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Pandemic has pushed demand for behavioral health services

Skagit Valley Herald - 10/18/2020

Oct. 18--Providers of mental health and substance abuse care in Skagit County are confronting a spike in demand spurred by prolonged loneliness, fear and financial insecurity caused by the COVID-19 pandemic.

Connie Davis, chief medical officer with Skagit Regional Health, said the effects of such despair are visible at Skagit Valley Hospital.

There, health care workers are seeing a noticeable increase in those seeking help who have never before presented with what are termed behavioral health issues.

The stress of unemployment and isolation is also pushing those with existing mental health issues to desperation, she said.

"It has me quite alarmed," Davis said.

Alcohol-related trips to the Skagit Valley Hospital emergency room have nearly doubled since the onset of the pandemic, and suicides and overdose deaths are also increasing, she said.

Patients are reporting anxiety over job loss or some other reduction in income, and Davis said there's little that can be done in the way of treatment for those who have lost a feeling of financial security.

Davis and her team in the emergency department see patients in crisis. Mental health care providers who treat patients in less urgent situations say things have worsened there, too.

Margaret Rojas, assistant director of the North Sound Behavioral Health Administrative Services Organization, said calls to the county's mental health crisis line have increased dramatically since the beginning of the pandemic.

Normally, she said calls are brief and specific, with callers asking for assistance or support on a single issue.

Now, though, she said callers are staying on the phone longer. Those who have never called before, and have never been treated for a behavioral health issue, are calling with concerns about the virus' impact on their lives.

"Most of the calls are about what's going on with the virus," Rojas said.

Pat Morris, senior director of behavioral health with Volunteers of America Western Washington, oversees both the mental health crisis line and the suicide prevention lifeline for Skagit and other counties in the region.

Calls are increasing month to month, with September showing a 17% increase over July, according to data from the nonprofit.

She said callers sound more distressed, and the emotional wear and tear of the pandemic is clear. Callers are complaining of missing family, or expressing fear over financial issues or eviction, she said.

"They're finding that they're at a loss," Morris said. "We're hearing (things like) 'I thought I could handle it for a few months.'"

While temporary federal unemployment assistance helped struggling households in the early months of the pandemic, she said now callers are saying they're afraid they won't be able to cover rent or feed their families.

"Usually we can see an end in sight, and my biggest concern is there's no end in sight," Morris said.

In Skagit County specifically, Rojas said behavioral health staff have had to involuntarily commit more people than at any point in recent history.

"It's the highest it's been in six years," she said.

A patient can be detained when they present a threat to themselves or others. They are kept for a short period of time while being stabilized and evaluated, then a determination is made whether they need further care.

Brandon Foister and Amy Pereira, who work in crisis care with behavioral health services provider Compass Health, said they've also seen an uptick in calls from those who have never sought help before.

As director of crisis response and stabilization and of Whatcom outpatient services, Foister oversees the team of mental health professionals who can respond to those in crisis anywhere in the region.

Compass' crisis responses are up about 13% during the pandemic, compared to the same period last year, he said.

Many Compass patients are experiencing difficulty accessing care, because of issues related to the pandemic. A lack of child care, housing instability, or the loss of insurance due to a layoff are all playing factors, Foister said.

"It's going to leave them more vulnerable than they were before," he said. "We are seeing the deepening of a crisis."

Pereira, associate director of crisis response and stabilization at Compass Health, said the provider has had to adapt to tackle this issue, and is focusing on offering services online.

While online services don't perfectly replicate the experience of an in-person session, she said patients are responding favorably.

"The beauty of this new system is ... we can respond to Concrete, if the technology is there, in 15 minutes," Pereira said.

Judy Heinemann, Compass' director of outpatient services for Skagit, Island and San Juan counties, said she's heard the same thing from her team.

"Many of the clients were surprised at how well it worked," she said.

There's been an increase in requests for services, specifically centered around depression and anxiety, she said. For those who deal with chronic mental health issues, the fear of joblessness, homelessness and the loss of access to care compound their issues.

"All of these pressures build up over time," Heinemann said.

Heather Young, vice president of advocacy and philanthropy with provider Pioneer Health and Human Services, said the pandemic has presented a roadblock to patients in substance abuse recovery.

In conversations with staff, Young said it's clear patients are relapsing at a higher-than-normal rate, citing isolation and anxiety.

"A big part of recovery is the community," she said. "It's really a group activity, and people can't take part in that."

Like Compass, Pioneer has expanded its telehealth operation, though Young said this kind of service hasn't proven to be well suited for all patients.

Pioneer's in-patient facility in Sedro-Woolley has had to modify layouts and reduce capacity because of the pandemic, meaning it can accommodate fewer patients at a time when demand is high.

Now, the challenge of meeting the demand for care caused by the pandemic is set to be compounded by expected seasonal increases in demand, as sunny summer days give way to a dark, wet fall.

"We're fearful it's going to get even higher," Rojas said. "If everything goes as expected, we're going to be swamped."

Between the expansion of telehealth and a drive to hire more staff, Heinemann said Compass Health is less concerned about an uptick in patients.

"We will do what we have to do," she said. "We have to meet the need."

-- Reporter Brandon Stone:, 360-416-2112, Twitter: @Brandon_SVH


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