Mental health is a bigger challenge during COVID; crisis does not get the attention it deserves, says doctor
Mental health was already in crisis in the United States, advocates say, but since the start of the COVID-19 pandemic, it has worsened.
Police and mental health professionals have been busy throughout the pandemic.
Schenectady Police continue to meet with mental health professionals from Northern Rivers Family of Services when certain emergency calls warrant this type of intervention.
And at Capital Region TMS, a depression treatment center on Union Street in Schenectady, clinical services director Mary Ruhle said she was making appointments with patients and Ruhle was logging over 60 hours. of work per week.
His colleague Dr Thomas Qualtere said the pandemic has widened the feelings of isolation, stress and even mourning for loved ones who have died from the coronavirus.
Qualtere said the mental health crisis is not getting the attention it deserves. He suggested it should be approached with the same urgency as the nation’s response to the opioid crisis.
“It’s unfortunate. We don’t talk about it enough. You have to deal with the negative stigma of mental health, and people are reluctant to come for treatment initially,” he said.
“And now with COVID they’re isolated, second. Third, the thought of having to be on medication or in treatment and having to admit it – that can put you behind the ball of eight. Between the economy, the lethality of COVID, the people having all of these losses and being isolated … it’s wreaking havoc, ”Qualtere said.
Before the pandemic, it was widely believed that one in five American adults suffered from mental health problems, according to Glen Liebman, chief executive of the Mental Health Association of New York State.
In the state as of May 2020, more than a third of adult New Yorkers reported symptoms of anxiety and / or depression in the previous week, according to the New York State Health Foundation.
The New York study says three times as many people reported anxiety and depression after the pandemic.
The proportion of state residents reporting poor mental health has remained high throughout the pandemic, reaching 37% of adult New Yorkers in October 2020, the foundation said.
In the meantime, Kaiser Permanente released a 12-month national study after the onset of the pandemic that found a 7% increase in visits for mental health treatment during the initial shelter-in-place period in 2020. , compared to the same three-month period in 2019.
In Schenectady, the police are busy with mental health calls. They answered 18,832 calls in 2020, up from 17,329 the year before.
Police sergeant. Nick Mannix stopped by before saying the city’s rise is linked to the pandemic. He said police have responded to mental health calls at a steady rate over the past five years, including in 2017, when they received 19,239 calls.
Leibman, of the state association, said the general population of New York City has been affected by mental health issues during the pandemic. He cites an increase in calls to an emotional support line established by Governor Andrew Cuomo last year, and more calls to the national suicide prevention line.
There are really two ongoing pandemics, suggests Liebman.
“This is the pandemic we are all familiar with – the impact of nearly 600,000 people who have died and the impact of their loved ones,” he said.
The other is about mental health, he said.
“It’s the pain people feel – the isolation they feel, being at home for 13, 14 months. The frustration, isolation and distance schooled children, ”said Leibman, while adding hope that this will go away as more and more people get vaccinated.
Leibman said he was also concerned about how people will deal with the impact of the long-term trauma of COVID, which he says will not be known for years to come.
“The younger people have understood what is going on in the last 14 months,” he said. “How will that affect them in terms of depression or anxiety?” It could be years before we find out the impact of this. ”
People are talking more openly about mental health than before the pandemic, said Leibman, perhaps the only good that emerged during the pandemic.
“I don’t think this would have happened if the pandemic had happened 10 years ago, that people were talking openly about their feelings and the feelings of the people around them,” he said.
Fortunately, the once-planned 20% reduction in mental health services across the state at the start of the year has been reinstated, now that the state has a surplus, Leibman said.
“As a mental health system we have always been traditionally underfunded,” he said, “so even going back to what was the norm is always way below what we should be.”
Police and mental health
At Schenectady, the Northern Rivers family of services is integrated with the 911 system, which means if someone calls the dispatcher for a disruption in which a mental health issue is in question, but there is no imminent risk , the dispatcher transfers the call to Northern Rivers for management. .
Police said it could be used for nonviolent “behavioral calls”, such as a teenager taking action. Police do not want to be involved in disciplinary matters involving adolescents, Mannix said.
For calls where there could be imminent danger, police and the Northern Rivers Crisis Mobile Team meet at the incident site.
Northern Rivers also joined Schenectady’s police on police trips, Mannix said.
