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#JamesDonaldson on #MentalHealth – #MentalhealthProfessionals Are The Ones Taking Care Of Us: Who’s Taking Care Of Them?

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you are worthy of love signage on brown wooden post taken
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USA TODAY spoke with half a dozen #mentalhealth workers who told us the #pandemic has been the most challenging year of their professional lives.

Alia E. Dastagir,

When a world in #pandemic shut down, the #mentalhealthprofessionals did not. They kept working, many more than ever, counseling patients on how to survive something they’d never seen before, something they feared themselves. They counseled while the virus ravaged their neighborhoods, with their #children in the background, through months of racial unrest and a presidential election that was the most polarizing in many of our lifetimes. 

“This has without a doubt been the toughest year of my life, let alone my career,” said Michael Mandel, a licensed clinical professional counselor who works with #adults and #adolescents.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

USA TODAY spoke with half a dozen #mentalhealthworkers who told us the #pandemic has been the most challenging year of their professional lives. Every one of them said they’d experienced symptoms of burnout. 

Some are in therapy themselves, but most are not. These professionals are helping their #patients cope with #stress, #anxiety and sometimes unimaginable loss while also managing their own suffering. Many have taken on heavier caseloads with more #patients experiencing trauma and #suicidalideation. Most have transitioned to telehealth, which made therapy possible during the #pandemic but reduced the intimacy many therapists count on to connect.  

Yet despite how they have risen to the occasion, nearly all clinicians interviewed felt guilt – for the answers they could not give their #patients, and for the many people they had to turn away. 

“In grad school, they don’t teach you how to provide therapy and help during a #pandemic,” said Janel Cubbage, a member of the #AmericanAssociationofSuicidology and a #psychotherapist in private practice. “This is unprecedented and at times I feel really helpless. I feel like I don’t know what to do other than be present with my client and validate what they’re experiencing.”  

Janel Cubbage
Janel Cubbage, a member of the #AmericanAssociationofSuicidology and a #psychotherapist in private practice
‘I’m going through the same things that they’re going through’

‘I’m going through the same things that they’re going through’

One of the most unique challenges of #COVID-19 is the parallel experience for therapists and their #patients who are experiencing many of the same fears and frustrations, brought on by many of the same external events. 

“I’m going through the same things that they’re going through,” said psychologist Colleen Cummings, whose husband is a hospital #physician and who spent months working from home with two small #children. “A lot of us feel lonely and worried about #coronavirus and are navigating work and #kids.”

Colleen Cummings
Colleen Cummings, a #psychologist

Mandel said while he feels capable of helping his clients cope with a number of stressors, his initial fears about #coronavirus sometimes left him at a loss for words. 

“If someone comes to me and says, ‘I had this panic attack for the first time,’ I can go, ‘OK, no problem.’ I know exactly what to do.’ But when someone comes in and says, ‘I’m worried about the #virus,’ it’s really hard for me to know what to say … because this is new for me, too,” Mandel said.

This spring, a client called to tell him her mother was in the hospital with #COVID-19, and he said it “completely knocked me off my feet.”

“I just remember repeating ‘I’m so, so sorry. I’m so, so sorry,'” he said. “It was almost like, I couldn’t think of what to say or what to do because it was so scary for me, too.”

#Therapists and their #patients have lost many tools they would normally use to cope. Cubbage used to decompress on her drive home, but now she works from a second bedroom she converted to an office. Mandel said while he would normally suggest someone experiencing #depression go see a movie with friends, that option is off the table.  

“The main feeling is frustration,” he said. “It definitely does feel very boxed in.”

"One of the biggest challenges is how limited life is right now for everyone. So many of the things that I might suggest to people who are suffering with depression or anxiety, I can't," Michael Mandel said.
“One of the biggest challenges is how limited life is right now for everyone. So many of the things that I might suggest to people who are suffering with #depression or #anxiety, I can’t,” Michael Mandel said.

A shift to telehealth

The shift to telehealth has been a massive change, lowering one barrier to care but bringing new therapeutic challenges. 

Cubbage said assessing a suicidal patient, for example, is something she’d prefer to do in person, rather than over Zoom. Cummings said she’s lost valuable connections with colleagues who she would stop in the hall to speak with after a difficult session. 

Even providers well-versed in telehealth were overwhelmed because they took on the task of training others. 

