CDC finds 40% of adults report COVID-19 mental health issues. There’s help in Whatcom
With the COVID-19 crisis weighing heavily on patients and providers alike, behavioral health services from Compass Health and Sea Mar have adapted by providing telehealth services and limited in-person care.
At the same time, behavioral health care providers are bracing for a growing behavioral health crisis. The Washington State Department of Health has been warning providers to expect the behavioral health impacts of the pandemic to peak around six months after the start of the pandemic, according to a July 23 report.
The department expects about 3 million Washington residents to experience clinically significant behavioral health symptoms over the next two to five months, the report read. Most of these symptoms are likely to manifest as depression, which may potentially affect 30% to 60% of the general population, according to the report.
Additionally, 40% of United States adults have already reported struggles with mental health and substance abuse in late June, according to a new survey from the Center for Disease Control and Prevention.
As the crisis continues, many people could lose their unemployment benefits if they are not extended and more still are likely to be affected by the shared trauma of the ongoing pandemic, said Compass Health chief executive officer Tom Sebastian.
Sebastian said he expects an increase in substance abuse and suicide rates. He also expects many people to feel isolated, which can exacerbate other behavioral health issues such as anxiety and depression.
Sea Mar has already had to intake more service requests, said senior vice president and chief behavioral health officer Claudia D’Allegri. They have also noticed an increase in substance abuse and domestic abuse cases, she added.
Compass Health and Sea Mar can assist low-income and marginalized communities that can be most at risk from the confluence of health crises and economic challenges. Such disadvantaged groups and essential workers are already experiencing disproportionately high behavioral health impacts, according to the state report.
Here’s how these two, major behavioral health care providers are tackling the issue.
Compass Health
Compass Health, which primarily serves Medicaid eligible individuals in five northwest Washington counties, saw a 750% increase in the number of services they provide via telehealth in Whatcom County, Sebastian said.
Nowadays, most of their clients primarily use telehealth for outpatient therapy, he said. To make this transition, the organization had to train 500 clinicians organization-wide in April, he added.
“We have a very high-quality visual telehealth platform that sits on Zoom,” Sebastian said. “It allows any of our clinicians from anywhere they are on any device they have to provide a service to any community member in Whatcom County that we’re serving on any device they have.”
At the start of the crisis, about 50% fewer people made use of their outpatient services, but usage has since returned to pre-pandemic levels thanks to telehealth services, Sebastian said. In fact, the percent of people who missed their appointments has decreased by half from about 30% to 15% with the development of telehealth, he added.
Sebastian attributed the drop in no-shows to the ease of access of telehealth services. He said he thinks telehealth is here to stay because it’s more accessible for marginalized, low-income communities.
“This is not just a tool that’s very effective right now, but one that I believe will transform behavioral health into the future post-pandemic,” Sebastian said. “I think we’ll never go back because the ease of access is so great for the clients we serve.”
Compass Health has also created a hybrid model including some in-person care for services such as their Wraparound with Intensive Services program that serves Medicaid-eligible youth with complex behavioral health needs, Sebastian said.
“That need was really exacerbated by the school systems, which was completely understandable,” Sebastian said. “A lot of the services, especially the specialized services to students who have behavioral health needs became a real challenge for the school districts.”
The organization has also added telehealth service to their Mobile Crisis Outreach Team, a short-term crisis intervention service available 24/7 for any community member regardless of their ability to pay, Sebastian said.
Amid an increase in calls for this team, he said Compass Health has installed tablets for telehealth service at six emergency rooms including at Peace Health St. Joseph Medical Center.
“The importance of that was we didn’t have to disrupt the emergency room,” Sebastian said. “They didn’t have to give us personal protection equipment and kind of monitor what we were doing. That was a real radical change for us.”
Sebastian said the statewide organization has raised about $1.24 million in July through government and philanthropic sources including United Way of Whatcom County, the Whatcom Community Foundation, Chuckanut Health Foundation and the River Styx Foundation. The funding supports their telehealth services and allows them to purchase necessary personal protection equipment for in-person care.
