Coping with COVID

Putnam mental-health providers brace for effects of isolation

Mental-health providers in Putnam County fear the effects of the COVID-19 virus on residents will be felt long after the pandemic subsides.

The county’s crisis hotline saw about a 30 percent increase in calls in March and April over the same period last year, according to Michael Piazza, the county’s mental health commissioner. He spoke recently to the Legislature’s Health Committee.

On the general 211 number, there were 1,851 calls between March 1 and May 4, including 1,400 related to the virus, he said. Most regarded food insecurity. “That’s the major issue that came up,” he said.

He said that while emergency-room visits for psychiatric crises, psychiatric admissions, fatal overdoses and suicides were lower than last year, he remains concerned about people’s mental health in the long run.

“In many parts of the country they are seeing increases in overdoses and they are seeing increases in suicide that we’re not seeing here,” he said. “We’re concerned we might be in a lag, so what we’re trying to do is be prepared for that.”

Piazza noted that people are also experiencing financial stress.

“People feel a lot of shame when they’re not working, when they’re not able to support themselves, or their family,” he said. “That leads to depression, that leads to thoughts of suicide. That’s what we’re really concerned about.”

In addition, he said, not being able to hold funeral services because of social-distancing restrictions undoubtedly takes a toll. “The problem with having a family member who has died of this illness is that you can’t be in the hospital with them, you can’t be with them when they’re dying, you can’t do a wake and a funeral and a burial and all those kinds of rituals that lead us to a closure and help us to grieve and help us to mourn.

“If you can’t grieve and you can’t mourn, and you turn right around and try to make do and shop and just do the things you need to do, we’re concerned about when the other shoe might drop.”

Health care workers also can suffer. “Emergency room staff are seeing death after death, and it’s not that they aren’t used to seeing that, but when they are the ones that have to have people say goodbye to their family members on a cellphone — and they don’t have the chance to go away for a couple of days just to get themselves back together, it’s a tremendous stress,” he said.

Piazza said the decline in reports of child abuse and domestic abuse has service providers concerned that victims have been silenced by social isolation.

“Are people home and not able to report that?” he asked. “Kids are not going to school and maybe not sharing with a teacher what’s going on. We can’t presume that things are bad, we are just concerned” that there are fewer reports.

According to the commissioner, outpatient service providers are seeing as many people as they did before the pandemic hit, but now they are seeing them via telephone or video conference. However, inpatient programs such as St. Christopher’s Inn in Garrison and Arms Acres in Carmel were hit hard by illness among staff and had to reduce activities as a result, said Piazza.

Another concern among Department of Social Services personnel is how state budget cuts will filter down to local agencies. “It’s a very grave concern among directors of community services across the state,” said Piazza.

So far, Putnam County has been able to process all applications for temporary assistance.

“In the midst of all this turmoil we went into a pilot project with a number of other counties,” he said. “People who want to apply for public assistance can upload documents from their phone directly to our computers, so they can be approved without them leaving their house.”

State Sen. Pete Harckham, whose district includes eastern Putnam, recently criticized a $3 trillion appropriations bill passed in the House that would, if approved in the Senate, send $22 billion in unrestricted funds to New York State and $100 billion to hospitals and health care providers nationwide, but provide only $3 billion for mental health support.

“I applaud our representatives in Congress for moving swiftly to shore up state and local governments, health care infrastructure, education and social service programs with this new relief package,” he said. However, the bill “fails to help the millions of Americans struggling right now with substance-use disorder and mental-health issues who are already falling between the cracks because of severe underfunding of treatment and care providers.”

Harckham said behavioral health providers have been pleading for $38.5 billion.

“The dire circumstances created by the COVID-19 pandemic — closed facilities, reduced access to supervised care and medication, social isolation — have resulted in ‘deaths of despair’ increasing across the country,” he said. “Dribbles of support will not help our friends and neighbors, and many will suffer and perish because of this relative neglect.”

If you or someone you know is in crisis or needs to talk, call the National Suicide Prevention Lifeline at 800-273-8255.

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