COVID-19 impacts on behavioral health

A few years ago, the County Council established the Mobile Community Intervention Response Team to address a high number of calls to 911 that needed assistance, but not by traditional first responders like law enforcement or fire and rescue personnel.

The program pairs a behavioral health professional from Comprehensive Life Resources (CLR), with a sheriff’s deputy or someone within emergency medical services. Together the team refers and connects people experiencing mental illness, substance abuse or other unmet medical needs with therapeutic outreach services. Prior to this program, many of these people ended up in jail or emergency rooms – all costly interventions that often resulted in repeat calls for service once individuals were released.

Recently, the Council’s Human Service Committee received a report about the impact of COVID-19 on the Mobile Community Intervention Response Team (MCIRT) from CLR CEO Kim Zacher, and Traci Krieg, Director of Behavioral Health Outreach.

Most people with behavioral health conditions live in our neighborhoods and receive the care and medication needed to lead a normal life. Due to COVID-19, many of these individuals saw a change in their condition due to lack of access or availability to community supports, according to Traci.

In 2019, MCIRT saw five re-referrals among its clients. This year that number more than quadrupled between March and August to 24 re-referrals. This is in large part due to lack of access to support. For some they faced another referral, others landed in the emergency room or jail.

This is disappointing news, especially as we consider one of the measures of success of the MCIRT program is stability for its clients and no further referral for assistance.

Heading into fall we know many of the negative behavioral health outcomes tied to COVID-19 will likely continue. This includes social isolation, fear of the unknown around further restrictions and economic losses, and stress and pressure related balancing childcare and work.

Among our geriatric population, we’re seeing increased depression, alcoholism, and self-neglect that appears to be due to increased loneliness, isolation, loss of connection to family and lack of services in the home. There is also an uptick in elder abuse due to lack of “eyes on” from other providers or family members. Adult Protective Services have reduced home visits, placing elders at risk.

Moreover, the recent fires and resulting poor air quality forced people to stay indoors even more than before, exasperating the situation.

It is anticipated increases in suicidal ideation, depression and anxiety and more frequent hospitalizations and emergency department visits will only grow as we enter fall and winter.

Our children are also at risk. CLR provides services to children in school AT school. This is not possible in the current remote learning environment. CLR saw a decline in the total number of children it helps, dropping from 420 students in February to 250 currently. Zoom therapy doesn’t work due to lack of privacy in a home. Other individuals experiencing severe mental health illness, or those experiencing a new mental health crisis, are not responding as well to telehealth. For people with a behavioral health condition, face-to-face connections are necessary for optimal stability and recovery.

CLR has worked to address these barriers. They have provided telehealth, personally delivered food and medications to clients and since June have opened their clinics to provide face-to-face treatment. It is still an ongoing challenge to re-engage those clients that fell away.

The County has provided some funds to help, but those funds run out at the end of the year. And yet, it is not likely that COVID-19 will disappear by then, or that this population will feel confident to seek direct services.

Heading into 2021 we know services continue to be needed. Additional funding is needed. Council support is needed.

And most importantly, community support is needed.