Ten Months In…Pandemics Suck for Mental Health

Our governor finally acknowledged what any one working in mental health has known since March. The pandemic caused a mental health crisis that our system is unable to manage.

The first few months of the pandemic I saw an influx of healthcare providers as clients. The next few months were more teenagers, mom’s, and postpartum illness. Since September it’s the teachers. Teachers are being asked to be infectious disease specialists, technology wizards, and still teach overnight. Their classrooms are ever changing due to quarantines and their fear and anxiety is palpable.

I’ve had clients attempt suicide more since March than in my six years outpatient. I was talking to my friend, another psychiatric APRN who works inpatient, and she told me they’ve been seeing the most severe mental illness since she started working inpatient almost seven years ago. I replied that she’s not seeing the five hundred people each outpatient provider is struggling to keep out of the hospital.

There are groups now on social media for burned out therapists and mental health providers. The posts are heart-wrenching and show the battles we are mounting in mental health. A forever up hill battle with what feels like avalanches raining down on us. Because we who work in mental health also have kids, families, friends, and responsibilities. We are feeling the isolation of COVID. We are missing seeing our patients in person. We are hearing and feeling the pain and isolation our clients feel.

The week before and after Thanksgiving were horrible sessions. Clients hitting rock bottom as they realized that they would be truly alone for this holiday season. Restaurant workers are scared they will be unemployed again and they don’t want to expose their family members. I heard about FaceTimes with relatives that ended in tears for everyone because videos widen the dissonance. So close but so far.

Never have I heard people yearn for human touch as I have since March. The grief of missing grandparents and parents from their adult children and also the grief of the parents and grandparents who feel they are missing out on large pieces of their kids and grandchildren’s lives.

Our Governor encouraged people to call 211 to “get connected to services”. Get connected where? To who? For what? I can tell you to get any of my clients in with a therapist right now I have to call in favors. Every one has a waitlist. I myself am booking into January and I’m not taking on any new teenage/pediatric clients right now at all as my panel is full. Parents have cried on the phone when I’ve told them I’m not taking any new pediatric clients. Cried.

I am human. We all are. I am a parent. It feels awful down to my bones to hold this boundary. I not only treat upward of fourteen or fifteen clients a day who are hitting rock bottom but I also take calls from parents and potential clients looking to schedule intakes who are frustrated and scared that they cannot find any one taking patients. I have people calling in favors to me too. I have taken people on and seen them at 8:00 at night after bedtime with my kids because I know it was the right thing to do.

I am just one provider. This is happening to everyone. There is not a mental health provider in my state that is not swarmed with calls, referrals, new patients, old patients, and every one is in crisis.

I have clients who cannot pay for food. I have clients who have lost housing, health insurance, family members and friends to COVID-19. But most of all COVID-19 has taken security, predictability, and cast in a massive light, how much we as humans depend on human to human connection to survive and thrive.

I booked some one who is very stable a May appointment recently for six month follow up. Their eyes welled as they said softly, “Maybe by then I’ll be able to see you in person!” We can only hope I replied.

There are not enough providers. The insurance companies are making life hell. Audit after audit. Medical record request after medical record request. So in response to my Governor saying call 211. I mean sure. Call 211. Then recognize that this is a broken system. Instead of directing people to the overrun providers maybe focus your attention on insurers who are breaking the backs of providers including state Medicaid with audits during a pandemic when we are overrun with sick patients and we do not have time to deal with insurer bullshit. We are not committing fraud. Well at least I’m not. Let me do the work. Because the work is so needed.

Give psychiatric providers resources like funds to purchase PPE, air purifiers, and plexiglass so we can resume seeing people in person who need to be. Reimburse us fairly. Not at half the rate of every other commercial insurer (eh hem Anthem and Medicaid). Treat us as allies and partners in this pandemic not as outsiders, in the wings, sweeping up the mess with wet mops.

Mental health providers are the unsung heroes in this pandemic. We are the front lines providers for front lines workers. We are burning out. We need help. Acknowledging the mental health crisis without acknowledging the lags and chasms in our system is just…painful.

To my fellow mental health workers: I see you. I feel you. You are not alone. I admire the professionalism and class in the people I collaborate with am honored to share a space in the field with you.