Professionals say COVID-19 crisis exacting mental and physical toll
Hotline operators say surge in calls may still be coming
FARMINGTON — While the physical impacts of the COVID-19 outbreak remain the primary source of concern for health care and government officials throughout New Mexico, it is clear the virus and its associated issues are taking their own toll on the mental health of many state residents as the shutdown continues with no end in sight.
The pandemic continues to claim new victims on a daily basis, testing the limits of health-care providers. But it also presents a stiff challenge to those who work to provide relief for people who are struggling to come to terms with how the virus has upended normal life, giving rise to a variety of fears and anxieties.
Some mental health and behavioral health professionals who operate crisis hotlines or online chat groups, or stage virtual therapy sessions say the pandemic hasn't necessarily resulted in a surge in the number of people seeking their services. But the reasons for that are complicated, they say, and that trend may not reflect the true demand for what they offer.
Molly McCoy Brack — director of the Agora Crisis Center, a University of New Mexico-based crisis center that serves callers from across the state — said it is difficult for her to gauge how many people are experiencing mental distress related to COVID-19 issues. Her organization has been impacted by social distancing requirements like everyone else, so for each shift, she is only able to have three volunteers answering crisis line calls instead of the normal six.
"We have fewer people answering phones, so we're logging fewer calls," she said.
Brack said the operators of other crisis lines around the country she has spoken to have not reported an increase in calls. But she said her organization has experienced a major increase in the amount of participation it sees in its online chat crisis interventions.
"There are about twice as many," she said. "Our chat numbers have more than doubled."
Wendy Linebrink-Allison, program manager for the New Mexico Crisis and Access Line, which is part of a nationwide network, said her organization also has not seen a surge in calls since the shutdown began. But she can tell the pandemic is having an impact on the mental well-being of callers, explaining that 35 percent of callers nationwide and 27 percent of callers in New Mexico have cited some aspect of COVID-19 as their motivation for seeking help.
"We don't see people in more distress currently because of what's going on," Linebrink-Allison said. "But that doesn't mean people aren't experiencing distress as a result."
Historically, she said, the mental and emotional impacts of such significant societal disruptions take a while to manifest themselves. So Linebrink-Allison said she won't be surprised if crisis line operators and other mental health and behavioral health care providers do witness a spike in demand for their services the longer the shutdown continues.
"That's consistent with historical patterns in crises like these," she said. " … The weeks and months following is when call volume increases."
It's not just the virus
The COVID-19 pandemic is causing fears, anxieties and stress in a number of areas. Many people are concerned first and foremost about contracting the virus themselves or seeing a loved one suffer from it. But many others are more concerned about the harm the shutdown of all nonessential businesses is doing to the economy, especially those who have lost their job because of that action.
Still others are struggling to adapt to the social distancing restrictions and are not dealing well with their inability to have regular in-person contact with their loved ones, friends or coworkers. Finally, a large percentage of the population is simply unnerved and frustrated by the changes to everyday life the shutdown has wrought, leading to an overwhelming sense of wondering when, and if, society will be able to resume in a more traditional fashion.
"There's more discussion of all those topics," Brack said, describing the nature of the calls her organization has been receiving from people in distress. "All of us are talking about that."
Greg Allen — executive director of the San Juan Safe Communities Initiative, a nonprofit organization that brings community leaders together and networks with other agencies to promote safety and a higher quality of life for county residents — said the disruptive nature of the situation has impacted virtually everyone, not just those who have contracted the illness.
"Especially right now, I'm sure there are a lot of people who are feeling frustrated and (unsettled) because we don't know when things are going to get back to normal," he said.
Allen noted his agency is not a direct service provider, but he did say the initiative works to connect people in crisis with agencies that can help them through its website. He also said he is working with Su Hodgman, behavioral health services director for San Juan County, on creating a series of five-minute videos that provide viewers tips on how to improve their mental health. The series will cover such topics as how to deal with anxiety, depression, fear and grief, and will teach coping skills in a very simple, matter-of-fact fashion, Hodgman said. Links to the series, which is expected to begin next week, will be featured on the social media sites of Allen's agency and Hodgman's division at the county.
Both Allen and Hodgman pointed out how the issues arising from the pandemic can exacerbate the difficulties faced by people who already were experiencing behavioral health problems, especially those recovering from substance abuse issues. Worries about paying the rent or keeping a family fed can serve as a trigger for someone with a drinking or drug problem, as can social isolation.
"People are going to drink more when they're stressed," Hodgman said, explaining that she expects people to struggle with their sobriety because of what has taken place.
She also said the inability to have close contact with other people likely will contribute to undesirable outcomes, but she hastened to add there are alternatives to face-to-face interactions.
"The whole social distancing thing has a way of distancing people, period," Hodgman said. "But there are a lot of ways to stay in touch with people – letters, phone calls. Social media isn't always accurate, but it is convenient."
Other ways to access services
Agencies that provide behavioral health or mental health services to those in crisis have had to adapt their service models quickly during the shutdown, given an inability to conduct face-to-face counseling or in-person peer group therapy sessions.
But new models have emerged, among them the NMConnect phone app launched by the state of New Mexico. The app links users to the New Mexico Crisis Access Line (NMCAL), which provides safety net services statewide, according to a press release heralding the introduction of the app.