Mary Alvord runs a large psychotherapy practice in Maryland that was providing telehealth services 10% to 15% of the time pre-#pandemic, she said. When her practice went exclusively remote, staff were able to adapt relatively quickly, but then she conducted telehealth training for more than 10,000 #mentalhealthproviders. 

“No wonder I am so exhausted,” she said.

More cases, more guilt, less personal time

More cases, more guilt, less personal time

People were encouraged during the #pandemic to reach for help when they needed it. And many more people needed it. 

The #CentersforDiseaseControlandPrevention has found elevated levels of symptoms of #anxiety and depressive disorders, substance use and #suicidalideation among #U.S. #adults and identified populations at increased risk, including young people, #racial and #ethnic #minorities, essential workers and caregivers of #adults.

Am I OK?: How to do a #mentalhealth check

#Mentalhealthprofessionals have been flooded with new requests. #Patients who stopped therapy asked to begin again. Some #patients who had only been doing one counseling session a month requested to be seen weekly. 

Sherry Burkhard, who co-founded the Texas nonprofit Mosaics of Mercy, which connects the community with #mentalhealthresources, recently surveyed local #mentalhealthprofessionals and found 84% had an increase in their caseload since #COVID-19 started.

Many therapists currently at capacity are taking on new cases. Some are doing it pro bono when they already struggle to earn a living wage. TWEETFACEBOOKLINKEDINEMAILSherry Burkhard, co-founder of Mosaics of Mercy

We’re helpers, we want to help everyone, we don’t want to turn people away. And so it’s really hard to say, ‘No, I can’t fit anyone else in.’ Or ‘I can’t help financially.’

“We’re helpers, we want to help everyone, we don’t want to turn people away,” Burkhard said. “And so it’s really hard to say, ‘No, I can’t fit anyone else in.’ Or ‘I can’t help financially.'”

Many therapists are working more hours to accommodate demand. Those who face child care issues are opening up weekends.

“From a #child care perspective it’s been pretty stressful,” Cummings said. “I can’t have a baby in my lap when I’m doing direct client care. … There was one morning where my daughter woke up and she had a bit of a cold and I knew I was counting how many patients I’d have to cancel that day.”

‘A culmination of crises’: #America is in turmoil, and a #mentalhealthcrisis looms next

#Psychologist Riley Benko has made an effort to keep his caseload manageable, which means he’s watched his waitlist grow. Last year, Benko was diagnosed with Hodgkins Lymphoma and worked through his treatment. He said “he was looking forward to 2020 as a rebound year. Instead, the world changed.”

In December, Benko and his wife, also a therapist, contracted #COVID-19. Benko has recovered, though his wife has lingering health effects. He said the hardest part of being sick was worrying about his clients. 

Riley Benko
Riley Benko, a #psychologist

“There was guilt,” he said. “I thought, ‘Wow, I got sick and now I’m not able to provide therapy or services like I otherwise would,’ which made it challenging to … take care of myself.”

Guilt was a common theme this past year, especially among #therapists who turned prospective clients away. Cubbage said as a therapist of color, she recognizes her services are in high demand.

According to the U.S. Census Bureau, only 4% of #psychologists in the #U.S. workforce are #Black.

‘For the first time in my life, I’ve experienced ... symptoms of burnout’

‘For the first time in my life, I’ve experienced … symptoms of burnout’

Experts say burnout occurs when #stress is prolonged, and there is no time to recover.  #Mentalhealthprofessionals are especially susceptible, and the #pandemic has made them more vulnerable. 

That feeling you can’t name?: It’s called emotional exhaustion

Tia Dole, a clinical psychologist in private practice and chief clinical operations officer at the Trevor Project, which works to prevent #suicide in the #LGBTQ community, said while #mentalhealthproviders are used to working in an emergency state, the duration and scale of the #COVID-19 emergency has been extraordinary.

"Personally, especially as a black woman, COVID was upsetting, All the events were upsetting but really the addition of what was happening over the summer with police brutality, that was actually what pushed me really hard," Tia Dole said.
“Personally, especially as a #black #woman, #COVID was upsetting, All the events were upsetting but really the addition of what was happening over the summer with #police brutality, that was actually what pushed me really hard,” Tia Dole said.

“Before, when you’d have a patient in crisis, it’s over in a couple of hours, you have a debrief, you huddle up, you go, ‘Whew,’ you go home. In this case, it is going on and on,” she said. “I became numb, and then I became overwhelmed, and then I kind of went back to numb.”

