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'We're Stretched': Mental Health Providers On The Pandemic's Toll

Sign outside of Rutland Mental Health, with orange leaves on the ground
Nina Keck
Since the start of the pandemic, Rutland Mental Health has seen a sharp increase in the number of people seeking help for mental health related challenges.

Doctors are still discovering new health ramifications for those who contract COVID-19. But the isolation and fear associated with avoiding the virus, along with the economic hardship brought on by the shutdown of the economy are creating another set of challenges: anxiety, depression and a rise in substance abuse. The trends are further stretching mental health providers and worrying those who work in recovery.

We joke about it during Zoom meetings, how we feel trapped in our houses or apartments.

We post funny photos on social media about the daily struggle to balance work and childcare.

More from Vermont Edition: VPR-Vermont PBS Poll Reveals Pandemic's Toll On Finances, Mental Health

Many of us are drinking or smoking more weed.

State officials say alcohol sales in Vermont have jumped by more than 10% during the pandemic, despite the fact that sales to and through bars and restaurants have plummeted.

But while we may laugh about that extra glass of wine every night, underneath, the fear and loneliness are  taking a toll.

A blond woman sits at her desk.
Credit Nina Keck / VPR
Laura Kass sits at her desk at Rutland Mental Health. Kass is Chief Services Officer and says people who have never been in the system before are coming to the emergency room or calling for help regarding anxiety or depression.

Laura Kass sees it every day. She’s Chief Services Officer at Rutland Mental Health, one of a network of community mental health providers in Vermont.  

“So we're seeing newer people,” she said. “People who have never been in the system before are coming to the emergency room or calling us looking for help regarding anxiety or depression.”

Kass has spent more than 20 years in the mental health field, working with children, families, people with developmental disabilities and those struggling with substance abuse.

“The data is showing across the state that we are seeing double the amount of people in crisis than we saw the year before [at] this time,” she explained.

Crisis resources: National Suicide Prevention Hotline: 1-800-273-8255 Vermont Suicide Prevention Center: Text VT to 741741 National Domestic Violence Hotline: 1-800-799-SAFE Disaster Distress Helpline: 1-800-985-5990 or text TalkWithUs to 66746

When the pandemic first hit and businesses had to shut down, she said Rutland Mental Health had mental health crisis teams at all the Rutland area food giveaways, handing out information about how to get help.

And while demand for their services has grown significantly, Kass said their staffing levels haven’t.

“It’s very draining,” she admitted. “We’re stretched.”

In a region that already has a shortage of clinicians, wait times to see a therapist are long, especially for kids.

Kerry Course, Principal of Rutland Intermediate School, which serves third-through-sixth graders, said it can take months for some kids to be seen by a therapist, despite the fact that they have two Rutland Mental Health clinicians and a full-time case worker at the school. Wait times existed before the pandemic, she said. "Now, they're even longer."

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Transitioning to tele-health, where case managers and therapists use video conferencing to meet with clients has helped some people, Laura Kass said.

“We just had a 19-year-old call us yesterday feeling extremely depressed and anxious," Kass said. "We were able to immediately get on a Zoom call with him and do a crisis face-to-face assessment with him…talk with his parents and come up with a plan. And instead of sending him to the emergency room, we were able to see him right away, with our ability to do telehealth.”

But for folks without access to high-speed internet or the right technology, the lack of in-person care has been more problematic.

Dick Courcelle in front of Rutland Mental Health
Credit Nina Keck / VPR
Dick Courcelle, CEO of Rutland Mental Health, said that providers are also struggling under the mental strain of the pandemic.

Dick Courcelle, Rutland Mental Health’s CEO, said it’s been a challenge to provide mental health care to the community when case workers and counselors themselves are struggling. “So many of them have been impacted by lack of childcare and hybrid learning … Your kiddos are home today and they're not home the next day, or they're home all the time. And that has been really challenging, because they too are struggling with the very same things that our clients are.”

Dr. David Rettew is a child psychiatrist at the University of Vermont Medical Center and serves as Medical Director for the Child Division of the Vermont Department of Mental Health.

He said, considering the many new demands put on mental health providers, he’s been impressed by the creativity they’re demonstrating to get services and information out there.

“So many different websites: whether it be the Department of Mental Health, or the Vermont Center for Children, Youth and Families, Vermont's suicide prevention center, you know, you see quite a bit of good guidance and recommendations related to the pandemic [on all of them], not to mention all the national sites that are doing the same thing," he said.

But Rettew said he still hears troubling pushback from people who believe depression and anxiety are normal at a time like this, and should just be coped with.

"Leading a mental health agency right now is like moving through thick fog with a dim flashlight." - Dick Courcelle, CEO at Rutland Mental Health

“That kind of logic really makes no sense to me," he said. "...Can you imagine an orthopedic surgeon saying, ‘Well, you know, of course you have a broken leg, you've been hit by a bus. So therefore, I'm not going to treat your pain or try to help you?’ I don't know why we reserve that kind of thinking in mental health. But you do encounter it quite a bit.”

It may be why a large number of Vermonters who could benefit from mental health treatment, may be self-medicating.

Daniel Franklin heads North Central Vermont Recovery Center in Morrisville.  Franklin believes substance abuse has risen during the pandemic. He said by how much is hard to quantify because people are working remotely and staying home. Plus, hospital emergency departments initially had encouraged people to stay away.

Clay Gilbert agrees. He directs the Evergreen Recovery Center in Rutland, and said tele-health doesn’t always work as well for people in recovery, who may need the face-to-face interaction of group therapy.

He said those required by law to go through treatment are finding new ways to get out of it by claiming they don’t have internet access for Zoom sessions or feigning illness for in-person meetings.

More from VPR: Brattleboro Retreat Will Receive $7.3 Million Bailout To Weather COVID-19 Crisis

Gilbert said for those people, the fallout from all of this will come later. “Whether that's, you know, broken relationships or fines or legal things or whatever the case might be," he said. "I think we're going to see aftershocks of this pandemic and one of them is going to be a great need for substance use treatment and mental health treatment.”

Red flags are already apearing: According to the state health department, 11 Rutland County residents died in 2019 from opioid-related overdoses. This year, in 2020, Rutland County hit that same number by July.

Chart showing opioid related deaths
Credit Screenshot / Vermont Department of Health
Vermont Department of Health
The preliminary data regarding accidental and undetermined opioid related deaths in Vermont in 2019, reported by the Vermont Department of Health in March 2020. So far, comparable data is only available for Jan. through July 2020.

So far, statewide overdoses are up 36% this year over last year, when you compare the data for January through July.

“When the stimulus payments came out, we had several overdoses immediately following that,” said Clay Gilbert. He said a participant in one of their group sessions made a point that struck him. “Her statement was, ‘I can't believe those stupid politicians are going to give us more money so we can buy more drugs and die.’”

More from Vermont Edition: Managing Stress And Anxiety During COVID-19

Back at Rutland Mental Health, Dick Courcelle sat behind a long conference table and sighed. "Leading a mental health agency right now is like moving through thick fog with a dim flashlight," he said. 

"The one silver lining of this dark pandemic," he continued, "is that never before has there been such a recognition of the importance of emotional health and well-being." 

Have questions, comments or tips? Send us a message or get in touch with reporter Nina Keck @NinaPKeck.

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