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National Children’s Dental Health Month highlights optimally fluoridated water

This year the February observance of National Children’s Dental Health Month honors the 75th anniversary of community water fluoridation with its theme, “Fluoride in water prevents cavities! Get it from the tap!”




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Addressing caries through the lens of social justice, health equity, human rights

It’s a conviction that was published in the November issue of The Journal of the American Dental Association and the basis for the October 2019 forum that Dr. Francisco Ramos-Gomez fostered, where dentists, physicians, nurses and public health and public policy experts proposed, discussed and recommended solutions for preventing early childhood caries through the lens of social justice, health equity and human rights.




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Indian Health Service honoring National Children’s Dental Health Month

The Indian Health Service is presenting a four-part series of messages focused on their younger patients’ oral heath in honor of the February observance of National Children’s Dental Health Month.




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HIPAA fee limitation no longer applies to third-party access to health records

Following a ruling in federal court two days prior, the Department of Health and Human Services announced Jan. 25 that the Health Insurance Portability and Accountability Act Privacy Rule fee limitations do not apply to requests to transmit copies of records to third-parties.




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Journal of Public Health Dentistry study finds association between man-made chemical, childhood caries

Circulating levels of perfluorodecanoic acid, a type of perfluoroalkyl acid, may be associated with dental caries in children, according to a study published in the fall 2019 issue of the Journal of Public Health Dentistry.




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World Oral Health Day calls for pledges to show unity

Pledge to celebrate World Oral Health Day on March 20 with the rest of the sphere.




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Indian Health Service, ADA collaborate on Give Kids A Smile for first time

It was a Give Kids A Smile event not only for the children of the Mississippi Band of Choctaw Indians but also no fewer than 117 Indian Health Service dental programs across 24 states that were participating in GKAS with the events alone estimated to involve 14,000 American Indian/Alaska Native children.




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March JADA finds past incarceration associated with oral health issues

Formerly incarcerated people in the U.S. have worse oral health outcomes than those who have never been in prison, according to a study published in the March issue of The Journal of the American Dental Association.




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American Institute of Dental Public Health mentors next generation of service-oriented dentists

Dr. David P. Cappelli, Ph.D., acknowledges that as providers, we don’t often understand difficulties that some patients face to receive needed dental care.




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Organized dentistry supports oral health literacy

The Organized Dentistry Coalition is applauding Congress for introducing legislation aimed at improving oral health literacy.




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New compendium summarizes best practices in oral health service delivery

Titled “Compendium of Innovations in Oral Health Service Delivery,” the 64-page digital booklet features organizations from across the country that have found success through varied measures in expanding oral care to underserved populations.




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HRSA updates FAQs for health centers during COVID-19

The Health Resources and Services Administration says it is working to keep health centers and health center program partners updated on the latest information regarding COVID-19.




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FDA alerts health care providers of EpiPen auto-injector errors

The U.S. Food and Drug Administration announced March 24 that it is alerting health care professionals, patients and caregivers of EpiPen autoinjector errors related to device malfunctions and user administration.




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ADA joins other health care organizations in appeal for more PPE, other supplies

The ADA and other health care organizations signed a public statement March 27 saying they “strongly” support emergency efforts at the federal level to dramatically increase the production and distribution of personal protective equipment (PPE) and other necessary medical equipment and supplies during the COVID-19 pandemic.




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Harvard dental student recipient of health literacy essay contest

An essay on community water fluoridation yielded a Harvard University dental student a first-place win in the annual American Dental Association’s Health Literacy in Dentistry essay contest.




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ADA asks Congress to ensure appropriate PPE for all health care workers

The ADA is calling on Congress to help ensure there is appropriate personal protective equipment available to all health care providers — including dentists — who continue to provide emergency care during the COVID-19 pandemic.




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Chicago Dental Society donates thousands of supplies to dental school clinic, health care facilities

The Chicago Dental Society and its members donated thousands of personal protective equipment to front-line health care workers in response to the COVID-19 pandemic.




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House of Representatives passes Paycheck Protection Program and Health Care Enhancement Act

The House of Representatives passed a new coronavirus relief bill April 23 that calls for additional funding for federal loan programs to help businesses nationwide, including dental practices, recover from the economic fallout of the pandemic.




