Addressing Mental Health as the ‘Next Wave’ of the COVID-19 Pandemic

STAUNTON—By now, many in the Staunton-Augusta-Waynesboro region have read this article citing Dr. Sandro Galea, the dean of Boston University’s School of Public Health, and his warning that mental illness will be the “next wave” of the COVID-19 pandemic. At ARROW, we have been asked about how to address concerns in the SAW region to prevent, or at least mitigate, the effects that persistent and pervasive social isolation may have on our individual and collective mental health.

For the sake of answering this question, we must note that we have to be careful about the words we use here, mainly because of our scope of cultural competence. Pandemic is a global term, literally. To speak competently about avoiding a mental health pandemic would require speaking to a wide range of researchers and providers who are knowledgeable and experienced with the nuances related to mental health in other cultures and regions of the world. What we can speak meaningfully about, however, is how to address the already occurring mental health epidemic in our community, how COVID-19 has exacerbated it, and what can be done now to address these concerns.

Inquiring minds in our community have known for a long time now that poor mental health is a major concern for residents of the SAW region. The 2019 Community Health Needs Assessment (CHNA), conducted by Augusta Health, reported the following:

• 7% of respondents reported “fair to poor” mental health in the region, nearly 5% higher than the national average, and nearly double what was reported in the 2016 CHNA.
• Incidents of depression is higher than the national average and nearly doubled in the region since 2016.
• Suicide deaths per 100,000 residents in the SAW region is 18.6. The national average is 13.6
• Nearly Two thirds of respondents named mental health as a “major problem” in the region, with access to affordable care and providers listed as the top two concerns.

These figures quantified what we collectively sensed from our time providing intensive in-home counseling to at-risk children and families.

The systemic stressors that COVID-19 has placed on our community at the individual and collective levels are almost certain to exacerbate these problems. Not only has the economy suffered terribly and left countless residents out of work, but the supportive services that helped families manage day-to-day demands have also closed. These include, of course, public and private schools and religious institutions, which provide services that are often associated with protecting mental health and quality of life. The closures of these institutions has been enough to create chaos in most, if not all, local families with the loss of built-in daily structure alone.

When you add the closures of the Staunton and Waynesboro YMCAs, Boys and Girls Clubs, daycare providers, the Valley Program for Aging Services (VPAS), the Wilson Workforce and Rehabilitation Center, local libraries, and many more, you have a recipe for community disintegration. It should also be noted that home is not a safe place for many in our society, and if children in abusive or neglectful households or victims of domestic violence are ordered to stay home, the well-known negative mental impacts of these experiences are likely to only worsen.

The programs and organizations listed above serve to help us meet two of our most basic psychological needs: the need for a sense of belonging and for having positive impact on the world around us. When these needs are left chronically unmet, our stress-response systems become persistently activated and we begin to notice changes like:

• Fear and worry about your own health and the health of your loved ones;
• Feelings of grief and anger in response to the death or possible death of a loved one;
• Changes in sleep or eating patterns;
• Difficulty sleeping or concentrating;
• Worsening of chronic health problems;
• Worsening capacity for adjusting to change;
• Decreased kindness to self and others;
• Increased use of alcohol, tobacco, or other drugs (usually in attempt to manage stress).

So the question for local providers becomes: what can we do to mitigate the negative effects on our social and mental health?

Two things come to mind that can and need to be addressed: access and stigma. Fortunately, many providers in the SAW region have had the flexibility and good sense to provide telemental health services. Telemental health is counseling, assessment, psychiatric medication management, and any other mental health service delivered through technology that allows the provider and client to be in different locations while working together. Telemental health can be provided in a way that complies with federal privacy law through the telephone, text message, e-mail, or video conference. The following link includes a fairly comprehensive list of providers who are accepting new clients and providing telemental health for residents of the SAW region and surrounding areas.

https://docs.google.com/document/d/1HpKRpTumfkXF8bU4z7PdhQLg9avZwuwXH6_ngxLQylI/edit

Also of note, many—if not all—insurance companies are paying 100% for the cost of telemental health sessions. That means that clients will not have to pay a co-pay, co-insurance, or any other form of “cost-sharing” for telemental health. These offers typically extend into June; clients should contact their insurance company, which may be as simple as visiting the company’s web site, to find out more.

For potential clients without insurance, multiple mental health organizations in our community have been awarded grants to mitigate or eliminate the cost of mental healthcare in response to this crisis. With these measures in place, many of the barriers to accessing mental healthcare—such as cost and transportation—can be overcome.

The other issue that needs to be addressed is the stigma that has plagued mental health and mental healthcare for generations. We now know that poor mental health is also associated with poor physical health, and the two have a very close and mutually influential relationship. This is especially the case in regards to chronic traumatic experiences. The persistent and pervasive social isolation qualifies as traumatic for many of us.

For this reason alone, mental health should be seen just as vital as respiratory health. If folks notice that they are running a fever or having difficulty breathing, they seek the assistance of a medical professional. Similarly, if a person is noticing changes like the ones listed above, they should take it seriously and contact a mental health professional for help. That’s a huge part of dispelling the stigma is just accepting and acknowledging when things don’t feel right. As well they shouldn’t during such a time of uncertainty.

Many mental health care providers are sharing resources, such as the ARROW field guide, that give community members access to useful resources when/if they are not yet ready to seek counseling. Providers are also working to create less-formal avenues for mental health supports that may seem less stigmatized for community members. For example, in addition to telehealth, ARROW is offering virtual check-ins and opportunities for people to sign up to participate in groups across multiple areas of community, youth, families, substance use, and LGBTQ identity.

We’ve noticed that our community has not yet begun to utilize these resources. And we acknowledge as mental health professionals that commonly what occurs when a person is in crisis is they can become just as overwhelmed with resources for help—or the thought seeking help—as they are with the actual experience for which they may need to seek support.

It is our hope that our efforts and those of other community members are sending a message of accepting “not OK” as an OK way to be to all of our community members. As far as we are concerned, there is no stigma or judgement, just an opportunity for meaningful supportive engagement that could be just as beneficial right now as yoga, or reading, or other forms of self-care in which community members are currently engaged. We do earnestly believe that whether the message is received and heeded will greatly affect the aftermath.

We hope that this helps as you sort through how to engage these issues as a member of the SAW community. We would love the opportunity to talk and assist further. We can be reached at hello@arrow-project.org or (540) 255-0972.

Warmly,

Sabrina L. Burress, MA, Resident in Counseling                  Charles F. Shepard, LPC, NCC

ARROW Executive Director                                                      ARROW Clinical Director