Robert Gehrke: Here is some advice we can all use from a mental health expert in Utah

For 10 weeks we have been dealing with the effects of the coronavirus, not the least of which are the feelings of isolation, anxiety and economic uncertainty.

It’s hard on everyone, but especially those who already grapple with feelings of depression. So I reached out to Doug Thomas, the director of the Utah Division of Substance Abuse and Mental Health, to find out what his office has seen when it comes to the impacts of the virus and what services are available for those who need help.

Here are excerpts of our discussion. It has been edited for length and continuity.

Gehrke: What are you seeing in terms of the mental health impacts of COVID?

Thomas: Nearly half of adults in the United States are reporting worse mental health since the pandemic began. … Anxiety and fear and depression, isolation and all of that uncertainty and unpredictability are stressors that are increasing risk factors that are associated with poor mental health, suicide and overdose and problem drinking and drug use.

There’s a small group of public health, health care and behavioral health experts in Utah that [is] doing surveillance on state numbers around suicide and crisis and overdose data, and when the pandemic began we started to really track it closely. Some of the trends are following other trends, so there are noticeably fewer people presenting in emergency rooms for suicide [attempts and ideations], but there are fewer people going to emergency rooms for everything. So that kind of behavior, we’re concerned about. We want to make sure people are reaching out.

Our crisis line usage has increased slightly for the last two months, which we’re glad that people are reaching out more since they’re not kind of feeling safe to just go and get seen. We’re averaging about 200 calls a day right now … just a slight increase here from about 175 [before]. But what we are seeing is that the people [who] are calling have more distress, so the calls last longer and the interventions may be a little more intense sometimes.

Gehrke: Can you talk a little bit about the types of stress people are under?

Thomas: The typical way we cope with things in life often involve social interaction, so when those things have been taken away, where do people turn? People have felt isolated. We’re all feeling an increase in uncertainty and anxiety. What happens next? What will happen with the economy? What will happen with social distancing?

One of the keys moving forward is, if you belong to a vulnerable population, you may need to take additional precautions and we’re figuring out how we can help them and support them. One of the unwritten truths of life is as if you're feeling down or bad, go help someone else and it will help you feel better. So as you look around in your community, find someone to reach out to.

Gehrke: You touched earlier on substance abuse treatment for those who are recovering from addiction. This has to be disruptive and makes it difficult to maintain, given the pressures. What are you seeing there and how are you approaching that issue?

Thomas: We just submitted a grant to FEMA and to the feds to be able to have our crisis counselors start reaching out on top of the existing resources. Some teams of crisis counselors will be reaching out to vulnerable populations, reaching out to people who’ve been sick, reaching out to families that have lost a loved one to COVID-19 and providing psychological first aid and some early intervention for them. And then if they need additional support, linking them to ongoing treatment resources and you really hope that we can help people right away.

Gehrke: It seems that there are probably additional barriers when we’re dealing with older populations or reaching minority populations. What’s being done to make sure you’re reaching people as broadly as possible?

Thomas: So to make sure that we’re reaching broad populations, one of the crisis counselor teams that we’ve asked FEMA to fund is a team that is focused on tribal populations and ethnic minority populations that are disproportionately affected by COVID-19 and rural hotspot communities. We’ve done that based on the data that we’ve seen that communities of color are being disproportionately affected. The other focus both in our grant and our outreach is with nursing facilities, both with patients and staff, to have the psychological first aid interventions.

The elderly, as we know, are more susceptible to the illness, so we’ve been working with the Department of Health and the nursing home association to provide tools and a special information packet to them to help with issues that are specific to the nursing home population.

Gehrke: Are there other resources available to the general public?

Thomas: We do have some new tools that we’re able to use, like the My Strength app, which is free for all Utahns. It has COVID-19-specific resources to help with the current changing landscape and how they manage stress and fear and anxiety. … The Intermountain Healthcare Emotional Health Relief Line [1-833-442-2211] that they opened up just in April is getting about 30 phone calls a day and is offering support and coping strategies and care options for callers, as well.

We have seen a slight increase in suspected fatal overdoses during the COVID period. Nonfatal overdoses were pretty stable until the week of [April] 26th when we did see an increase in suspected opioid-involved nonfatal overdoses, though, so we're looking at those.

And really what we're understanding is that the mental health and substance abuse consequences are likely to be present after the peak of the pandemic. So what we're trying to do is get a lot of early intervention things out there so that people can manage with some tools on their own. We've increased the telehealth availability of mental health and substance use, therapists and counselors and doctors and all those associated four-fold since the epidemic started

Gehrke: That’s significant. How does it work if someone wants to access those telehealth resources? What do they need to do?

Thomas: So if someone’s wanting to get some help … they can call their local mental health or local substance abuse authority or find the treatment locator map online. … [After they register] they’ll get an invite and click into a secure link and have an appointment with a professional who will do an intake and assessment and then provide a treatment plan. And sometimes that will just be therapy and maybe it’ll involve some other psychotherapeutic interventions. And sometimes, depending on the severity, it may include medications.

We’re really just encouraging everyone to reach out. Reaching out is a sign of strength. It takes courage to reach out when you need help. And we don’t want people suffering alone.

Additional mental health resources are available from the Utah Division of Substance Abuse and Mental Health (dsamh.utah.gov). Those in immediate need of help should call the Utah Crisis Line at 1-800-273-8255. Mental health services can also be accessed through healthyminds.org or utahsuicideprevention.org.