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ADA asks FCC to include dentists in COVID-19 Telehealth Program

The ADA is asking the Federal Communications Commission to extend the agency’s COVID-19 Telehealth Program to include dental practices regardless of the practice’s size, location or for-profit status.




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Poverty, poorer health make some in the Bronx more vulnerable to COVID-19

New York City has been the epicenter of the COVID-19 outbreak in the United States, with immigrant populations in areas such as the Bronx "disproportionately" affected, a commentary in JAMA Internal Medicine says.




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Use of Antihyperglycemic Medications in U.S. Adults: An Analysis of the National Health and Nutrition Examination Survey

OBJECTIVE

1) To examine trends in the use of diabetes medications and 2) to determine whether physicians individualize diabetes treatment as recommended by the American Diabetes Association (ADA).

RESEARCH DESIGN AND METHODS

We conducted a retrospective, cross-sectional analysis of 2003–2016 National Health and Nutrition Examination Survey (NHANES) data. We included people ≥18 years who had ever been told they had diabetes, had an HbA1C >6.4%, or had a fasting plasma glucose >125 mg/dL. Pregnant women, and those aged <20 years receiving only insulin were excluded. We assessed trends in use of ADA’s seven preferred classes from 2003–2004 to 2015–2016. We also examined use by hypoglycemia risk (sulfonylureas, insulin, and meglitinides), weight effect (sulfonylureas, thiazolidinediones [TZDs], insulin, and meglitinides), cardiovascular benefit (canagliflozin, empagliflozin, and liraglutide), and cost (brand-name medications and insulin analogs).

RESULTS

The final sample included 6,323 patients. The proportion taking any medication increased from 58% in 2003–2004 to 67% in 2015–2016 (P < 0.001). Use of metformin and insulin analogs increased, while use of sulfonylureas, TZDs, and human insulin decreased. Following the 2012 ADA recommendation, the choice of drug did not vary significantly by older age, weight, or presence of cardiovascular disease. Patients with low HbA1C, or HbA1C <6%, and age ≥65 years were less likely to receive hypoglycemia-inducing medications, while older patients with comorbidities were more likely. Insurance, but not income, was associated with the use of higher-cost medications.

CONCLUSIONS

Following ADA recommendations, the use of metformin increased, but physicians generally did not individualize treatment according to patients’ characteristics. Substantial opportunities exist to improve pharmacologic management of diabetes.




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Clinical and Public Health Implications of 2019 Endocrine Society Guidelines for Diagnosis of Diabetes in Older Adults

OBJECTIVE

Screening for diabetes is typically done using hemoglobin A1c (HbA1c) or fasting plasma glucose (FPG). The 2019 Endocrine Society guidelines recommend further testing using an oral glucose tolerance test (OGTT) in older adults with prediabetic HbA1c or FPG. We evaluated the impact of this recommendation on diabetes prevalence, eligibility for glucose-lowering treatment, and estimated cost of implementation in a nationally representative sample.

RESEARCH DESIGN AND METHODS

We included 2,236 adults aged ≥65 years without known diabetes from the 2005–2016 National Health and Nutrition Examination Survey. Diabetes was defined using: 1) the Endocrine Society approach (HbA1c ≥6.5%, FPG ≥126 mg/dL, or 2-h plasma glucose ≥200 mg/dL among those with HbA1c 5.7–6.4% or FPG 100–125 mg/dL); and 2) a standard approach (HbA1c ≥6.5% or FPG ≥126 mg/dL). Treatment eligibility was defined using HbA1c cut points (≥7 to ≥9%). OGTT screening costs were estimated using Medicare fee schedules.

RESULTS

Diabetes prevalence was 15.7% (~5.0 million) using the Endocrine Society’s approach and 7.3% (~2.3 million) using the standard approach. Treatment eligibility ranged from 5.4 to 0.06% and 11.8–1.3% for diabetes cases identified through the Endocrine Society or standard approach, respectively. By definition, diabetes identified exclusively through the Endocrine Society approach had HbA11c <6.5% and would not be recommended for glucose-lowering treatment. Screening all older adults with prediabetic HbA1c/FPG (~18.3 million) with OGTT could cost between $737 million and $1.7 billion.

