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Years of work ahead for mental health professionals after pandemic: Much of that will happen in local, rural communities

In February the Kaiser Family Foundation reported that the pandemic and economic recession that ensued had a negative impact on many people’s mental health.

They reported that around 40% of adults in the U.S. reported symptoms of anxiety, or depressive disorder. It was a significant bump from the pre-pandemic rate of 10%.

A tracking poll from July 2020 found that many adults were also reporting specific negative impacts on their mental health and well-being, such as difficulty sleeping- reported by 36% of respondents, eating- reported by 32%, and increases in alcohol consumption or substance use- reported by 12%.

Point being, the pandemic is laying the groundwork for years of necessary effort by mental health professionals across the board to undo damage done by the pandemic.

Margaret Morse is the director of community services in Seneca County. Over the weekend she talked about some of the trends Seneca has experienced throughout the duration of the pandemic.

“We are seeing an increase in severity of mental health symptoms including depression, anxiety and psychotic symptoms. Additionally we are also seeing an associated increase in mental health calls to 911 resulting in law enforcement response,” Morse explained. “Continued isolation, while necessary for public health as it relates to COVID-19, is unfortunately counter indicated for persons managing mental health and substance use disorders.”

She echoed the findings of the KFF report, noting that there’s been a tangible increase in symptoms of certain conditions like depression.

“We are seeing increased symptoms of depression and anxiety in addition to psychotic symptoms among those with a diagnosed mental health disorder. We are also having people present with a first time diagnosis of depression and anxiety,” Morse continued. “I think the loss of connection, actual physical connection with our loved ones and with other humans in general is taking its toll. We are social being and require connection to maintain good mental health. We are also seeing an increase in substance use and relapse.”

The changes that have taken place over the last year are not likely to be reversed with the presence of a vaccine, though. “Some individuals are anxious about the vaccine of course however as we have been working to get vaccinations, including an onsite vaccination clinic for our clients, there has been an outpouring of gratitude from our clients,” Morse explained. “People break down in tears when we tell them that we are going to help them get access to vaccinations. They are very relieved. I’m hearing less about vaccine anxiety then I had imagined.”

But what about the transition to ‘normal’? Morse says there’s a bit of concern there for her staff, who are working with those who are feeling anxious about it.

DiSanto Propane (Billboard)

“I am concerned about anxiety associated with ‘returning to normal’. The way I think about it, we as a community and individually are moving through the stages of grief and loss, Denial, Anger, Bargaining, Depression, Acceptance. This process isn’t linear so depending on the individual’s process they can move forward and back through the stages over time. A lot of people are stuck in anger, bargaining and depression while others are in denial,” she explained. “It’s also difficult when we still have to follow all the public health guidelines despite being vaccinated. It’s the right things, but it’s hard to digest. We are looking for relief, it’s in sight, but we aren’t quite there yet. The uncertainty of it all is very stressful and can increase anxiety and depression for individuals.”

Across the state there have been significant concerns voiced about finances for mental health services. The threat of cuts is not something Morse looks forward to, and at the moment- she feels pretty good about things. “I am actually feeling more hopeful at the moment in terms of the impact of the state’s fiscal picture on delivery of mental health and substance use disorder services,” she said. “The 20% withholds to state aid in quarters 3 and 4 of 2020 to OMH and OASAS funded services have been lifted and with the new federal government’s intention to support to the states and municipalities, I am hopeful that any reduction to state aid will be minimal. It is however a waiting game, and again, that increases anxiety right? In any case, we will do everything in our power to ensure that services continue at current levels and that we are meeting the increasing need for mental health and substance use disorder services in our community.”

Beyond the pandemic, there are going to be opportunities to continue delivering services in ways that before it were not possible. “Full implementation of Telemental Health Services is one of the biggest changes in 2020,” Morse recalled. “This has been wonderful for our community as it has alleviated some historic barriers to treatment including transportation. Productivity has been up over the past year and I think that has a lot to do with the fact that we have made it easier to access services via remote technologies. Patients have wonderful things to say about this access and most really like Telemental Health modalities. Additionally, we have increased use of telemental health approaches to crisis response. We are utilizing iPads in collaboration with local law enforcement to provide telehealth evaluations and crisis stabilization supports to individuals experiencing a mental health crisis being responded to by law enforcement. We will continue our CIT collaboration and hope to expand these in person team responses to mental health crisis moving forward..”

She says that continuing those services beyond the pandemic will be crucial to keeping balance, especially if there’s a need for more services.

It is our intention to continue to innovate in order to remove barriers to treatment access for those living in our rural community. We plan to increase in-home services and off-site services in order to ‘meet patients where they are at’,” she said. “Once we have the ability to go back into people’s homes- we do still do this in some instances- we hope to build additional programming to support this. Additionally, as I stated above, we hope to continue to increase our law enforcement telehealth crisis response services and build out enhanced mobile crisis response services.”