It’s almost invisible if you don’t look for it, but Bonner County is in the midst of a health crisis and it’s not COVID-19.
While last year’s fighting stories have often focused on the physical impacts of the pandemic, another effect accompanied and gained strength, alongside the virus: an almost overwhelming need for health care providers. mental health services in northern Idaho and elsewhere, making them work overtime to meet.
A year ago, one or two behavioral health care providers could have waiting lists, said Eric Ridgway, founder and advisor of The Human Connection Counseling Services. Now, almost everyone does.
“It was never like this before, where everyone did it,” he said. “The level of stress we generated from isolation with COVID-19: marriages experienced more stress, children [had more stress], [and] his school was interrupted ”.
Mental health during a pandemic
The problems for people’s mental health over the past year are twofold, said Gina Beck, director of behavioral health at Kaniksu Health Services. The first is that the added stress, including financial hardship, isolation, and fear of the virus itself, caused more anxiety and depression.
The second is that many of the protocols needed to maintain physical safety (social distancing, quarantine, and generally avoid contact with people outside the home) fell in direct opposition to many standard treatment options for those with depression. .
“If people might have a little bit of depression, it would increase their depression significantly,” he said. “We’re telling people they had to stay home and isolate themselves, which is a symptom of depression.”
Suicide rates also rose in 2020, Beck said, after falling in 2019.
According to the National Foundation for Suicide Prevention, Idaho as a state ranks ninth in deaths from suicide, and suicide is the eighth leading cause of death. The death toll per 100,000 is also 20.3, well above the national average of 13.93.
“In 2019 it fell, you know, it was big,” Beck said. “And then COVID passed away a year later and it’s backing up again.”
Suppliers have been working harder than ever to meet rising demand, Beck said. At Kaniksu, advisors sometimes adjust clients in crisis to the meal times or periods they would normally process. That’s something they will always prioritize, he said.
Crisis calls are another thing that has increased. When these come in, counselors work to see patients immediately, Beck said. In extreme situations, a person can be sent to the hospital and, for general referrals, patients are placed on a waiting list and given a list of additional providers in case someone else can adapt them sooner.
The pandemic has also increased the symptoms of people with trauma and PTSD, Beck said.
“With people saying they were traumatized before, what can make some of these symptoms worse is that they don’t feel safer,” he said. “If they are always worried that they may contract COVID, this may also increase these symptoms.”
People struggling with substance abuse were also affected and had a higher relapse rate due to interruptions in their recovery routines, Ridgway said.
Even for people without many mental health issues before the pandemic, last year had a profound impact on the emotional well-being of many people, he said.
Children and families were especially affected by school inconsistency, additional pressures, and the inability to relate to peers for much of the year.
While adults are able to understand the reasons for some of the nasty requirements of a pandemic, children may not always understand it, Beck said. Unlike adults, they don’t have such well-established social networks either.
“A young child may not understand the overall picture of COVID and may not be able to see their grandmother,” Beck said. “[We focus on] helping them to identify how they really feel and then get better coping skills to lessen them if they have anxiety ”.
Among adults, many were affected by the loss of employment and business owners had trouble wondering if they could keep their business open. Teachers were in a particularly difficult position, Ridgway said.
“It simply came to our notice then. In the 30 years I’ve been here, I’ve never been so stressed, “he said.
Poverty and mental health
While the pandemic alone would have created more demand from mental health care providers, an increase in people able to afford counseling also increased with the expansion of Medicaid in 2018, said Catherine Perusse, counselor at Seven Peaks Counseling at Sandpoint.
Currently, only a few behavioral health providers, such as Kaniksu, accept Medicaid, in large part because of the prohibitive processing that requires a lot of labor to accept it. Still, it is significant that it has expanded the number of people seeking mental health treatment, he said. Other providers accept payments on a variable scale. Some, like Perusse, offer both.