CONCLUSIONS

Adopting the 2019 Endocrine Society guidelines would substantially increase the number of older adults classified as having diabetes, require significant financial resources, but likely offer limited benefits.




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Dietary Manganese, Plasma Markers of Inflammation, and the Development of Type 2 Diabetes in Postmenopausal Women: Findings From the Womens Health Initiative

OBJECTIVE

To examine the association between manganese intake and the risk of type 2 diabetes in postmenopausal women and determine whether this association is mediated by circulating markers of inflammation.

RESEARCH DESIGN AND METHODS

We included 84,285 postmenopausal women without a history of diabetes from the national Women’s Health Initiative Observational Study (WHI-OS). Replication analysis was then conducted among 62,338 women who participated in the WHI-Clinical Trial (WHI-CT). Additionally, data from a case-control study of 3,749 women nested in the WHI-OS with information on biomarkers of inflammation and endothelial dysfunction were examined using mediation analysis to determine the relative contributions of these known biomarkers by which manganese affects type 2 diabetes risk.

RESULTS

Compared with the lowest quintile of energy-adjusted dietary manganese, WHI-OS participants in the highest quintile had a 30% lower risk of type 2 diabetes (hazard ratio [HR] 0.70 [95% CI 0.65, 0.76]). A consistent association was also confirmed in the WHI-CT (HR 0.79 [95% CI 0.73, 0.85]). In the nested case-control study, higher energy-adjusted dietary manganese was associated with lower circulating levels of inflammatory biomarkers that significantly mediated the association between dietary manganese and type 2 diabetes risk. Specifically, 19% and 12% of type 2 diabetes risk due to manganese were mediated through interleukin 6 and hs-CRP, respectively.

CONCLUSIONS

Higher intake of manganese was directly associated with a lower type 2 diabetes risk independent of known risk factors. This association may be partially mediated by inflammatory biomarkers.




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Predicting the Risk of Inpatient Hypoglycemia With Machine Learning Using Electronic Health Records

OBJECTIVE

We analyzed data from inpatients with diabetes admitted to a large university hospital to predict the risk of hypoglycemia through the use of machine learning algorithms.

RESEARCH DESIGN AND METHODS

Four years of data were extracted from a hospital electronic health record system. This included laboratory and point-of-care blood glucose (BG) values to identify biochemical and clinically significant hypoglycemic episodes (BG ≤3.9 and ≤2.9 mmol/L, respectively). We used patient demographics, administered medications, vital signs, laboratory results, and procedures performed during the hospital stays to inform the model. Two iterations of the data set included the doses of insulin administered and the past history of inpatient hypoglycemia. Eighteen different prediction models were compared using the area under the receiver operating characteristic curve (AUROC) through a 10-fold cross validation.

RESULTS

We analyzed data obtained from 17,658 inpatients with diabetes who underwent 32,758 admissions between July 2014 and August 2018. The predictive factors from the logistic regression model included people undergoing procedures, weight, type of diabetes, oxygen saturation level, use of medications (insulin, sulfonylurea, and metformin), and albumin levels. The machine learning model with the best performance was the XGBoost model (AUROC 0.96). This outperformed the logistic regression model, which had an AUROC of 0.75 for the estimation of the risk of clinically significant hypoglycemia.

CONCLUSIONS

Advanced machine learning models are superior to logistic regression models in predicting the risk of hypoglycemia in inpatients with diabetes. Trials of such models should be conducted in real time to evaluate their utility to reduce inpatient hypoglycemia.




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The Association of Energy and Macronutrient Intake at Dinner Versus Breakfast With Disease-Specific and All-Cause Mortality Among People With Diabetes: The U.S. National Health and Nutrition Examination Survey, 2003-2014

OBJECTIVE

This study aims to evaluate the association of energy and macronutrient intake at dinner versus breakfast with disease-specific and all-cause mortality in people with diabetes.

RESEARCH DESIGN AND METHODS

A total of 4,699 people with diabetes who enrolled in the National Health and Nutrition Examination Survey from 2003 to 2014 were recruited for this study. Energy and macronutrient intake was measured by a 24-h dietary recall. The differences () in energy and macronutrient intake between dinner and breakfast ( = dinner – breakfast) were categorized into quintiles. Death information was obtained from the National Death Index until 2015. Cox proportional hazards regression models were developed to evaluate the survival relationship between and diabetes, cardiovascular disease (CVD), and all-cause mortality.

