COVID-19 strains mental health for many

Amidst the current global pandemic, physical health is often at the forefront of many people's minds. But one facet of health and wellness that people may be neglecting is their mental health.

The World Health Organization defines mental health as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.

But in a year with unprecedented stress and uncertainty for many, what impacts on mental health might be going unacknowledged or untreated?

Marketing Director and Public Information Officer for Mental Health Partners, Kristina Shaw, said that the non-profit organization, which serves Boulder and Broomfield counties, is seeing an uptick in mental health issues.

"I think it's across the board. I think everyone is being affected by the pandemic, and everyone's mental health is being affected. That's not a light thing to say. I can't think of another time in history when one incident has affected everyone in some way," Shaw said.

Recent findings from an annual poll conducted by the Colorado Health Foundation reported that one in two Coloradans have experienced mental health strain because of the coronavirus with 53% of Coloradans reporting increased mental health strain such as anxiety, loneliness, or stress. This strain has often tied to financial stress, especially for unemployed Coloradans, a number that theU.S. Bureau of Labor Statistics reported at 206,100 people or 6.7% of the state's population as of August 2020.

"We're seeing that populations who were already in unstable situations are really impacted by it," Shaw said. "Older adults who often feel isolated or depressed through life transitions are feeling a little more isolated or a little more depressed because of the COVID restrictions."

Christine Ruth, M.Div., MS, LMFT, who owns Niwot Counseling Center, has been a licensed therapist for 15 years with a private practice for over 20 years. In 2010, she shifted to marriage and family therapy with a focus on relationships. She has been practicing in Niwot for the past two years, and when COVID-19 closures went into effect in March, she shifted her services to telehealth. Now, she is seeing patients both in person and virtually.

"A lot of my patients are having a really rough time with telehealth, especially seniors," Ruth said. "I am working with a lot of seniors who are living all by themselves, and I am the only person with whom they interact."

According to Ruth, children, especially teens, are another demographic that is being disproportionately affected as they are dealing with instability, missed life events, breaks in continuity of learning, and changes to their routine. Often parents or caregivers aren't equipped to provide help, as they are navigating similar but different mental health strains themselves.

"Teenagers are really struggling because of online school. It's really creating some havoc for kids. I have a lot of teenagers who are really struggling right now with their family dynamics and not being able to be with their friends," said Ruth.

And Ruth noted that for couples and families, relationship strain is rampant, in part due to the effects of quarantining together. "The two demographics I am seeing the most increase in during COVID are couples and teenagers. And COVID has been really hard on marriages. It's provoked a lot of couples to re-evaluate their relationships," she said.

Much of the mental health strain is related to financial insecurity and unemployment, with low-income families and individuals citing the greatest levels of concern. According to the Colorado Health Foundation poll, more than one in five Coloradans (22%) are worried about losing their home in the next year, more than one-quarter (27%) are concerned about going without health insurance, and one in five (20%) are worried about being able to afford to feed their family.

"On top of COVID, [people are] absolutely dealing with the stress of financial insecurity, the stress of having to relocate, the stress for many of them who are having to pay rent for small businesses when their small businesses are closed," said Ruth.

And as financial strain worsens, people are less likely to seek mental health support for ongoing issues. According to the Colorado Health Foundation poll, 33% of Coloradoans cited cost/expense as the main reason that prevented them from seeking mental health services or substance use services when they needed them, followed by inconvenience and not knowing where to go (26%), not having insurance or having insurance that wouldn't pay (19%), and stigma or fear of judgment (14%).

"Several of my clients who really need therapy had to stop receiving therapy because they lost their jobs. Even though my practice has doubled, I've lost 20% of my clients who said they couldn't afford it," said Ruth.

But even as people are feeling less able to seek these services, the need is on the rise. Ruth has had to limit the number of intakes she can do and is seeing a maximum of about 20 patients per week. "It happened so fast, and, as a mother, I have been trying to stay part-time, and I could easily go full-time right now," she said.

Both Ruth and Shaw also called attention to worrisome trends in increased suicidality and suicidal ideation. "The rates of suicide and suicide ideation have gone up in the past six months," said Shaw

"I'm dealing with a ton of kids related to suicidality and suicide thoughts, and I haven't had anything like this before," said Ruth. Colorado normally has one of the higher rates of suicide compared to other states in the U.S., and the pandemic seems to be exacerbating this problem.

Suicide prevention is a core focus of MHP, and the organization routinely works to raise awareness through suicide prevention training and mental health education. "Our goal is to make a suicide safer community with everyone to be aware of suicide, especially during challenging times," said Shaw, who encouraged people to visit www.mhpcolorado.org for more detailed resources.

For those looking to connect with a mental health professional, one positive that has come from the coronavirus is that many practitioners and organizations have made a rapid shift to increase their telehealth offerings, enabling communications with clients who previously might not have been able to attend in-person sessions.

While telehealth is not a new concept or technology, Shaw says MHP has seen a bit of a mindset shift with clients and practitioners being more willing to try new methods of care. "The pandemic has opened up opportunities to explore telehealth to a greater degree. We have found that most of our clients really enjoy the telehealth setting. It eliminates a lot of barriers to care that our population has with transportation," she said.

Ruth confirmed seeing positive results for certain clients in her own private practice as well. "Teletherapy is ubiquitous. It's easier to do therapy now than it ever has been. The brilliant thing is that teletherapy is working really well, and I am finding my clients are more relaxed," she said.

Both Ruth and Shaw encouraged people to be aware of their mental health and to seek help as needed.

In addition to offering personalized care plans for individuals seeking mental health support, MHP also offers a wide variety of online resources and educational opportunities such as the upcoming Community Conversations series, a free virtual event focusing on the impacts of mental illness on social systems and programs that address these challenges.

And at the end of the day, Ruth noted, sometimes a conversation can be hugely beneficial. "I would really encourage people to reach out for support," she said. "A lot of people are making use of and benefiting from just talking about what this has been like for them, and it's really important to try to put it into words."