“I try to take a couple of pro bono cases [too], but I have to pay the rent. So I have to limit them, “he said.” But I usually have one or two people at work who are pro bono. “
The ongoing challenges of Medicaid, Perusse said, make it more difficult for providers to provide affordable care to patients who need it.
“This is so detrimental to families living in poverty. They have to worry about, ‘Not only do I have to have dinner, but what am I going to do? Because I have a box of mac and cheese in the house and four kids. That’s stressful, ”he said.
While poverty makes it harder to access mental health care, it also greatly increases their need, Ridgway said.
“[People in poverty] they have the least ability to pick themselves up using bootstraps. As a society, we have to care about each other, ”he said.
Ridgway believes it is an ethical obligation to make counseling accessible, he said, as have many other counselors.
While cost is a common factor as to why people don’t seek advice, Ridgway said this should not deter people from seeking help.
“I do not want them to be held back by the concern that they do not have the money to pay. I don’t want people to stop asking, “he said.” If they really seek help and talk to a mental health professional who works in this field for the right reason, they shouldn’t be distracted. “
Who the advice is for
One of the novelties he saw last year, Beck said, is that the demand for mental health care shows that there are more people seeking help. While struggles for mental health continue to be stigmatized, people tend to be more willing to talk about their struggles.
While clients sometimes feel weak to receive therapy, Beck said he applauds anyone who chooses to ask for help.
“I often hear from my clients that they feel it’s a weakness that they have to go to counseling,” he said. “This is a huge force to acknowledge that you have something going on. And you need help to change that. That requires a lot of strength and power. “
Another positive aspect of pandemic-era health care is that insurance companies are covering telehealth, according to Beck. This change increased accessibility for many patients and will continue to do so as restrictions increase, assuming these online visits remain covered.
While there is a huge demand for advice, Beck said, that shouldn’t stop people from seeking help either.
“I get people to say,‘ Well, there are so many people who’ve had things bigger than me. ’I’m sorry often, and it doesn’t matter. What’s your trauma?” She said.
Ridgway said counseling can also benefit anyone, not just “crazy” people or those people who suffer from acute mental health issues. Counselors are specifically trained to help people improve anxiety, stress, depression, and communication.
Not all counselors will be right for one person, he said, but people seeking help should not give up if the first person they talk to is not the right person.
Perusse noted that when she went to counseling, one of the first counselors she worked with was too “warm and confused” to be a good match for her, so she found someone who was better.
“It’s like buying a hairdresser you like and trust,” he said. “You don’t keep going backwards when it doesn’t work for you. And don’t stop cutting your hair, you’re looking for someone else ”.
While seeking help from a professional is very beneficial, communities that support each other are also important, Beck said.
“[When] the geese fly, they fly in this V formation, right? And the strongest ahead, and then they come back when this one gets tired. And then, when one goes wrong, another will be left behind. And then, when they are better, they fly together, ”he said. “They are working together. And I feel like a community, we have to do that too. “
Ridgway said one thing he has noticed during the pandemic is that many people are more generous and kind to each other. Some of his clients, for example, have asked him to prioritize clients in crisis. Ridgway also noted a generous donation and attention to the community at large.
“I saw that people were more sensitive and cared about strangers,” he said. “People who tell strangers at the grocery store already know,‘ Be safe, be careful, I hope your family is safe. ’So I saw generosity, and kindness and compassion spread. “And that encourages me to see a global crisis that brings out the best in some people.”
Small words and actions can make a big difference for people who are struggling, Beck said. Both she and Perusse noted that helping create hope for their clients is an important part of their job.
As suicide rates rise, it’s important to hold conversations with people who may be at risk, he said. Asking honest questions can be difficult, but it can help save someone’s life.
“I’d like people to talk about it more, rather than suffer in silence,” he said. “Just asking this question is helping this person. Don’t be afraid to say it. “Did you have the idea to kill yourself?” This is a powerful statement. People are afraid to say it. They’re afraid, “Well, maybe by asking them, I’ll put that thought in their head.” If you ask, they’ve probably had that thought before. “