RESULTS

Among the 4,699 participants, 913 deaths, including 269 deaths due to diabetes and 314 deaths due to CVD, were documented. After adjustment for potential confounders, compared with participants in the lowest quintile of in terms of total energy and protein, participants in the highest quintile were more likely to die due to diabetes (hazard ratio [HR]energy 1.92, 99% CI 1.08–3.42; HRprotein 1.92, 99% CI 1.06–3.49) and CVD (HRenergy 1.69, 99% CI 1.02–2.80; HRprotein 1.96, 99% CI 1.14–3.39). The highest quintile of total fat was related to CVD mortality (HR 1.67, 99% CI 1.01–2.76). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with 4% and 5% lower risk of diabetes (HR 0.96, 95% CI 0.94–0.98) and CVD (HR 0.95, 95% CI 0.93–0.97) mortality, respectively.

CONCLUSIONS

Higher intake of energy, total fat, and protein from dinner than breakfast was associated with greater diabetes, CVD, and all-cause mortality in people with diabetes.




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Podcast: Police Response to Quarantined Mental Health Crisis

What happens when the police are called to handle a mental health emergency? And is the current coronavirus pandemic affecting their response? In today’s podcast, Gabe interviews Sergeant Matt Harris,...




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[ Women's Health ] Open Question : Ovulation like discharge before period?

I have a 23 day cycle and around day 19 up until my period I produce a ovulation like discharge, it’s clear/ white and super stretchy. I don’t get this during the “ovulation” time frame, it tends to be thick and cloudy then. Why? And when am I ovulating?




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Psychological Trauma Is the Next Crisis for Coronavirus Health Workers

Hero worship alone doesn’t protect frontline clinicians from distress

-- Read more on ScientificAmerican.com




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The Color of Health Care: Diagnosing Bias in Doctors

Long before word recently broke that white referees in the National Basketball Association were calling fouls at a higher rate on black athletes than on white athletes, and long before studies found racial disparities in how black and white applicants get called for job interviews, researchers no...




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Latinos &amp; Immigrants in Kansas City Metro Area Face Higher Health Insurance Coverage Gaps, Even as They Represent Fast-Growing Share of Workforce

WASHINGTON — Latinos and immigrants are at least twice as likely to lack health insurance coverage as the overall population in three central Kansas City metro counties, a new Migration Policy Institute (MPI) study reveals. In fact, they are four times as likely to be uninsured in Johnson County, Kansas. 




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As U.S. Health Care System Sags under Strain of Pandemic, Immigrants and Refugees with Degrees in Health Care Could Serve as an Important Resource

WASHINGTON – Even as 1.5 million immigrants and refugees are already employed in the U.S. health care system as doctors, registered nurses and pharmacists, another 263,000 foreign-born health care graduates are on the sidelines during the COVID-19 pandemic—many of them because of difficulties getting their credentials accepted by employers and licensing bodies.




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As Millions Are Pushed from Jobs amid Pandemic, the Loss of Employer Health Coverage &amp; Limited Access to Public Coverage for Many Immigrants Hold Major Implications for Them – and U.S. Overall

WASHINGTON – As more than 33 million U.S. workers have lost their jobs since March amid the pandemic-induced economic crisis, immigrants are among the most vulnerable: They are more likely than the U.S. born to be laid off and to live in communities with high COVID-19 infection rates, and less likely to have health insurance coverage and access to a doctor or other usual source of health care.




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COVID-19 in Latin America: Tackling Health Care &amp; Other Impacts for Vulnerable Migrant Populations

This MPI webinar brought together public health and migration experts to analyze the impact that COVID-19 preventative measures will have on vulnerable immigrants and refugees in Latin America, with a particular look at Colombia as a case study. Speakers also discussed how policymakers and international organizations can include migrant populations in their emergency response plans.




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COVID-19 in Latin America: Tackling Health Care &amp; Other Impacts for Vulnerable Migrant Populations

This MPI webinar brought together public health and migration experts to analyze the impact that COVID-19 preventative measures will have on vulnerable immigrants and refugees in Colombia and Latin America. Speakers also discussed how policymakers and international organizations can include migrant populations in their emergency response plans.




