YOUNGSTOWN, Ohio – COVID-19 brought the perfect storm for the mental health field. People reported substantially more symptoms of anxiety and depression while safety measures helped to exacerbate those issues in some cases.
Local care providers have seen an increase in the number of patients seeking care, sometimes at record levels while at the same time dealing with a shortage of counselors to deal with the surge. Alta Care Group, for example, has a waiting list for treatment for the first time in its history, says CEO Joe Shorokey.
“We’ve always prided ourselves on immediate access to care. We could get them in the same day for an initial appointment and then get them set up in a week or two with ongoing appointments,” he says. “That just isn’t there now.”
Still, those working to help people with their mental health and mental illnesses remain dedicated to providing care.
“There’s a sense of being overwhelmed over all these changes. I see that in the people we work with and in ourselves,” says Hope Haney, executive director of the National Alliance on Mental Illness-Mahoning Valley. “Some of the most common questions we’re getting through our website or Facebook are from people who haven’t had a diagnosis, but because of the continued increased stress are having panic attacks. That itself is extremely frightening. It truly is anxiety, all capital letters.”
Mental health conditions such as depression and anxiety – two of the most frequent issues seen over the course of the pandemic, local professionals say – can be exacerbated by uncertainty and stress. The constant tide of the pandemic and all that came with it makes dealing with such conditions more difficult.
“If you’re afraid of heights, you try not to put yourself in situations where you’re high up. If you’re afraid of water, you can step away. But here, if you’re afraid of what’s happening with the pandemic, where do you go?” asks Nikunj Patel, chief behavioral health officer for Meridian HealthCare. “You’re stuck with that emotion, that heightened feeling, at all times. So whatever typical emotions you have about it, they grow more intensely.”
A January survey by the Kaiser Family Foundation reported 41% of adults had symptoms of anxiety disorder and/or depressive disorder, a jump from the 11% reported between January and June 2020.
For those who had lost their jobs since March 13, 2020, that number was 53.4%. The ratio of people experiencing symptoms of anxiety and depression closely follows age groups: 56.2% for those between 18 and 24, 48.9% for 25 to 49, 39.1% for 50 to 64 and 29.3% for 65 and older.
Mental health concerns were also related to levels of income, with 56% of those earning less than $40,000 per year reporting the pandemic had an impact on their mental health, a figure that dropped to 51% for those earning between $40,000 and $89,000, and 48% for those earning above $90,000.
Throughout the area, mental health professionals have reported a surge in new people seeking care. One of the positives to be drawn from such a year, they say, is that many are thinking about mental health in new ways and are more willing to engage in treatment and therapy.
“Through the stigma of mental health, we’ve seen more and more people really talking about it. They realize it’s vital and important,” says Michael Nyers, social media and interactive coordinator for the Mahoning Valley chapter of the National Alliance on Mental Health. “Until you experience it – even if it takes something like this to make people realize it – you don’t always understand it. This will change a lot by making people more aware of the mental health of their employees and their own mental health.”
Part of the reason for that increase, Meridian’s Patel says, is likely because of what came along with the pandemic: We lost our escapes. Before the pandemic, people dealing with less severe anxiety or depression could go out and do things – shop, hang out with friends, go to their favorite restaurant – but because of COVID-19, those were lost.
“It’s not necessarily that we had never experienced these things [like depression or anxiety] before,” Patel says. “When the weather got nice, we saw people get better about quarantine because they were able to get outside. We also saw people turn to negative escapes like drinking because it’s easier to sit with that consistent behavior than the already-difficult work of engaging with yourself and responsibilities when you’re feeling that way.”
As the Kaiser Family Foundation survey reported, the pandemic also took a larger mental-health toll on younger people, which Alta CEO Shorokey says is an often overlooked population. Because of the move to remote education, many children missed out on social interaction with others their age at a crucial stage in their mental development.
“What we see is kids needing help to manage that discomfort they’re feeling as a result of getting back to some level of normalcy that they’ve become unaccustomed to over the year,” he says. “But we have the resources and skills and experiences to draw from to work through it. Younger kids don’t have that.”
As 2021 unfolds and the pandemic winds down, some of the changes implemented by the mental-health field are going to be permanent additions, namely telehealth.
The professionals note, however, that offering counseling virtually is not a panacea. It can break down several barriers to access – transportation, child care and scheduling issues among them – but many say there isn’t a substitute for in-person service.
“We’ve realized it’s not a panacea, not the be-all answer we thought it might be. People still need that in-person, face-to-face connection,” says NAMI’s Haney, who works part-time as a social worker in addition to her work at the nonprofit. “I came to realize that there’s a massively missing component compared to when you meet face-to-face or have a support group in-person. You feel the emotions going on and you can connect with other people.”
However, notes Mahoning County Mental Health & Recovery Board Executive Director Duane Piccirilli, the addition of telehealth treatments helped to break some of the stigma around getting treatment.
“It can be difficult to make that initial contact and walk into an agency. Now, it can be done over the telephone and services are available in your house,” Piccirilli says. “That, I think, helped reduce some of the stigma people feel about going and sitting in a waiting room somewhere.”
The surge of people who seek counseling comes at a time when the industry is facing a shortage of people entering the field. Beginning last May, Shorokey says, talk in the industry shifted from delivering care during the pandemic to having enough people to provide care.
“It’s the first time we’ve seen massive waiting lists. It’s not because of funding. It’s because we don’t have enough professionals to provide treatment,” Piccirilli says, noting that some counselors have left the field during the pandemic.
“It’s not an easy job,” he says. “The pay is not wonderful. I’ve been a counselor since 1985 and I know it can be very rewarding and very stressful.”