Mental health providers see demand grow amid pandemic

'It is a global crisis that we are all dealing with'

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The coronavirus crisis has impacted mental health services across metro Denver in different ways.

One provider, AllHealth Network, with locations in Arapahoe and Douglas counties, has taken on hundreds of new clients amid the COVID-19 pandemic. It's also seen an increase in pharmaceutical needs and expects that demand for treatment will continue rising.

Another, Community Reach Center in Westminster, reports a dip in the number of new clients it typically takes on, while also watching demand among its acute care services rise. That's left the center's chief clinical officer afraid that community members are pushing off mental health treatment during the pandemic until they reach a crisis point.

Both organizations report seeing higher levels of loneliness, anxiety and depression within their communities. The COVID-19 pandemic is also unique, they said, in that it has affected people across the globe and across demographics.

“Historians and probably social scientists around the world are grappling with that right now,” said Abigail Tucker, chief clinical officer for Community Reach Center. “Something that is so unique to COVID is that it really is, other than I suppose perhaps climate change, it is a global crisis that we are all dealing with.”

The pandemic hasn't caused fear about physical health, job security, and economic stability alone, Tucker said. It also created barriers to common coping mechanisms. Ways someone might usually relieve stress — eating at a favorite restaurant, visiting a friend — are harder or impossible amid the pandemic.

Cynthia Grant, chief clinical officer for AllHealth Network, based in the Centennial area, said the organization has seen nearly 500 new clients since the state's stay-at-home order began. The pharmacy department's volume is up more than 30%.

“Demand for services is high and it's continuing to go up,” she said. “Everything at the beginning was focused on medical and now we're seeing a shift toward behavioral health. I really think this is just the tip of the iceberg.”

Staff delivered more than 6,400 therapy services in the past month, and the no-show rate among clients is sitting around 8%, a couple percentage points lower than usual, she said.

“Everyone shows up,” she said. “It's a very captive audience.”

Roughly 71% of services are being delivered by telephone and 23% by video conference. Certain services are still available to in-person care, including AllHealth's acute treatment unit, crisis stabilization unit, walk-in crisis center and medication services. Similar programs are also available to in-person treatment at Community Reach Center.

Grant said she has heard anecdotally AllHealth is seeing “a lot of people who are” essential workers like restaurant staff, grocery store employees and people providing delivery services.

AllHealth typically serves 18,000 people a year and employs 200 clinical staff across 11 locations. It also has providers at south-metro schools and jails.

Community Reach Center serves numerous communities in the north metro, including Westminster, Thornton, Northglenn, Brighton, Broomfield and more.

The mental health center has largely transitioned to using Telehealth, a remote platform, during COVID. Early into the transition, the center saw clients spending roughly 20 minutes on sessions, Tucker said. Three to four weeks ago, that shifted, and clients began spending 30, 45 and up to 60 minutes in a session. That is more typical of sessions before the pandemic struck, Tucker said.

“We know that people are sort of settling back to their treatment goals,” she said, explain that's brought relief amid other troubles. “One of the things that we do see emerging though that does concern us is the level of acuity.”

Acuity means people who are acutely psychotic, struggling with suicidal thoughts or experiencing symptoms in multiple areas of their life.

Along with higher acuity, the center has seen fewer new clients seek services amid the pandemic. On average, Tucker said, they sign up between 800 and 1,000 people in a month. That's dropped to between 600 and 800 in April and March.

She worries those 200 people they would usually bring in as clients are not getting help until they are acutely ill.

Tuckers understands the hesitation to seek help. People are scared to leave their homes, afraid of taking a spot at the center from someone in more distress or combatting stigma and isolation, she said.

Tucker also fears some people are not aware they can continue receiving behavioral healthcare during community shutdowns, despite the center's best outreach efforts.

“Access to treatment sort of changed overnight,” Tucker said. “We don't want people to think that they cannot get mental health services.”

One of the center's school based managers March Ryan said there are positive outcomes from the behavioral healthcare world's experience with COVID.

Community Reach Center operates the largest school-based services program in Colorado, according to its website. The program provides students with counseling and case management in school.

Using Telehealth has allowed the center to continue fostering relationships with clients while they cannot meet in person, Ryan said. Her team is also seeing higher engagement among parents of younger children while administering care remotely.

Ryan thinks people will continue using remote services after the pandemic, and that Telehealth might eliminate some barriers to treatment, allowing the center to reach families whose parents work long hours or struggle with childcare.

That's a good thing as she braces for future demand and continued effects on the community's mental health, she said.

“I'm anticipating that we're going to have an increase when we do come back to school,” she said. “It's tough, it's hard for kids to be out of that structure and routine (of school) and coming back there may be anxiety.”

COVID-19, Colorado

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