Dole, who in her private practice focuses on treating #Black, #Brown and queer people, said not only were many of her #patients struggling with a #virus that disproportionally affects people of color, but they were also traumatized by the death of #GeorgeFloyd this summer and the ensuing #racial unrest.

#Patients are also coming to therapists with more acute symptoms. Kimberly Griffin, a substance use disorder counselor at Lionrock Recovery, an online drug and alcohol addiction rehab program, who also has a private practice, said she’s seen an increase in substance use disorders as well as #domesticviolence.

Kimberly Griffin
Kimberly Griffin, a substance use disorder counselor

“For the first time I believe in my life, I’ve experienced … symptoms of burnout,” she said. “The #stress comes from trying to figure out how to help people who are experiencing something new at the same time that I’m experiencing something new.”

The #pandemic has been a traumatic experience for many people, she said. Before the #coronavirus she had a couple of clients coping with trauma, now she says she’s seeing trauma on “a mass scale.” 

“I think this past year was the most challenging in my career because it magnified how many people were really suffering mentally and emotionally,” she said. “As a therapist,  I wish I could help everyone, but that thought becomes overwhelming and, of course, it’s not realistic.”

Study: #Pandemic could push up suicides, drug deaths

For some mental health care workers, COVID-19 is a potent threat

For some #mentalhealthcare workers, #COVID-19 is a potent threat

Not all #mentalhealthprofessionals are providing care exclusively through telehealth. Some are working in hospital settings and continue to face health risks. 

Dole, who works in New York City – once the epicenter of the #COVID-19 crisis –  said when a #patient having a psychotic episode comes into an emergency room, they are not likely to follow #COVID-19 precautions. 

“You have someone who’s in a psychiatric crisis who is not thinking, who is not in their right self, who is not going to wear a mask, who is going to get too close,” she said. “I know personally so many people who ended up getting sick because of that.”

Know a #mentalhealthprofessional who is struggling? Share this storyShare on Facebook

These professionals go to work each day not knowing whether they will be exposed to the #virus, or whether they’ll expose a loved one. Those who work in hospital settings also end up providing support to their medical colleagues who lose #patients to #COVID-19.

“Not only are you treating #patients, you’re also helping out your co-workers,” Dole said. “They’re trying to be strong, be present for their peers in the workplace environment. … Everyone is just really broken down. You’re watching people die who are 30 years old and it just doesn’t make any sense.”

A mental health crisis with no end

A mental health crisis with no end

The #pandemic has been raging for nearly a year and has not abated. Experts say the negative #mentalhealth impacts will outlast the current crises. Research suggests the extreme and prolonged #stress of the #pandemic may lead to longer-term psychiatric disorders.

Many therapists said they are learning – or relearning – the importance of self-care during a crisis they know will not end for their profession with widespread vaccinations. 

More mental health coverage

How to find a therapist if you’re suicidal →Chrissy Teigen’s latest post about her pregnancy loss has an important message about grief →Why it’s so important to hope →The lifesaving lesson suicidal people can teach a world in a pandemic →Thousands of messages show what it really means to help someone who’s suicidal →

“Even though we are therapists and #mentalhealthprofessionals and we have training and understanding of things above what the average person does, it doesn’t mean that we aren’t susceptible to dealing with our own #mentalhealthchallenges,” Cubbage said. “As much as we show other people grace, we ask that people please extend that grace to us.”

#Mentalhealthprofessionals say they need organizational support to help ward off burnout. That could look like granting a clinician their day off request or respecting when they say they can’t take on another case. They also need better pay, Dole said, so more people can enter the field, stay in the field, and serve a greater share of the population.

In the immediate future, therapists also need to be able to continue to see #patients remotely, Dole said, and they need insurance to continue to pay for it. Some insurance companies have already made moves to scale back coverage of telehealth services. 

More: As #virus rages, insurance companies look to scale back telehealth

Despite the myriad challenges, #mentalhealthprofessionals say people who are suffering should always seek help. 

“We’re challenged, we’re stretched thin, we’re finding higher acuity in #stress levels in our #patients but it’s what we’re here for,” Benko said. “People should still reach out.”

If you don’t have access to the care you want right now, there is still help available:

You can call the U.S. #NationalSuicidePreventionLifeline at 800-273-TALK (8255) any time day or night, or chat online.

The Crisis Text Line provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.

The #NationalAllianceonMentalIllness has support groups for people living with #mentalillness.

you are worthy of love signage on brown wooden post taken
Photo by Tim Mossholder on Pexels.com
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