Turbulent times worry Upper Valley mental health providers

  • Photographed with one her cats Marbles at her home in Walpole, N.H., on June 12, 2020, Winonah LeVine, a case manager for adult services at Health Care and Rehabilitation Services, speaks to clients from home on a “warm line” for clients and community members struggling with stress and anxiety caused by COVID-19. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Jennifer Hauck

  • Rick Logan, facilities manager, left, Hal Moore, chief financial officer, and Anne Bilodeau, chief human resources officer, all of Health Care and Rehabilitation Services check their Hartford office on Friday, June 12, 2020. Along with Rebecca Brown, manager of nursing services (not pictured), they are examining the building in Hartford Village, Vt., to determine how to safely bring employees and clients back to the site. (Valley News - Jennifer Hauck) Copyright Valley News. May not be reprinted or used online without permission. Send requests to permission@vnews.com. Valley News — Jennifer Hauck

Valley News Staff Writer
Published: 6/13/2020 10:06:31 PM
Modified: 6/13/2020 10:06:29 PM

LEBANON — As the COVID-19 pandemic persists, killing nearly 115,000 Americans, it also has sent shockwaves that have destabilized the economy, isolated people and reshaped daily life.

“It’s also like an earthquake (in that) the experience has been traumatic for a lot of us,” said Dartmouth-Hitchcock psychiatrist Dr. Will Torrey, who made the natural-disaster analogy during a May Facebook Live session on the subject of navigating stress and well-being, part of an ongoing series of webinars on mental health by D-H for coping through the pandemic.

Amid the outbreak, as well as the turmoil surrounding police violence and racial inequity, anxiety and depression are on the rise even in people without preexisting mental illnesses.

While at least to a degree those are normal responses to a troubling time, mental health providers and public health officials are monitoring their clients and trends for signs of more serious illness, and also helping people manage feelings they may not have experienced before.

“This is really anxiety’s time to shine,” Robert Brady, a psychologist who directs D-H’s anxiety disorders service, said during the Facebook Live session.

The purpose of anxiety is to help people respond to a threat or perceived threat by acting cautiously, he said. But if anxiety does not diminish once a threat is gone, then it might be a sign of a mental illness requiring treatment. The pandemic may have stripped people of some of the ways they were previously managing anxiety and stress, such as in-person visits with friends and family, sports, or other hobbies and activities.

Pandemic or no, about half of all Americans will develop a mental illness or a substance use disorder in their lifetimes, Torrey said. But, he said, “there really is a lot of good news. People get better when they have access to good care.”

Signs of stress

While calls to the Hartford Police Department were down in the early days of the pandemic, Chief Phil Kasten said they have increased in recent weeks.

“Stress is up among everybody,” he said.

Kasten pointed to “tension between neighbors” as the primary cause for calls at this time. He said that tension is likely due to stress people are experiencing as a result of economic uncertainty, national events and questions about the future.

“People are getting frustrated,” Kasten said. “Some of that is manifesting itself in some of the dispute-type calls.”

In many of these situations, law enforcement action isn’t required; officers simply need to help mediate, he said.

In April, Vermont saw an increase of 45% in the number of people reaching out for help via a crisis text line, said Alison Krompf, who is director of quality and accountability for the Vermont Department of Mental Health, as well as the state’s suicide prevention coordinator.

Initially, people using the text line were mostly feeling anxiety directly related to COVID-19, then more started to struggle with job loss, isolation and loneliness, she said.

In response to the pandemic, Health Care and Rehabilitation Services, which is the designated mental health agency serving Windham County and most of Windsor County, in April began offering a new “warm line” for clients and community members struggling with stress and anxiety caused by COVID-19.

Those who have called in have expressed extreme anxiety, stress, parenting-related stress, concerns about their own health and that of loved ones, Kate Lamphere, who directs HCRS’ adult services division, said in a phone interview last month.

People were struggling with the “impossible feeling of managing this uncertainty,” she said.

Despite the increase in people calling for support, Lamphere said HCRS at least initially saw a decrease in the number of people calling for mental health treatment.

“Part of it is I’m sure people probably believe (they) can’t access us without coming in,” she said. “That worries me.”

HCRS and many other providers have and continue to be accepting new patients even during the pandemic.

Suicide risk

Prior to the pandemic, the Twin States both had high rates of suicide: 19.4 per 100,000 people in New Hampshire and 18.8 per 100,000 in Vermont. The national average is 14.2 per 100,000.

Krompf said risk factors in Vermont include living in a rural area, being older and having a high rate of gun ownership. Combining those things with the added challenges of the pandemic has meant that the potential for an increase in suicide is “something we’ve been very aware of and concerned about,” she said.

As a result, health officials in Vermont are now monitoring the suicide rate weekly, rather than a few times a year as they did prior to the pandemic.

So far there have been 45 suicides in Vermont this year, down from the five-year average of 53 in the same period. In New Hampshire, between January and March there were at least 46 deaths by suicide, which is not an increase over prior years, according to Jake Leon, spokesman for the New Hampshire Department of Health and Human Services. But the data is not yet complete because some autopsies are pending, he said.

There are, however, some early signs of concern. In May in Vermont there were 17 deaths by suicide, which is well above the five-year average for May of 9 deaths due to suicide, according to preliminary data from the Vermont Department of Health. In May, there also was a spike in the number of calls from Vermonters to a national suicide life line, Krompf said. The typical average per month is 175, but in May it was 226, an increase of nearly 30%.

Krompf said that people perhaps felt “more of a sense of purpose in the beginning” of the pandemic. “As this goes on, you have to stay more and more resilient,” she said.

Krompf said she wasn’t surprised that people have found that they need to be rallying for a cause such as racial justice right now. Two of the biggest risk factors for suicide are a lack of purpose and a sense of hopelessness, she said.

“A sense of purpose is a good thing,” she said. “Hopefully it would be a constructive sense.”

Among the Vermonters to have lost their lives to suicide in May was a family friend of Chittenden County State’s Attorney Sarah George, who grew up in Quechee and graduated from Hartford High School in 2001.

She took to Twitter in late May and wrote: “Seems like we are losing more Vermonters to suicide during COVID than we are talking about. Can we start talking about it please?

“It could save a lot of lives, or even just one, but if it had saved my dear friend this week, that would have been worth it.”

To George’s knowledge, the family friend, who lived in the Upper Valley, had not previously struggled with his mental health, but he recently struggled with negative thoughts about the human suffering caused by COVID-19 and the response to the pandemic.

“There’s so much trauma and pain in the world right now,” George said in a phone interview. “In this last week, it’s only magnified with the racial issues going on. People are really having a hard time. They’re just really finding it hard to be positive.”

George said her friend talked to his primary care provider and tried to connect with a therapist, but found it difficult to develop a relationship with a new person through video technology. Friends and family tried to get him out of the house, but they struggled to find things to do amid the pandemic-related restrictions.

“What can we be doing to take care of one another and still be safe and not put vulnerable people at risk or ourselves at risk?” she said. “That’s what I’m hoping might come out of this.”

Despite the problems George’s friend had in developing a connection with a therapist, providers and mental health agencies say telehealth has improved access to treatment and support during the pandemic.

In Monday’s Valley News: A look at telehealth. 

Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.

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