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Mental Health Risks and Resilience among Somali and Bhutanese Refugee Parents

Somali and Bhutanese refugees are two of the largest groups recently resettled in the United States and Canada. This report examines factors that might promote or undermine the mental health and overall well-being of children of these refugees, with regard to factors such as past exposure to trauma, parental mental health, educational attainment, social support, and discrimination.




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The Nutritional Health of Young Refugee Children Resettling in Washington State

Refugee children are vulnerable to health and nutrition risks that can have long-term consequences for their development and well-being. This report examines the prevalence of malnutrition—from stunting and wasting to overweight and obesity—among refugee children from birth to age 10, using data from an overseas medical screening exam before they were resettled in Washington State between 2012 and 2014.




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Health Insurance Test for Green-Card Applicants Could Sharply Cut Future U.S. Legal Immigration

A new Trump administration action requiring intending immigrants to prove they can purchase eligible health insurance within 30 days of arrival has the potential to block fully 65 percent of those who apply for a green card from abroad, MPI estimates.




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Health Insurance Coverage of Immigrants and Latinos in the Kansas City Metro Area

Latinos and immigrants are at least twice as likely to lack health insurance coverage as the overall population in the Kansas City metropolitan area. This gap that has significant implications for the region, as Latinos and immigrants will form an ever-growing share of the area’s labor force and tax base amid anticipated declines in the native-born, non-Latino population.




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Barriers to COVID-19 Testing and Treatment: Immigrants without Health Coverage in the United States

As millions of U.S. workers lose jobs and the health insurance associated with them, Medicaid and similar programs are increasingly important for people seeking COVID-19 testing and treatment. Yet many low-income uninsured noncitizens, including green-card holders, are excluded from such programs because of their immigration status, as this fact sheet explores.




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Health Care Transition in Adolescents and Young Adults With Diabetes

Michael E. Bowen
Jun 1, 2010; 28:99-106
Feature Articles




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Diabetes Self-Management in a Community Health Center: Improving Health Behaviors and Clinical Outcomes for Underserved Patients

Daren Anderson
Jan 1, 2008; 26:22-27
Bridges to Excellence




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4 Ways Therapists Assist People with Mental Health Issues

One of the primary reasons people seek therapy is to get help with mental health issues. Some of the more common mental disorders affecting individuals today include depression, anxiety, post traumatic stress (PTSD), phobias, addiction, and attention deficit hyperactivity (ADHD). Depending on the type and intensity of your issue, your therapist may adjust his treatment […]




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How health workers are responding to the COVID-19 pandemic | Esther Choo

The coronavirus pandemic is unlike anything we've ever seen in health care, says emergency physician Esther Choo. Sharing insights into how health workers are responding to the outbreak, she explains what makes this public health emergency different from others -- and provides a few simple things you can do to help. Watch to the end to hear about Choo's work deploying mobile ICUs across the United States as hospitals start to reach capacity. (This virtual conversation is part of the TED Connects series, hosted by current affairs curator Whitney Pennington Rodgers and head of curation Helen Walters. Recorded April 7, 2020)




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An evolutionary perspective on human health and disease | Lara Durgavich

How does your genetic inheritance, culture and history influence your health? Biological anthropologist Lara Durgavich discusses the field of evolutionary medicine as a gateway to understanding the quirks of human biology -- including why a genetic mutation can sometimes have beneficial effects -- and emphasizes how unraveling your own evolutionary past could glean insights into your current and future health.




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The mental health benefits of storytelling for health care workers | Laurel Braitman

Health care workers are under more stress than ever before. How can they protect their mental health while handling new and complex pressures? TED Fellow Laurel Braitman shows how writing and sharing personal stories helps physicians, nurses, medical students and other health professionals connect more meaningfully with themselves and others -- and make their emotional well-being a priority.







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How Do Films Like ‘Joker’ Shape Attitudes Towards People With Mental Health Issues?

By Emily Reynolds. Study finds viewers had slightly more negative perceptions of people with mental illness after seeing the movie.




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Schools Struggle to Meet Students' Mounting Mental-Health Needs

Keeping up with students’ growing mental-health needs was a concern for districts long before the pandemic began. It’s even harder now, educators and psychologists say.