Users are provided with free, 24-hour crisis and noncrisis support and access to behavioral health professionals. Those professionals are available to speak with callers via text or talk, offering long-term support or just serving as a momentary mechanism through which callers can vent their anxieties or frustrations.
"As the COVID-19 pandemic continues to force physical isolation, many people may experience challenging behavioral health symptoms, some perhaps for the first time," Bryce Pittenger, CEO of the New Mexico Behavioral Health Collaborative, stated in the press release. "This app connects to NMCAL, which is a one-stop shop for any and all behavioral health resources across the State of New Mexico."
Jodi McGinnis Porter, director of communications for the New Mexico Human Services Department, said as of April 22, the app had been downloaded nearly 2,600 times. She said the department estimates that approximately 2,000 of the people who downloaded the app actually used it.
NMCAL's Linebrink-Allison echoed Hodgman's comment about how people can employ other methods of feeling connected to each other besides face-to-face contact.
"Social distancing does not mean social isolating," she said, encouraging anyone experiencing feelings of loneliness or isolation to reach out to a friend or loved one on the phone or through social media.
Linebrink-Allison explained that she has adapted to the situation by playing games with her adult children through video apps or enjoying Zoom dinners with her mother.
"There are all sorts of ways to connect with people," she said. "You don't have to stop just because of social distancing."
COVID-19 issues can transcend age
It's not just adults who are feeling the strain these days, according to Dr. Preston Harrington, a member of the pediatrics team at San Juan Regional Medical Center. He said children naturally pick up on the worries and concerns of their parents, and young people can be just as impacted by these issues as adults.
So he cautioned parents to take a positive approach to the crisis, even if they are feeling stress about the health of their family or their financial situation.
"Some people will cope better than others," he said. "If kids have support from their parents and are aware their parents aren't freaking out, you don't have to worry about this."
As is the case with adults, how children are reacting to this situation varies from individual to individual, he said.
"Some kids don't have a care in the world," he said. "But others are worried about the price of oil. Those are the kinds of things kids shouldn't be worried about."
Harrington noted that, in some ways, children may be better suited to adapt to this new normal far better than their parents. He cited the resiliency of children who have grown up in wartime environments.
"In many ways, those kids were less scarred than adults," he said. "That's because they may not know what to compare it to."
Harrington recommended that any parent who has a child who is expressing fear or anxiety about the pandemic should turn to healthychildren.org, which is an American Academy of Pediatrics website that offers free parenting news and advice to users, including valuable information about dealing with COVID-19. They also can call their pediatrician or family doctor and seek advice, he said.
But the greater danger remains a youngster picking up and adopting the fear or anxiety being experienced by a parent, Harrington said.
"I would be more concerned if a parent was on the edge," he said. "If they start to decompensate, I think that really affects the kids."
Tod Smith, the chaplain at the hospital, said he does not have much interaction with families or patients these days because of the social distancing requirements, and he acknowledged he has little sense of how the population in general is handling the stress of the pandemic.
But he recalled a brief conversation he had with the proprietor at a local plant nursery last weekend when Smith and his wife stopped to pick up some tomato plants. The owner brought their order out for curbside pickup and stopped at an appropriate distance to chat.
"I'm just making it up as I go," Smith recalled the man saying. It was a pronouncement that resonated with Smith.
"I'm hearing that from everybody, and I'm feeling that way, too," he said.
Smith worries about the doctors, nurses, aides and staff members he works with every day at the hospital as the physical and mental demands on them grow. He said he certainly has heard some fears and anxieties being expressed, but mostly, he said, he sees people simply going about their work, continuing to do the best job they can under taxing circumstances.
Smith said he is struggling to find a way to help his coworkers without getting in their way or making them feel pressured to express their feelings. He said the hospital CEO asked him to create a devotional video over the Easter holiday for hospital personnel, and now he plans to do a weekly series of "Chaplain's Chat" recordings for any staff member who cares to listen.
In general, Smith said he simply tries to make himself available to anyone who wants to vent, expressing the notion that, as a nonprofessional in the health-care world, perhaps he can see a few things doctors, nurses or aides can't. Though the hospital staff is holding up remarkably well, he said, it is clear the demands of the past month have taken their toll.
"You don't have to scratch very deep to uncover any of these underlying issues," he said of the fears and anxieties health-care workers are feeling just like everyone else. "It's not like they're whining about it or looking from someone to tell. But I'm pretty good at picking up on that stuff and reading the subtleties of human behavior."
Smith is experiencing his own set of frustrations, but he said he has chosen to focus on simply being a reliably friendly face in a time of great upheaval.
"I've asked a lot of people what I can do, and to a person, they've all said the same thing – just keep showing up," he said, describing the we're-all-in-this-together atmosphere that has taken hold at the hospital. "That doesn't sound very fancy, but that's what counts."
That notion also has occurred to Brack at the Agora Crisis Center. Searching for a silver lining to the situation, she referenced the universal nature of the pandemic and wondered if that element of the crisis alone might cause people to stop and reconsider their connection to everyone else on the planet.
"One of the things that strikes me is this is the first time in my lifetime that literally every person on the planet can be impacted by this," she said. "And wouldn't it be nice if this shared experience brought us together?"
Mike Easterling can be reached at 505-564-4610 or firstname.lastname@example.org.