Many of us have had that awkward Zoom moment.
The dog incessantly barks when a delivery person arrives during a virtual strategy meeting with co-workers, for example. Or a young son or daughter needs immediate attention and playfully interrupts your conversation with the boss.
Rather than feel awkward, Robert Sheehan urges people to share the humor of the moment. Doing so can provide a small break from the heightened tension of the COVID-19 pandemic that’s disrupted daily routines and has driven up stress and anxiety.
“The absurdity in some of the (virtual) meetings is helpful,” said Sheehan, CEO of the Community Mental Health Association of Michigan, citing both the tragedy and comedy of the prolonged crisis.
“You don’t want to laugh at the damaging parts of it, but you do want to just laugh because there is a funny side to it,” Sheehan said. “And it does help us get through.”
Finding ways to provide even a brief respite for employees is one tip mental health care professionals suggest for employers to ease stress and tension, or break a sense of isolation that can occur from working at home.
“People forget: Even simple connections to others is what keeps us buoyed, keeps depression away and keeps anxiety away, because we can talk to people that we love and care about,” Sheehan said.
Mental health indicators up
As the pandemic continues, mental health professionals worry about heightened rates of anxiety, depression and substance use as people increasingly experience difficulty coping with fears of contracting a fatal illness or losing a job and the resulting financial stress.
Community mental health agencies across the state report increased calls to suicide prevention lines and for counseling and substance use treatment. Some agencies report increases as high as 60 percent in calls to crisis or suicide lines, Sheehan said.
“When a crisis situation becomes chronic, and you don’t see an end in sight, that’s when people struggle,” he said.
Incident rates of depression, anxiety and suicide have risen during the pandemic, which mental health professionals worry will worsen in the months ahead, straining their ability and capacity to provide care.
At Pine Rest Christian Mental Health Services, outpatient visits initially dropped early in the pandemic because of stay-at-home orders, said Vice President and COO Bob Nykamp. Volume from July to September then rose 20 percent “from where we expected to be,” he said.
Part of that increase may result from a higher awareness and a lessening of the stigma of behavioral health care out of the pandemic, combined with a pent-up demand that the pandemic unlocked, he said.
“I think COVID has raised awareness on behavioral health issues to the point where people who might not have sought care from an outpatient perspective are now actually seeking care because their anxiety or depression has been exacerbated by COVID,” Nykamp said. “They were probably struggling with it prior to COVID, but just never sought care.”
Inpatient volumes are up similarly at Pine Rest, which is seeking state approval to add 60 adult inpatient beds at its 68th Street campus in Cutlerville.
System stretched thin
Nationally, the advocacy group Mental Health America recently reported that through August nearly 390,000 people who have used its mental health screening program since the pandemic showed signs of moderate to severe anxiety and depression. That total is beyond what’s typically expected. More than 131,000 people had thoughts of suicide or harming themselves, according to the organization.
The mental health system was already stretched thin prior to the pandemic, said Dr. Carey Krause, a psychiatrist and medical director for behavioral health in West Michigan for Mercy Health. People experiencing symptoms of a mental illness often wait weeks to get into care for an outpatient visit, and most beds for inpatient mental health care are usually full, Krause said.
In the months ahead: “We have every reason to believe that the demand is just going to go up,” Krause said.
Well before the pandemic, Mercy Health was planning to embed social workers with psychotherapy experience at primary care offices. A medical assistant who meets with a patient at the start of a doctor visit goes over a series of questions to screen for signs of depression and anxiety. If needed, the primary care doctor can then send the patient to meet with the office social worker for further evaluation and follow-up care.
The initiative is in place at a handful of offices. Since the pandemic took hold, the initiative has taken on a heightened importance and Mercy Health has accelerated the rollout, Krause said.
“Our thought is we’re going to be able to get to people who otherwise were not getting to in a typical behavioral health office because those waits can be weeks or months,” he said. “We can impact more people, we can impact them proactively by asking the questions and really try to stay ahead of what is probably going to be an increase in the curve in depression and anxiety in the next several months.”
Given what’s occurred and what’s expected, Krause suggests employers remind their employees of the mental health benefits they have as part of their health coverage, or about any employee assistance program in place.
Managers and employees need to look out for one another as well by watching for co-workers who are withdrawn, not as talkative or engaged as they once were, increasingly taking sick days, or are more short-tempered or angry, Krause said.
Sheehan advises employers to readily talk about the pandemic, rather than ignore the obvious, and to allow employees to vent their feelings and acknowledge their fears as a group, rather than as individuals through an Employee Assistance Program (EAP).
“People think, ‘Well, I’m the only employee that has this problem. So, I’ll seek it,’” he said. “We’re urging small employers and large employers to talk about loss and anxiety as a whole and say, ‘We as an organization are going through this. We as an organization felt this. It’s normal and natural to feel it.’ Saying that kind of stuff is important.”
Substance use rising
The pandemic has driven up substance use incidence rates as well.
At Samaritas, a nonprofit whose services include treating substance use disorder, referrals have grown 20-25 percent from pre-COVID. A 50-percent increase over the next six months from pre-COVID levels “would not surprise me,” said Anthony Muller, vice president of substance use disorder services at Samaritas.
“Things progressed to a certain point and then it’s just a breaking point. And, unfortunately, we are seeing the breaking point for a lot of people and we’re still not even near the end of the surge,” Muller said.
That increase stems directly from the stress and isolation people have felt during the pandemic, Muller said. They resort to alcohol or other substances such as opiates or methamphetamine, he said.
Samaritas, which is headquartered in Detroit, has 50 treatment locations across the state, some of which are in leased locations like churches and are open a few days a week. Samaritas in August opened a clinic in Holland and is working to open a Grand Haven satellite location in space leased from a local church.
“We know stress and anxiety increases people’s triggers (and) increase their struggle to cope,” Muller said. “All of us had our world shifted a little bit.”