A pandemic of mental proportions: COVID-19 affects Chatham’s, America’s mental health

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Kristin Krippa works with crises for a living. As a mental health therapist, she’s used to people sharing their mental and emotional issues with her.

But nothing she’s faced has been like the COVID-19 pandemic.

“This is an ongoing crisis and there’s no particular end in sight for some people,” said Krippa, who operates Krippa Family Psychological & Wellness Services in Pittsboro. “So they have much higher stress levels — anxiety, depression, sleep problems. And these are all in people that don’t necessarily typically suffer from those issues.”

Health officials across the world have been expressing concern about the mental health of people in the response to the COVID-19 pandemic, and early research on the topic has proven that concern valid.

A pair of surveys — one from the University of Michigan’s Parenting in Context Research Lab and another from the Kaiser Family Foundation — found that many American adults are struggling with their mental health in this time.

“Nearly all respondents’ mental health and wellbeing appear to have been affected by the pandemic,” wrote Shawna Lee and Kaitlin Ward from the University of Michigan. “Common concerns were feeling tired or having little energy, trouble sleeping, and feeling hopeless. The majority of respondents reported feeling nervous, having trouble relaxing, and being afraid several days or more in the previous two weeks.”

And Chatham County is no different — as public health and safety officials and mental health practitioners are seeing high numbers of calls for depression and suicide and people who don’t normally have mental health issues experiencing them more regularly.

An age of anxiety

The University of Michigan study surveyed 562 American adults asking about their mental health in relation to the novel coronavirus pandemic. Lee and Ward’s report stated that of respondents, 75 percent reported feeling tired or having little energy and 67 percent said they were feeling “down, depressed or hopeless” over the prior two weeks. Additionally, 84 percent reported feeling “nervous, anxious or on-edge.” Those are clinical symptoms of depression and anxiety.

“For nearly all Americans, daily life has been significantly disrupted. People must navigate this unfamiliar terrain under enormously stressful conditions of economic uncertainty,” the report on the study stated. “As the pandemic worsens, and disruptions to daily life worsen, mental health professionals need to be prepared for an increase in mental health and substance use problems.”

The Kaiser Family Foundation’s April poll came to a similar conclusion. Forty-five percent of US adults surveyed “reported that their mental health has been negatively impacted due to worry and stress over the virus.”

“As the pandemic wears on, it is likely the mental health burden will increase as measures taken to slow the spread of the virus, such as social distancing, business and school closures, and shelter-in-place orders, lead to greater isolation and potential financial distress,” the report stated. “Though necessary to prevent loss of life due to COVID-19, these public health measures expose many people to experiencing situations that are linked to poor mental health outcomes, such as isolation and job loss.”

Chatham County residents haven’t been polled related to COVID-19 — although a collective of agencies will be working in the coming months on a study related to the pandemic utilizing members of the study cohort of the Chatham County Community Assessment. But anecdotal reports from those on the frontlines indicate that more people than just those already experiencing mental illnesses are taking advantage of help. Krippa said the amount of fear and stress her clients are feeling is higher than what she saw after 9/11.

“This is bigger,” she said. “This is worldwide, and it’s not happening ‘over there.’ The virus is invisible. I’ve had people have panic attacks in the store because, ‘People are getting too close to me, and they weren’t doing their part and I was six feet away.’ In that respect, I think it is different. This is a threat that can come into my home.”

Dr. Luke Smith, director of El Futuro, a mental health clinic in Siler City that serves the Hispanic population, said the families he’s seeing are experiencing stress that far surpasses what others might be having, leading to an “increase in demand” for services.

“I think some of us got a taste of that when our toilet paper rolls ran low and we worried about getting the next roll,” Smith said. “For many of the families we help, the scarcity is not just with toilet paper but with food, medicine, rent payments and light bills. This has been a really hard time for the Latino community and so depression and anxiety have increased.”

Chatham County Sheriff Mike Roberson told the News + Record last month that the department has “seen an increase in depression, mental health calls, overdoses, suicides, mental health commitments, and even responded to a fair number of domestic-related calls.”

Looks different for everybody

How mental health issues manifest in people is not universal, but often depends on age and situation in life.

Children have had their entire routines, for the most part, upset with the closure of school building and shift to online learning. Stay-at-home orders will often keep them from seeing friends and family. Krippa said she has been talking with children and teenagers daily about what they’re feeling.

“What we’re seeing now in kids who had been very resilient, now they’ve regressed and their stress levels are very high,” she said. “Children’s behavior is how they communicate – so that translates into behavior problems, sleep problems, things that parents are concerned about.”

Krippa added that these children are “being expected to complete school work during a pandemic,” producing the dual challenges of wrestling with anxiety, depression and stress and trying to learn and be educated. It’s a “challenge,” she said, “that some are not able to meet.”

Schools being closed adds an extra layer of stress for parents as well, Krippa said. If the parents are employed and still working during the COVID-19 pandemic, they face a new responsibility: home-schooling.

“This increased number of roles is overwhelming for many parents,” she said. “Then add to that their children and teens developing increased behavioral or emotional concerns.”

