Clinical therapist Alayna Brinton didn’t expect to be talking to couples through a computer screen when she designed her relationship workshop.
“It was supposed to be an in-person group,” she said.
Now the chief clinical officer and owner at Anchor Point Counseling is not only working with couples virtually, today she launches another online group aimed at women — “Finding Passion and Purpose,” while another clinic counselor tackles “Managing Meltdowns & Alegbra” in a weekly parent support workshop that starts Thursday.
Yet another is preparing for “Free to Be Me,” aimed at teens discovering how to identify and express themselves, starting next month.
With offices closed for the COVID-19 pandemic, mental health practitioners — already in notoriously short supply across rural communities — are pivoting to online groups, video conferencing, messaging and more to connect to clients.
The use of technology for health care services, known as telehealth, is crucial to serve what is expected to be growing numbers of people as coronavirus-related restrictions on work and mobility create stress, anxiety, fear and, for some, post-traumatic stress.
“Telehealth is, for the first time, getting a huge opportunity to grow in our world,” said Nikki Sharp, Healthy Communities Division manager for Walla Walla County Department of Community Health.
How big client numbers will grow here is hard to determine, mental health practitioners say.
By the launch of the Walla Walla Mental Health Network website — a monthslong initiative to offer one-stop access and community engagement to mental health providers — the dozens of clinicians listed for the area were already full, Sharp said.
Wait lists for providers had already been growing before the outbreak.
Evidence shows demand could be far greater with the loss of work, isolation, worry about the virus, demands on time, home-based public schooling, limited movement and more.
One factor contributing to service: The telehealth options that expand capacity for providers is not embraced by some clients.
“A lot of people are putting their care on hold because they don’t want to do telehealth,” Brinton said.
Some simply struggle connecting through a screen, she said. For others, access to technology may be a barrier, along with financial resources for data.
Yet others struggle to identify what they’re processing, Sharp added.
“Some people don’t even know what they need,” she said. “Life factors for me: I need to eat, sleep, get some form of exercise for my mental internal health.”
Working through stress can be a matter of identifying needs with specific goals, whether that’s making time for a daily walk, 30 minutes of quiet time, or reaching out to a certain number of people each day, she said.
“If we don’t give homework, I think we’re going to miss something,” she said.
Some services at Anchor Point have shifted similarly toward short-term, brief solutions. A COVID-19 mental health telehealth line is one example.
The phone or video conferencing offers short-term support for those struggling through the pandemic. Callers do not have to be current patients. Most insurance is accepted, and a sliding scale for cash pay is also offered.
“We have these open spots. We want to serve somebody,” Brinton said.
The clinic’s group models are a way to use the time that’s available in the most efficient manner for clients and providers, she said.
With so many people experiencing similar challenges, groups are a way to serve many people at once in a shorter time than could be accomplished through one-on-one appointments. An added bonus is that groups can help those involved to see they’re not alone in their challenges, despite the isolation.
“It normalizes the fact that we’re all having our own response,” she said. “We’re all having a mental health response to this, whether we’re recognizing it or not.”
According to a late-March survey from the Kaiser Family Foundation, 45% of respondents reported stress and worry from the pandemic was having a negative effect on their mental health.
The Associated Press reported calls to the Substance Abuse and Mental Health Service Administration’s disaster distress hotline rocketed 891% from March 2019 to March 2020.
Part of the goal of the Walla Walla Mental Health Network is to offer immediate tips and information for those processing overwhelming feelings and to help identify potential responses and steps, Sharp said.
It’s even more important with the suspension of primary care services. Through integrated care, screening through primary care visits could often identify patients experiencing depression, anxiety or some form of mental health symptoms.
Now some clients that would have been referred could wait even longer for coordinated care, Sharp said.
In her practice as Walla Walla Clinic’s Pediatric Behavioral Health consultant, licensed clinical psychologist Emily Rea said clients she’d see last week would have been scheduled last November or December. Those calling now would book for August or later.
Thus, finding ways to prioritize through screening with a smaller staff has been an adjustment.
“We’re trying to figure out ways to be diligent,” Rea said. “This has created angst in children as much as it has adults.”
Rea experiences the hardship many people face. In her case, there’s no loss of work. Rather the load has increased with kids home and schooling taking place at the same time she’s juggling demands from clients in need.
For Rea, it’s forced her to relinquish control as a planner and experiment with new activities, something she believes other parents are also facing through this time.
“There have been some silver linings,” she said. “In being stressed to our limit, we are forced to be creative.”
If there’s an overriding worry for providers, it’s that the economic hardship of the time will further stratify mental health care delivery. Insurance plans that have become thin on reimbursement may leave out some of the most vulnerable clients who need help.
That aspect has created a new level of stress for the providers on top of the pandemic.
“How do you make sure clinicians are taken care of and people also have access to care?” Brinton posed.