‘Downward spiral of depression’: Coronavirus jeopardizes senior, child mental health

Marilyn Rix misses the sense of community from the fitness class she frequented before the coronavirus pandemic disrupted everything.

Without the classes, in-person church services and Al-Anon meetings, the 79-year-old Modesto resident says she’s fighting back cabin fever in the mobile home she shares with her son and daughter-in-law.

Mental health experts warn that the stress and anxiety of the pandemic will take a toll on mental health for people of all ages, but seniors and children face high risk.

Rix is among the 90,000 Stanislaus County seniors whom therapists say are especially vulnerable to social isolation and loneliness during the stay-at-home order.

While calling or texting isn’t quite the same as sitting down with her bible study friends, Rix says the contact and her faith help her cope.

But the phone isn’t enough for some seniors, said Vintrica Grant, a mental health clinician for the county Aging and Veterans Services.

“There are some who are definitely starting to feel that they’re going into that downward spiral of depression because of lack of physical interaction with individuals,” said Grant, who has checked on seniors over the phone. “…Some family members may not be able to come see them or they basically have to stay at home, not go to their exercise classes, go to certain meetings or have lunch with their friends. That’s definitely contributing to a depressive state.”

ECONOMIC INSECURITY ADDS TO ANXIETY

Financial hardship can further exacerbate depression in seniors amid the pandemic, said Marjorie Sturdy, a licensed clinical social worker in Stanislaus County. The majority of Sturdy’s senior clients live from paycheck to paycheck, relying on monthly social security and Supplemental Nutrition Assistance Program benefits. The current economy can jeopardize their livelihood, Sturdy said, as their spouses and adult children lose their jobs and ability to support them.

“You already have food insecurities because they only get $150 or $200 a month in food stamps,” Sturdy said. “You already have financial insecurity: Can I even buy deodorant next week? Then add this on? It’s pretty overwhelming for people.”

As food banks serve more people and essential items fly off store shelves, Sturdy added that seniors won’t get substantial direct help from the federal coronavirus relief package, either. Unlike those who could work before the pandemic, Sturdy said seniors will not receive unemployment benefits.

Even so, help is available for struggling seniors, Sturdy said. Therapists, both inside and outside county services, are working with seniors in phone and video calls.

Stanislaus County Aging and Veterans Services, for one, has replaced home visits with phone call sessions for participants in Project Hope. The calls are shorter than in-person visits, Grant said, but the county is working with seniors through issues such as bad phone reception and fatigue from holding a phone.

The general senior information line has received an influx of calls in the past few weeks, so Grant encouraged people to leave a message with their name and number if they don’t reach an operator right away.

CHILD CRISIS, SUICIDE HOTLINE CALLS INCREASE

Demand for child crisis services has also increased with the spread of COVID-19, said Ruben Imperial, director of Stanislaus County Behavioral and Recovery Services (BHRS).

Services include emergency psychiatric evaluations for individuals who are a danger to themselves or others or are gravely impaired and need immediate intervention.

Imperial emphasized that the pandemic is a dynamic situation and said, “We are closely monitoring our crisis and Access hotlines so we can respond to our community’s needs.”

An increase in suicide is also feared by research psychologists, based on experience with previous disasters. Some individuals already struggling with suicidal ideation — thinking about or planning a suicide — may find such thoughts amplified during this stressful time.

Compared to the same time last year, Imperial said the Central Valley Suicide Prevention Hotline has received more calls.

The Central Valley hotline receives calls from throughout the region, but they are able to track the county from where the calls originate. The regional hotlines are linked with the national suicide prevention lifeline at 1-800-273-8255.

National lifelines are seeing an increase in calls, according to Elinore McCance-Katz, assistant secretary of the Substance Abuse and Mental Health Services Administration, in a March 29 interview with NPR.

MODESTO-AREA SCHOOLS CONTINUE COUNSELING

School districts across the county realize children and families are under the strain of the pandemic, and are continuing to provide mental health services even while campuses are closed.

