Pandemic threatens to deepen crisis in mental health care

Pandemic threatens to deepen crisis in mental health care

NEW YORK — More than three weeks after Brandon Bell stopped showing up at a New York office that serves people with schizophrenia, employees finally located him at a nearby homeless shelter.

The office remains open, but patients aren’t stopping by as much during the pandemic. Group activities such as the weekly Caribbean lunch that were also an important source of food have ended because of the coronavirus. Visits from caregivers are less frequent and shorter — usually five or 10 minutes — to reduce the risk of infection.

When a caregiver recently checked on him, Bell noted that life before the pandemic was happier and “more social.”

His experience highlights the challenges for providers and patients as the pandemic strains the nation’s mental health care system. Even before COVID-19, access to mental health services in the U.S. could be difficult, including for people who have insurance. Now experts fear the virus will make the situation worse, putting the patients most in need at risk of falling through the cracks and inflicting on countless others newfound grief, anxiety and depression.

Already, social-distancing orders are affecting access to treatment across income levels as therapists and patients scramble to adjust. Medicare and Medicaid have relaxed rules to allow counselling by phone, FaceTime or other remote means. But many of the elderly and poor who rely on those plans aren’t comfortable with the alternatives. Some do not have phones or access to the internet.

“For people who are socially disadvantaged and have mental illness, it’s just a lot to ask,” said Dr. Jeanie Tse of the Institute for Community Living, which treats Bell and others who would not seek care on their own but are referred to the city by social workers and shelters.

Fewer than half of Americans with mental illness reported getting help in the past year, according to a federal survey. Among the big barriers are costs and a shortage of providers.

At clinics that offer free or low-cost therapy, wait lists often stretch for weeks in normal times. And getting treatment can be just as difficult, or even harder, for people who earn too much to qualify for state help, yet still struggle to get by.

In Pittsburgh, Pennsylvania, for example, Karalyn Hipsley was working extra on weekends to cover co-pays for therapy and the insurance she has through her husband’s job.

Then the pandemic left her out of work for six weeks, and her weekend cleaning jobs disappeared. She’s afraid she will have to cut back on therapy, which helped her establish a stable life after an abusive relationship.

“I’ve been in some very, very low places, and I don’t want to be there again,” said Hipsley, 27.

Most insurance plans offer coverage for mental health services, but finding a counsellor who takes insurance can be a headache, and fees for people without coverage can easily top $100 a session.

The virus also threatens to send many new patients in search of help. Nearly half of Americans say worry or stress tied to the pandemic has negatively affected their mental health, according to a poll by the Kaiser Family Foundation.

“You can’t put people into situations where they’re locked in their homes for weeks on end and not expect that there’s going to a significant number of people that develop mental health problems,” said Elinore McCance-Katz, who leads the federal Substance Abuse and Mental Health Services Administration.

In New York, the city is already seeing more people reaching out to its NYC WELL hotline that offers crisis counselling and referrals for longer-term care. The city plans to expand its staffing from 104 to 191 counsellors.

“This is the beginning of meeting the new demand we anticipate will continue,” said Susan Herman, the program’s director.

Many homeless people are avoiding shelters out of fear of infection, making it harder for agencies to identify people in need of treatment.

Tse of the Institute for Community Living said the vast majority of the people referred to the city for care have schizophrenia, which can manifest in many ways, including delusional thinking and the tendency to self-isolate.

After social distancing orders went into effect, Tse and her team have continued to check on people who were already under their care. But now the short visits are mainly to ensure people have basic needs such as soap and food, which have become even harder for them to come by.

During her recent check-in a shelter in Brooklyn, Tse noticed Bell had lost weight, but she was encouraged that he seemed on friendly terms with people as she took him to a bodega for a sandwich.

Bell also seemed upbeat, even as he noted the disruption caused by the pandemic.

“It’s going to take time to get your mind back into your regular schedule and programming,” he said.

___ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

John Minchillo And Candice Choi, The Associated Press

mental health

Get local stories you won't find anywhere else right to your inbox.
Sign up here

Just Posted

All Halkirk 2 Wind Project tower permits now approved

Appellants have 30 days to file an appeal

1 in 7 Albertans have been tested for COVID-19

56 additional cases Thursday, 1,107 active cases remain in the province

Green earns big win as PBR returns to action

Meeting Creek cowboy continues to make his mark in bull riding

94 new cases of COVID-19 in Alberta on Wednesday, two more deaths

1,146 active cases with 9,891 recovered cases

COVID-19: One more death reported in central zone

Number of active cases has decreased by more than 200 since last week

Protestors for Indigenous Lives Matter gather in Wetaskiwin

Protestors gathered along 56 St Wetaskiwin, Alta. August 4, 2020 for Indigenous Lives Matter.

‘Caught up in the frenzy:’ Oilers 50/50 draw breaking ticket sale records

Previous record was held by Toronto Raptors fans when a 50/50 raffle reached $2 million

Alberta jury trials to resume next month at offsite locations due to COVID-19

About 12 locations across Alberta may host the trials in halls, hotels and community centres

Alberta school curriculum to focus on basics, keep out political bias: minister

NDP education critic says the kindergarten to Grade 4 changes should have been implemented a year ago

Statistics Canada says country gained 419,000 jobs in July

National unemployment rate was 10.9 per cent in July, down from the 12.3 per cent recorded in June

Canada plans $3.6 billion in retaliatory tariffs on U.S. in aluminium dispute

The new Canada-United States-Mexico Agreement that replaced NAFTA went into force on July 1

Walmart to make face masks mandatory for customers across Canada

Requirement goes into effect on Wednesday, Aug. 12 across Canada

Canada ‘profoundly concerned’ over China death sentence for citizen in drug case

Police later confiscated more than 120 kilograms of the drug from Xu Weihong’s home

Answers to 5 common questions facing families for the COVID-19 school year

COVID-19 protocols are likely to vary even more at the school board level, and even and school-to-school.

Most Read