Keeping mentally strong in isolation

“The immigrant population is most vulnerable and what we’re also finding is a decrease in reporting to Child Protective Services. Are there things happening that we’re not aware of,” said Hughes. “A population I’m also worried about is older adult males with the financial fallout and the rates of suicide and isolation in that community are the worst three things you can put together for adult males. They don’t typically seek help with mental illness.”

Caminar CEO Mark Cloutier, echoed Hughes’ concerns for the elderly, encouraging the public to check on their neighbors.  

“I think it’s seniors who we know are at increased risk if they acquire a COVID diagnosis. They have an acute risk of dying and just by understanding that, they are quite anxious. They’re higher risk and isolated. It’s important we’re reaching out to our neighbors who are seniors to make sure they feel some social support and possibly looking at them,” said Cloutier. 

As a nonprofit behavioral health organization founded in San Mateo, Caminar serves 20,000 individuals across San Mateo, Santa Clara, San Francisco, Solano and Butte counties. Caminar will be hosting a remote panel noon, Friday, April 23, with Dr. Jess P. Shatkin, a New York-based professor of child and adolescent psychiatry and pediatrics, to discuss the effects a crisis like COVID-19 can have on a child and how to develop resilience. 

Cloutier also raised concerns for the well-being of children who he said are vulnerable during these confusing times due to a loss of stimulation and a lack of understanding. 

“There are special issues that kids can present like fear of getting sick and dying, families getting sick and dying. Schooling at home is an added level of complexity for parents. Not having interaction with school and friends is difficult for kids,” said Cloutier. “Validate their feelings and not necessarily wait until their child says something, observe if they are isolating or playing video games, have a change in appetite.”

Dr. Steven Tulkin, a practicing psychologist of 40 years, raised his own concerns for immigrant populations and those already experiencing socioeconomic disadvantages. He also stressed the importance of having a social network that can enable a feeling of connectivity. 

“People who have less comfort in their lives have no home or an overcrowded home or have lost their jobs and lost their routine in their lives. ... People are at risk when they don’t have a developed social system, people who are not members of a group like church or synagogue or community organization,” said Tulkin.

Each mental health professional pointed to job insecurity and a lack of open space as triggers for feelings of anxiety and depression. It’s these stressors layered on top of past traumas that are leading to an increase in service requests, said the mental health professionals. 

Accessing services

Most services are being provided remotely with some being hosted through video calls like Zoom. Telehealth sessions have been hosted well before the pandemic but Cloutier said new pressures forced government officials to further loosen some HIPAA privacy requirements in regards to group sessions. 

While mental health professionals welcome telehealth as a tool to continue providing services, Hughes said it limits the intimacy typically felt in face-to-face sessions. 

“I like having a client in my room so I can watch their leg movements and mannerisms. I feel like I’m operating with one hand behind my back without them in the room. There are shear distractions with virtual sessions and multiple people at home. I notice clients are not speaking freely out of concern someone will hear them,” said Hughes. “For now it’s awesome to reduce risks, I think it can be vital when decreasing risk.” 

Tools for coping

Coping with mental illness during normal times was considered a struggle but, with the added stressors that come in with surviving a pandemic, each mental health professional spoke to the need to slow down and be mindful of thoughts. 

“This is a real opportunity for priorities and values. Slow down and look at our lives which isn’t bad. We were moving too fast anyways,” said Hughes. 

Tulkin said thinking of what can be controlled like washing our hands while remembering loved ones can be an important tool for combating intrusive thoughts. 

“Looking out my window and getting joy from that and not getting into a trap of feeling like I can’t have positive thoughts. I have people in my life I appreciate,” said Tulkin. “Remember the things we can do to relax. We can take a walk, do some stretching, those things don’t take very much prep or practice.”

“At a high level, they’re dealing with it like everyone else is. They’re trying to follow the rules, they’re scared. Our staff is trying to stay in contact but most live at the lowest level of income and don’t necessarily have internet, computers or phones,” said Melissa Platte, executive director at Mental Health Association of San Mateo County. 

MHA, a nonprofit organization aimed at providing shelter and support to particularly those struggling with mental illness and HIV/AIDS, has been handing out coloring books and task booklets along with basic essentials to their clients as a way to encourage connection. 

“It doesn’t do someone a whole lot of good to tell someone to stay home when all they have are four walls to stare at,” said Platte. 

Looking out for symptoms

If someone fears their loved one may be struggling with mental health issues, Hughes said, “Err on the side of caution. If this is happening beyond one incident it can be long term so it’s better to get help early.”

Symptoms to look out for include a change in sleep and eating patterns, outbursts of rage, periods of isolation, and excessive changes in weight or motivation. 

While many are seeking assistance now, mental health professionals say a full picture of how COVID-19 has affected the population will be available a year from now. 

“There’s a lot of readjustment that has to occur, we’re seeing more sadness and depression. What I’m projecting is that people who could pay out of pocket can’t afford services anymore,” said Hughes. “I think we’ll see an upsurge of low-fee therapy and a need for low-fee therapy. In the coming weeks and months there will be a tsunami of services needed. For now everyone is getting into a pattern.” 

If you are experiencing severe mental health issue please call 911 or the National Suicide Prevention Lifeline at (800) 273-8255. Visit onelifecounselingcenter.com for more information about One Life Counseling Center. Visit caminar.org for more information about services provided through Caminar. Visit youtube.com/watch?v=TsaT9jKZpHI to participate in Caminar’s live program. Visit mhasmc.org to learn more about the Mental Health Association of San Mateo County.