Sea Mar Community Health Centers
The behavioral health services at Sea Mar Community Health Centers, which serves anyone regardless of income in 13 western Washington counties, have also transitioned to telehealth services since the start of the pandemic, D’Allegri said.
Sea Mar has noticed a general increase in mental health crises, domestic abuse cases and substance abuse cases over the past few months, she said. In response, they have introduced more hybrid service options with some in-person care, she added.
“We have seen a lot more altercations between the (patients and) parents or family members,” D’Allegri said. “There have even been a couple times where people in telehealth have been able to see arguments that happen at home while they try to provide the service.”
In-person services now take on precautions such as physical distancing, glass dividers and masks, D’Allegri said. It has been difficult to secure enough personal protective equipment for all staff, so Sea Mar only provides it for those who have direct contact with clients, she added.
Requests for services have increased since the beginning of the crisis as well, D’Allegri said. To help manage the requests, she has proposed hiring more staff just to perform intake assessments. Sea Mar is also considering creating more group therapy options via telehealth to break the sense of isolation many may be feeling, she added.
D’Allegri said there is also a lot of concern for staff amid all these challenges because they will experience secondary trauma at work in addition to experiencing the COVID-19 crisis. Just as more staff is needed, some have left to care for their children who are at home now.
“I think the biggest challenge for us is going to be a high number of clients with lower numbers of staff,” D’Allegri said. “The staff also has their own personal lives… they have their own concern about the pandemic. And on top of that, we are saying, ‘OK, help people. Help the community, but we don’t have enough of you in the community.’”
Sea Mar has tried to add more staff but not enough have applied, D’Allegri said. Even before the pandemic there was a shortage of mental health counselors, she added. Such counselors must meet a list of requirements including achieving a masters or doctoral degree in Washington state.
Additionally, there has been a shortage of bilingual mental health counselors to the detriment of marginalized communities, including the Hispanic communities who are often on the front line of this pandemic, D’Allegri said.
In Washington state, Hispanics represent 43% of confirmed COVID-19 cases despite being just 13% of the population. Likewise, Hispanics account for 29% of confirmed cases in Whatcom County despite being just 9% of the county population. With the virus disproportionately infecting Hispanics, there is also concern for the mental health of this population.
“They have a lot of economic stressors,” D’Allegri said. “On top of that, they know family members who have been affected and died. So definitely, I think that has created a mental impact.”
D’Allegri said she has conducted outreach in Hispanic communities through radio and in conferences with community health care promoters. However, she said she expected the impact on Hispanics to get worse under current conditions.
“Its going to get worse because the families are not finding ways to get back to work,” D’Allegri said. “And I think that it’s going to create an impact.”
Whatcom County
The Whatcom County Health Department is not tracking any behavioral health-related cases since the start of the pandemic and is not offering resources to residents directly, a county spokesperson told The Bellingham Herald in an email statement.
Given the expected rise in behavioral health cases across the state, the Whatcom County Health Department is concerned about locally available services being overwhelmed, according to the statement. Currently, capacity is not enough to meet the need, the statement read.
However, the department has checked in on service providers to determine their capacity needs and support their funding efforts, the statement read. Additionally, they have coordinated with regional and state partners to optimize treatment options and worked with community partners to ensure support services are available for vulnerable populations, according to the statement.
In cooperation with the city of Bellingham, Peace Health and Sea Mar, the county has continued to fund the GRACE program, a community-based effort to support individuals who repeatedly cross paths with emergency services and the criminal justice system.
D’Allegri said the program, which is operated by Sea Mar, has continued to conduct outreach and collaborate with first responders to help people in crisis during the pandemic. She added the program has played a key role in coordinating services and is looking for more workers to meet the growing need.
If you are in need of immediate help you call the Compass Health Crisis Care Line at 800-584-3578 or the National Suicide Prevention Lifeline at 800-273-8255. For treatment options, you can call Compass Health at 360-676-2220 or Sea Mar at 360-734-5458.
This story was originally published August 16, 2020 at 5:00 AM with the headline "CDC finds 40% of adults report COVID-19 mental health issues. There’s help in Whatcom."
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