The goal is to deflect some of the lower level offenses with an underlying mental health issue, he said.
“It’s better to have a trained advisor and all that on top of that commits the officers for a while,” said the sergeant.
Another option is for concerned citizens to call the Northern Rivers Crisis Line directly at 518-292-5499. This would be the case in cases where the public is unsure whether an agent is needed, said Jennifer Eslick, executive director of the crisis services program for Northern Rivers.
“We encourage people to call us and let us help us decide whether the police should be involved or not, or whether we can just go out safely and provide them with what they are really looking for, which is to say. helping their mental health, ”Eslick mentioned.
Mobile Response Teams act almost like emergency mental health paramedics and deal with crises in Albany, Rensselaer, Saratoga, Schenectady, Warren and Washington counties.
It responds to adults, adolescents and children in all counties except Albany, where it does not respond to adult seizures.
Northern Rivers is handling the situation over the phone or meeting the person in crisis at their home, school, mental health facility, Stewart parking lot or wherever the person wants, Eslick said.
Nearly 11,000 people across the six counties have called the crisis line from its opening in June 2018 until March 31, 2021, Eslick said. Of these calls, 7,100 required an in-person response from an advisor.
People often call the crisis line for teens who are depressed or have expressed suicidal thoughts after being upset by a parent about setting limits. Or it could be a suicidal adult, or someone acting weird while walking down the street, she said.
“A lot of times when we get there, individuals are just looking for someone to talk to, or to talk to them about what’s going on, and so many times we are able to free the police from the situation and we just stay and provide that support, ”Eslick said.
Depending on the particular case, the organization can follow up with young people for up to 14 days to keep them out of crisis and manage other supports they have, Eslick said.
The process avoids the cost of an ambulance response, or for the person to sit and wait for hours in emergency rooms at most, she said.
The Northern Rivers service is state and county funded and is free to anyone with an emotional or mental health crisis. The insurer is not billed, although in some cases Medicaid may be billed. However, recipients of the service never receive an invoice.
The line is answered from 7 a.m. to 11 p.m. Monday to Friday and from 11 a.m. to 7 p.m. on weekends. It strives to become a 24/7 operation.
TMS from Capital Region Relocates to Albany; extension of brain stimulation treatment
Capital Region TMS, Schenectady’s Union Street mental health associate, is moving to Albany in June where it aims to continue expanding its use of NeuroStar “TMS” therapy, or transcranial magnetic stimulation.
It is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression.
Qualtere said his organization owns the only NeuroStar machine in the Capital District. He said he got theirs in May and has since purchased a second machine due to high demand. He plans to buy a third soon.
The Federal Drug Administration approved the use of TMS therapy for major depressive disorder in 2008. Insurance companies began covering it in 2013.
Insurance companies typically cover treatments for those who have had an unsatisfactory response to antidepressants or who cannot tolerate the side effects of antidepressants, Qualtere said.
As of Thursday, the TMS in the capital region had performed 2,267 treatments on more than 100 patients. So far this year, he’s had a 75% response rate, meaning the patient’s depression has improved, while 37% are symptom-free, Qualtere said.
If three separate antidepressant drugs have not worked, the chance that a fourth will put him into remission is less than 7%. The remission rate with the NeuroStar machine is 40-45%, he said.
Within a 30-mile radius of Schenectady, there are more than 75,000 patients with four or more antidepressants in their history, 60% of whom have never seen a psychiatrist, he said.
TMS performs treatment five days a week for about seven weeks, without the possible side effects of dry mouth and eyes, constipation and weight gain from antidepressants, the doctor said.
One patient, Laci Matthews of Ballston Spa, said on Friday she was about three weeks after her MSD treatments, and after 25 years of severe anxiety, she can’t remember ever feeling so well.
“I’m still taking medication, but I’m coping with the change 110% better than I would have been last year without the treatment,” Matthews said. “I am able to manage and cope with my anxiety. I can just let it sit there and not worry about it and I’m not obsessed with it. I look happier. I feel happier.
“I’m going to start seeing a therapist, just to get things done. But like I told Mary [the clinician], it saved my life because my anxiety was probably going to give me a heart attack, ”Matthews said. “I am a total supporter of this. I can’t believe how well it worked.
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