Pandemic puts strain on mental treatment

LITTLE ROCK n— Arkansans seeking help with symptoms of anxiety and depression amid the covid-19 pandemic may have to wait up to a month to secure a bed in an inpatient psychiatric facility, according to the chief clinical director of a nonprofit mental health provider.

“There’s most definitely a wait list,” said Peggy Kelly, chief clinical director at Youth Home.

Youth Home offers inpatient and outpatient services for youth. The top diagnoses treated in its residential program are depression, anxiety and trauma, according to Kelly.

In late June, the Centers for Disease Control and Prevention did a survey on adverse mental health outcomes, increased substance use and suicide ideation during the pandemic. Almost 75% of the 731 respondents between ages 18 and 24 reported experiencing an adverse mental or behavioral symptom.

Of that same group, about a fourth considered suicide in the past 30 days, according to the survey.

Additionally, a fourth started or increased substance use to cope with pandemic-related stress.

Kelly said children who experienced trauma in early childhood and are now living through the pandemic find it difficult to cope.

“Navigating any kind of change in their environment is more challenging,” she said.

Prior to the pandemic, Kelly said patients were admitted about a week after paperwork was completed and insurance was verified. Now wait times are at least two months for the inpatient program, she said.

There is some good news, Kelly said.

“There is a lot of help available on an outpatient basis right now,” she said. “We’re normally able to get people an appointment pretty quickly.”

The Arkansas chapter of the National Alliance on Mental Illness has noticed similar problems with admission wait times.

“It’s horrible, actually,” said Buster Lackey, executive director of NAMI-Arkansas. “Since covid’s come, a lot of hospitals, they’re not even taking patients unless they go to the ER and have testing.”

Many hospitals have restricted their beds to the most serious cases, Lackey said, although admission policies during the pandemic will likely be different at every hospital.

If an individual is considered suicidal or homicidal, the staff gets the person inpatient care but it takes longer because they have to make sure the individual is covid-free and isn’t experiencing symptoms, Lackey said. If the individual is not suicidal or homicidal, the person likely won’t get inpatient care but will instead be referred back to a therapist for outpatient care.

“Many [hospitals] are requiring people seeking to be admitted to go to the local ER to be medically cleared,” Lackey said. “This causes undue stress on the ER staff and more stress for the person seeking mental health help. I would think that many just will not go to the ER and therefore will not get the help they need.”

Lackey said some hospitals offer partial hospitalizations, in which a person goes to a clinic for half a day, or sometimes the whole day, but returns home at night.

Isolation is the primary thing people are struggling with, Lackey said. He related this to people’s fight-orflight responses. In normal times children can go to school and parents can go to work, which allows them get away from a particular situation, regroup and come back. Now, all people can do is “fight,” Lackey said, with any minor thing capable of “setting a person off.”

“I wish they would not have called it ‘ social distance,’ but ‘physical distancing,’ ” added Lackey, noting that term can lead some people to believe they cannot leave their house at all.

He recommended people get out for walks and get exercise to open their lungs.

Lackey, who also runs a private social work practice in North Little Rock, also said even if multiple places have said they don’t have space, patients shouldn’t lose hope.

“Any community mental health center, there will be a therapist that will see you,” he said. “Many private practices will, even for an abbreviated session.”

Children at Youth Home aren’t getting passes to go home for the weekend because the center is trying to keep children in residential care safe from covid, Kelly said.

“Family connection is really important, because we’re working on healing the whole family,” she said.

While kids have been in residential care amid the pandemic, they have had grandparents who have passed away, parents with medical conditions and the children want to go home to be with them and they can’t, Kelly said. In lieu of in-person visits, the treatment center has relied on Zoom calls between children and family members as often as they can.

“I worry somewhat about family connection and how that’s going to be affected for these kids,” she said.