Pandemic stresses mental health services
While medical professionals predicted a mental health crisis when the coronavirus pandemic slammed into Connecticut this spring, Richard Shulman, director of Volunteers in Psychotherapy, began to see some attrition among his agency’s clients.
That dip lasted only a little while, just at the beginning of shutdowns and furloughs. Then the reality of social distancing, job loss and the loss of life took over, and over time — Shulman insists there’s no pun intended here — clients got over their distaste for teletherapy, and zoomed back into therapy.
Just two years ago, less than half of psychotherapists offered teletherapy. Insurance didn’t always reimburse medical professionals for telephone or telescreen sessions, but that changed in March, when the Centers for Medicare & Medicaid Services expanded telehealth Medicare reimbursements for the pandemic.
The pandemic is testing the best of us with the constant loss and fear, washed through the understanding that there is no leadership in Washington to get us through this. Connecticut residents, at least, have a governor who appears to pay attention to science. Pity the snowbirds of Florida, whose governor recently sallied through a super-spreader event for Donald Trump, giving high fives to attendees without wearing a mask.
The disconnect is maddening.
An August report from the Centers for Disease Control and Prevention said nearly 41 percent of adults in the U.S. said they were struggling with substance abuse or mental health issues. People between the ages of 18 and 24 reported more symptoms of anxiety or depression disorders, as well as serious thoughts of suicide. Men said they thought about suicide more than did women. Ironically, trauma or stress-related disorder (TSRD) was reported more among people who had jobs and — not surprisingly — essential workers who have continued going to work throughout the darkest days. In May, a National Institute of Mental Health official was quoted in the Washington Post saying the country’s fragmented and often difficult-toaccess mental health care system keeps her up at night.
Now in its 21st year, VIP was born out of psychologists’ criticisms of commonplace procedures through managed care or in public clinics that can impede effective psychotherapy. The country’s mental-health system requires a diagnostic label in order for insurance to pay for treatment. Those labels can be arbitrary or destructive, and they become part of people’s permanent medical records. Insurers can require contracting therapists to send reports of people’s private therapy discussions, which undermines privacy. Also, insurance often will not pay for therapy unless it’s deemed medically necessary – but no underlying physical pathology documents what is called “mental illness.” Psychotherapy can be out of the financial reach of people, particularly people who’ve lost jobs or don’t have jobs that provide insurance.
Shulman and some colleagues grew tired of sharing war stories about the institutions where they all worked, so they banded together to create a nonprofit where psychotherapists offer services to clients, in exchange for those clients volunteering four or so hours at a nonprofit of their choice for every therapy session. The psychotherapists are paid roughly a quarter of their regular fee from grants and donations. No insurance companies are involved, so sessions are uniquely private.
Over the years, volunteers have seeded nonprofits in and around the central part of the state. The organizations in which they served ranged from hospices to homeless shelters, from Locks of Love to blood drives.
Even before the pandemic, VIP psychotherapists participated in 685 sessions in 2019, up from an average of 500 sessions a year. Shulman said there’s every indication that this year, with videoconferencing and telephone sessions, the group will offer at least that many sessions. Clients are reacting to the challenges and losses of the pandemic, and “you have a president doing all this irrational stuff, telling people this doesn’t matter, and that’s not how it works, scientifically,” Shulman said.
He likens the state mood to a forest fire.
“We’re all sort of tinder,” Shulman said. “We’re vulnerable to this. If you think it cannot affect you, all of a sudden somebody comes into your circle who is contagious and doesn't realize it.”
Shulman said VIP has loosened some of the rules for volunteering, given the need for social distancing. When the pandemic lifts, clients will be asked to make up the time, but for now, physical and mental safety is the priority.
Shulman declines to call VIP pandemic sessions “remote.” He says the sessions are every bit as personal as in-person therapy sessions, and they’re far more private because there are no required reports to insurers. He’s always looking for more licensed psychotherapists to sign on. The holidays are coming. People who’ve lost loved ones may find themselves facing the abyss, in need of a phone call, or a Zoom meeting with a professional.