Smith said many of the adults El Futuro treats haven’t taken off from work because they work in factories, construction, housekeeping — jobs that are considered “essential.” But if those factories do close down and jobs are lost, the anxiety ratchets up.

“When factories have shut down, it has been very, very stressful for the workers because they are pushed to the breaking point as economic resources dry up,” Smith said. “For those who don’t have citizen benefits and no stimulus benefit is coming to them, it’s quite concerning. That stress in the family affects the adults and the children alike.”

The Kaiser Family Foundation survey reported that 31 percent of individuals 65 years old and older reported negative mental health impacts. Dennis Streets, the executive director of the Chatham County Council on Aging, said in an April 2 interview that his agency has taken extra care to reach out to the seniors in Chatham they serve during the pandemic.

“I think the tricky thing in this is about a quarter of our seniors in the community live alone,” Streets said. “Restricting visitation is so vital. At the same time, we don’t want to leave these folks socially isolated. And so it’s that balancing act.”

The COA has been making friendly calls to try to connect with these seniors and delivering meals, word search puzzles and more items to attempt to boost spirits and keep them, as Streets said, “not only active and engaged but mentally active and engaged.”

A unique stress

In late April, The New York Times reported a suicide, but not just any suicide.

Described by the paper as “a top emergency room doctor at a Manhattan hospital that treated many coronavirus patients,” Dr. Lorna Breen took her own life on Sunday, April 26. Breen, the medical director of the emergency department at NewYork-Presbyterian Allen Hospital, had contracted COVID-19 herself and took a week-and-a-half off. According to her father, she did not have a history of mental illness, but she took a turn in the weeks prior to her suicide.

“He said that when he last spoke with her, she seemed detached, and he could tell something was wrong,” the NYT report stated. “She had described to him an onslaught of patients who were dying before they could even be taken out of ambulances.”

Dr. Philip Breen told the paper: “She was truly in the trenches of the front line. Make sure she’s praised as a hero, because she was. She’s a casualty just as much as anyone else who has died.”

Krippa said she’s spoken to children of healthcare professionals who are petrified of what might happen to their parents.

“I’ve had 10-year-olds tell me, ‘I know my parents are getting sick, it’s just a matter of when,’” she said.

Michael Zelek, the division director of health promotion and policy at the Chatham County Public Health Department, said the agency has been sharing mental health help resources with both its own staff and Chatham healthcare workers during this time.

“Frontline workers and essential workers can experience burnout in addition to fear of exposure to the virus,” Zelek said. “Responding to COVID-19 is a full-time (7 days/week) effort for many of our staff, and we are constantly looking out for and checking in on each other. The good thing for us in Chatham is that we work well together and take care of each other, and I think that setting a tone of support and camaraderie is where it begins.”

The CCPHD was among the first responders in North Carolina to a COVID-19 case, as Chatham was home to the second announced positive test in the state back in early March. CCPHD Director Layton Long told the News + Record later that month that his department was “holding together, some days more than others.”

“But we’re here for the public,” Long said. “It is our core mission. It is why we exist. It is. It is a public health department. We do a lot of individual services for the community. But at the core of our mission, the reason we exist is to help the public’s health and that’s what we’re striving to do.”

Resources available

While Chatham County residents have in the past expressed a relative lack of knowledge of mental health services — just 39.5 percent said they knew where to find such services, according to the 2018 CCCA — there are a number of options available for individuals seeking help during the COVID-19 pandemic.

Three new helplines have been created during the pandemic to provide mental health help:

• Hope4NC (1-855-587-3464) is available in all 100 counties and “connects North Carolinians to additional mental health and resilience supports that help them cope and build resilience during times of crisis,” according to a N.C. Dept. of Health and Human Services press release.

• Hope4Healers (919-226-2002) is specifically for providing “mental health and resilience supports for health care professionals, emergency medical specialists, first responders, other staff who work in health care settings and their families throughout the state,” NCDHHS said.

• **ASK (**275), operated by Cardinal Innovations Healthcare, is a new mental health helpline for Cardinal’s service area, which includes Chatham, designed to “make Emergency Departments available for those in the most acute need,” according to CEO Trey Sutten.

CCPHD also has webpages with lists of resources for people seeking help during the COVID-19 pandemic and needing mental health help. They include:

chathamnc.org/coronavirushelp

chathamnc.org/coronavirusayuda (in Spanish)

chathamnc.org/mentalhealth (year-round mental health resources)

Advocates and health officials have said that connecting with others and supporting each other is the best thing people can do for mental health in general.

“It could happen to anybody,” Krippa said. “We don’t know what our neighbor or our loved one may have experienced in the past that may make them vulnerable to anxiety, depression, stress. Sometimes when people are overwhelmed, then you can’t handle the day-to-day things that you normally would be able to. We need to be able to extend some patience to people, and understand they’re probably doing the best they can with what they have right now.”

Zelek encouraged those who are struggling to “please reach out.”

“There are people out there who can help and you are not alone,” he said. “Remember, we are all in this together, so let’s all look out for each other.”

Reporter Zachary Horner can be reached at zhorner@chathamnr.com or on Twitter at @ZachHornerCNR.