayne County's top health problems

WOOSTER — The coronavirus proved the most critical health issue in 2020. It also exacerbated existing community health issues, such as mental health, drug abuse and child abuse and neglect.

The Wayne County Community Health Assessment 2020, released in late December, identified mental health, cancer and child abuse/neglect as the most important “health problems” cited by residents in a survey of the community taken in April, May and June of 2019. More than 500 residents participated in the survey and key informant interviews.

The survey showed 65% identified mental health as a critical health problem. The pandemic only made that problem worse with many seeking help for the first time in their lives.

“At the close of the pandemic, more people are needing treatment than ever more because it’s been a really tough time,” said Judy Wortham Wood, executive director of the Mental Health & Recovery Board of Wayne & Holmes Counties. “We are at a peak, a peak need. … It’s a traumatic event and trauma relates to mental health and addiction.”

One positive identified in the survey was the decrease in the ratio of providers per individual in Wayne County between 2015 and 2020. The bigger cause of concern was the lack of prescribers, mental health professionals who could prescribe medications to clients. It’s an issue already being addressed with positive results.

In 2019, the average number of individuals on the wait-list to see a prescriber was 99 and the average number of children on the list was 6.2. The wait-list now stands at 12 individuals and zero children.

“That’s never been true in our community,” Wood said of the low waiting list. “We’ve done an excellent job recruiting additional child psychologists.”

Wayne County boasts one full-time board-certified psychiatrist for adults, two part-time board-certified pediatric psychiatrist and two advance practice nurses with a specialty in psychiatry who can prescribe medications.

The Counseling Center of Wayne and Holmes Counties is the primary contractor for psychiatrists in the area. Catholic Charities Wayne County also has a part-time psychiatrist who serves the youth population.

The social service agencies work together to find residents the help they need. By calling any of the mental health agencies in Wayne County, representatives will direct callers to the right provider. The Counseling Center also offers a 24/7 crisis hotline at 330-264-9029.

About 20% of respondents listed suicide as one of the most important health problems. Wayne County saw its highest number of suicides dating back to 2002 in 2019 with 20, doubling the number of suicides just a year earlier. Data from Jan. 14, shows the number of suicides dropped back to 13 in 2020.

The health report also tied Adverse Childhood Experiences (ACEs) to future mental health and addiction issues. These stressful or traumatic childhood experiences, such as abuse, neglect or forms of household dysfunction, are a common pathway to social, emotional and cognitive impairments that lead to increased risk of unhealthy behaviors, violence or revictimization, disease, disability and premature mortality.

Wayne County’s rate of two or more Adverse Childhood Experiences is 26.8%, higher than the state average of 25.1% and other surrounding counties. Respondents showed a greater awareness of child abuse and neglect in the community with 34% identifying it as a major health problem.

Deanna Nichols-Stika, director of Wayne County Children Services, hasn’t seen much change in the way of data relating to child abuse/neglect in the area, but she is hearing more people talking about the issue.

“Things going on in the nation or at the state and local level. They have a personal experience or know someone that’s been personally affected in some way. It’s brought greater awareness,” Nichols-Stika said.

The county agency had seen the number of intake calls climbing since 2015, reaching a peak of 1,010 in 2019. The number sunk back into the 800 range in 2020.

“It was very much impacted by the pandemic,” Nichols-Stika said. “When the pandemic first hit, Wayne County saw its child abuse and neglect reports decrease by 50%. Our average was a 27% decrease. Then we rebounded.”

The overall decrease was due to a significant drop in March, April and May when children were kept out of school buildings where many of the reports are generated. By the summer months, the average number of reports was nearly identical to previous years.

“Wayne County persevered so well,” Nichols-Stika said. “Our community awareness, people were taking care of family, friends and neighbors. Checking in with them throughout the pandemic. The local impact was not as great as some of our peer communities.”

The greater awareness of child abuse/neglect by survey respondents came as a bit of a surprise to Nichols-Stika and Wayne County Health Commissioner Nick Cascarelli. The Children Services director wasn’t on the steering committee when the process began, but when they received the survey results, Cascarelli quickly called in Nichols-Stika.

“People are becoming more aware of the needs of children and families,” Nichols-Stika said. “I think the impact of addiction has brought about more awareness and its impact on children and families.”

In 2018, 110 children were placed into custody with Wayne County Children Services. The main reasons for the removal of children from their homes included dependency (34%, no one available to provide for the child’s care or supervision), neglect (16%, child not receiving proper care or supervision) and abuse (11%, physical and sexual).

The community survey feedback addressed a need for more parent/caregiver programs, and Nichols-Stika said the community needs to help families find their natural supports such as other family members, friends or neighbors. People who can provide day care or parent support that can lead to the prevention of a child’s removal.

She also sees help on the horizon with the recently approved Family First Prevention Services Act, a major child welfare reform initiative.

“It’s a change from reactive to proactive. We’ll be able to do more prevention efforts than ever in the history of child welfare,” Nichols-Stika said. “How do we prevent removal? We prevent the need for removal. … Our system has never been able to draw down federal funding for prevention efforts. We’ve always had to respond to what has happened.”

Survey respondents also identified cancer as the second most important health problem in Wayne County. Cancer is the second-leading cause of death in Wayne County exceeded only by heart disease. The death rate of cancer in the county is 163.6, which is lower than the state but higher than the Healthy People 2020 goal of 161.4, according to the assessment.

The three most prevalent cancers in Wayne County since 1996 are breast cancer (2,196 cases), lung and bronchus cancer (1,775 cases) and prostate cancer (1,519 cases).

The Wayne County Health Department delayed the release of the survey due to the pandemic, according to Cascarelli. The improvement planning steering committee chose to wait and see what health impacts would occur as a result of the pandemic, but as the crisis wore on, the decision was made to release the findings.

Two community health issues identified because of the pandemic include communicable disease control, which is directly linked to the pandemic, and overdoses, which increased with the advent of the pandemic, according to the assessment.

Reach Emily at 330-287-1632 or emorgan@the-daily-record.com

On Twitter: @mogie242