“School counselors have scheduled ‘office hours’ each day when they are available to students and parents without appointments. We also have a Counseling Support Hotline phone number,” said Tracy Manzoni, director of student support services for Patterson Unified School District in an email to The Bee.

Manzoni reviews all support line calls to help identify services. The district also has a licensed therapist through a partnership with Legacy Health Endowment.

In addition, Patterson, Denair, Turlock, Ceres and Modesto City Schools districts, as well as others in the county, are providing ongoing access to school counselors and other services. Most offer support in English and Spanish.

Although the districts expressed worry over all their students, they noted additional concerns for those at risk for maltreatment and pre-existing mental health challenges. Most districts have implemented plans to contact the particularly vulnerable families proactively, and their websites provide information for mental health resources.

“We are contacting parents of students receiving mental health services by clinicians for ongoing check-ins and support,” said Marie Russell, communications coordinator for the Turlock Unified School District.

Russell said TUSD is providing multiple ways for students and parents to access services, including an online TOOLBOX (mental health resources), TUSD’s newsletter, social media, and TUSDtv broadcast.

Modesto City and Ceres Unified districts’ websites provide information to access resources for students and parents.

HOW TO GET HELP IN STANISLAUS COUNTY

In addition to crisis services, the county’s Imperial said Behavioral and Recovery Services is continuing to operate essential programs for their clients.

The agency is also responding to new requests. New clients go through a phone screening to assess the acuity of their needs. For those in crisis, an immediate response is provided, and others will be given an appointment.

Imperial said the triage team will make routine phone checks while clients await their appointment.

Ongoing BHRS services include:

  • Psychiatric crisis evaluations
  • Medication services, including methadone programs
  • Community Emergency Response Team, CERT, continues to respond to people with psychiatric emergencies, such as suicide attempts, typically seen at local hospital emergency rooms
  • Residential programs, including accepting new patients after screening for COVID-19
  • Outpatient programs are also remaining open, but by appointment only

BHRS currently uses telehealth for some psychiatry visits, in part due to the chronic low number of psychiatrists in the county. They’re broadening these services to include counseling, too.

“With the pandemic, we are expanding our use of telehealth visits,” said Imperial, “Changes in state legislation has allowed the flexibility for us to increase these services.”

He said an example of change is allowing the use of a wider range of software, such as FaceTime, which wasn’t permitted before.

BHRS also operates a senior access treatment team specifically designed to meet the unique mental health needs of senior citizens, including coordination of physical and mental health care.

AN OPTION FOR PRIVATE PRACTICE THERAPISTS

Private practice therapists are also providing telehealth services during the pandemic. Insa Duke, a licensed marriage and family therapist, said she hosts Zoom sessions from her office so her patients see her with a familiar background.

“I’m trying to maintain as much normalcy as possible for my clients,” Duke said, noting their most common diagnoses are general anxiety, depression and post-traumatic stress disorder.

Advice she shares with her clients includes:

  • Practice mindfulness to focus on the moment, and not the fear of the future
  • Identify things over which you have control, such as hand hygiene, to help to not feel so powerless over the pandemic and the related panic
  • Participate in activities that help relieve stress, such as walks outside
  • Try to keep routines as normal as possible

The following help lines are also available:

Suicide Prevention & Crisis Services, 24/7 call 1-800-273-TALK or 1-800-SUICIDE

Emergency Services, call 1-209-558-4600 if you are in a crisis and need to speak to someone; non-English assistance is also available.

Stanislaus County Behavioral Health Program, call 1-888-376-6246 to access county program information, mental health and alcohol and drug services.

Stanislaus Center for Aging Senior Information Line, call 209-558-8698 to get connected to local senior services, including counseling and elder abuse support.

Stanislaus County #211 or https://stanislauscounty211.org/ for health and human services assistance.

This story was produced with financial support from The Stanislaus County Office of Education and the Stanislaus Community Foundation, along with the GroundTruth Project’s Report for America initiative. The Modesto Bee maintains full editorial control of this work.

Read the full article here.