Demand rises for mental services

Specialists: Crises up since pandemic onset

Mental health specialists in Marin say they’ve seen an increased demand for their services since the coronavirus emergency began.

The number of patients who were taken to MarinHealth Medical Center in Greenbrae on psychiatric holds increased from 32 in April to 46 in June, a 44% increase.

Section 5150 of the California penal code authorizes the confinement of people suspected of having a mental disorder that makes them a danger to themselves or others. MarinHealth is the designated 5150 center for the county.

Rebecca Maxwell, MarinHealth’s director of behavioral health, said that because most outpatient mental health treatment is being supplied via telemedicine, and some people are avoiding hospitals due to fear of coronavirus infection, more patients are failing to get care in a timely fashion.

“People are increasingly encountered at a

crisis level and require an involuntary detention to get help,” Maxwell said.

The number of patients who required psychiatric services in MarinHealth’s emergency department for alcohol or substance use disorder increased from 25 in April to 45 in June, an 80% jump.

“We’re seeing a lot more overdoses,” Maxwell said. “We’re seeing a lot more alcohol intoxication and need for access to detox and inpatient rehab.”

And the number of patients admitted into Marin County’s crisis stabilization unit, which is adjacent to MarinHealth Medical Center, increased from 87 in April to 117 in June, a 34% increase.

Most patients don’t remain in the unit long because it has only 17 beds. Many Marin residents who require hospitalization for a mental illness must be sent to hospitals outside the county.

The number of Marin mental health patients requiring hospitalization increased from 36 in April to 44 in May before returning to 36 in June.

Kaiser Permanente declined to supply data on the number of patients seeking mental health services in San Rafael over this period.

However, Dr. Nick Winer, Kaiser’s chief of psychiatry and addiction medicine services in San Rafael, said, “We’ve definitely seen a rise in anxiety and an increase in substance use disorders related to COVID-19 in the last last couple of months.”

Mitesh Popat, CEO of Marin Community Clinics, said the number of completed mental health visits in his organization have increased from roughly 900 to 1,400 per month due to two factors: increased demand, and telemedicine resulting in fewer no-shows.

Maxwell said, “Routine in our daily lives supports us in ways that we don’t necessarily appreciate until our routine gets upended and then some of our maladaptive coping skills like drinking and drug use tend to compound.”

Maxwell also said there has been an increase in suicide attempts and suicidal ideation among Marin patients during the pandemic. She said over the last three months the number of people who jumped off the Golden Gate Bridge or were talked down from the bridge went up.

Paolo Cosulich-Schwartz, a spokesman for the Golden Gate Bridge district, said he couldn’t supply numbers for those months. He said 12 people have died since the beginning of the year, compared with 28 who jumped during the first six months of 2019.

He said the number of interventions so far this year, 96, appears to be up slightly; there were 167 during all of 2019.

Jei Africa, director of Marin County’s Behavioral Health and Recovery Services division, said the weekly average number of people calling Marin’s suicide hotline is up about 27% since mid-March.

Africa said there has been about a 33% increase in people calling a “warm” phone line with less critical needs and a 17% increase in calls for the county’s mobile crisis unit, which assists people with urgent mental health needs.

Despite the sharp rise in patients requiring alcohol or substance use disorder services at MarinHealth Medical Center, Maureen De Nieva-Marsh, program coordinator for RxSafe Marin, said the coronavirus crisis hasn’t derailed the county’s attempt to address the prescription drug epidemic.

The county’s monthly average of suspected opioid overdoses was 16 during April, May and June of 2020, compared with 11 in 2019.

Maxwell said people should be alert to signs that friends or loved ones are in need of help. These signs include changes in sleep or eating patterns, loss of energy, feelings of being overwhelmed, increased anger or irritability, a loss of interest in usual activities and increased use of alcohol or drugs. Those in need of help can call Marin’s all-hours suicide prevention and crisis hotline at 415-499-1100.

Maxwell said it is understandable that not just people with a history of mental illness are experiencing intense anxiety given the uncertainty surrounding the current pandemic. More than 34% of respondents to a national survey of 1 million households conducted by the National Center for Health Statistics in May reported symptoms of anxiety disorder or depressive disorder.

“We can’t replace the loss of somebody’s income or the loss of somebody’s housing,” Maxwell said. “Those are real and not going to be better with medication. But what we can do as mental health providers is teach people some coping skills, provide them with a level of support and let them know they’re not alone in this.”