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Not Your Normal: Discussions of mental health ramp up during quarantine

Financial concerns and feelings of isolation are common reasons that people have cited for turning to mental health professionals during quarantine. [Source: Pixabay]

When the impact of COVID-19 started to gain mainstream attention in early 2020, frontline workers were tasked with keeping the world turning while others were told to shelter-in-place for an indefinite amount of time. For some, this means hours of nonstop work or having to shelter in less-than-ideal conditions.

For others, the abrupt change in routine and constant onslaught of fatality statistics is enough to turn a new situation into a distressing one.

In response to the varying amounts of distress, the Saint Louis Mental Health Board [Saint Louis MHB] forged a partnership between the United Way and Behavioral Health Response, a mental health service provider in Creve Coeur. For many years, United Way’s 211 hotline has been a free and confidential referral and information helpline that helps connect individuals of all ages to essential health resources in a variety of fields. However, when Saint Louis MHB introduced a collaborative element with the Behavioral Health Response team the helpline became a hotline that combines experts in both the fields of mental health and social services.

The hotline provides access to free, professional mental health resources for St. Louis-area individuals during the COVID-19 pandemic. The line is accessible by dialing 211 and pressing 1. Doing so will connect the caller with a medical health professional while the caller’s identity remains completely confidential.

According to Serena Muhammad, director of Strategic Initiatives at Saint Louis MHB, the service is funded by all local governments that have taxes for children’s’ mental health, including St. Charles County.

There is also a separate text-based line that is available for youths that are feeling stressed. The service is available by texting BHEARD to 31658.

“Some young people don’t feel comfortable making a phone call as the first point of contact,” Muhammad said.

The goal of both systems is to provide guidance to those who are feeling overwhelmed by current events. According to Muhammad, the 211 hotline and its text counterpart differ from other similar services in that they are not solely crisis or emergency response lines.

“You can call if you’re just feeling different and you’re not feeling like yourself, or you’re not sure what’s going on,” Muhammad said. “Maybe you’re anxious or you’re not sleeping well. Whatever is happening with you that you feel like is not your normal, you can call this line. We don’t screen anybody out.”

According to Muhammad, this referral system also works for individuals who are suffering from intense anxiety or need emergency medical attention.

“For some people, they just need someone to talk to and express things, and that’s all,” Muhammad said. “Others may have a more serious need, and they would be connected to professional mental health sources. Even if you are in crisis and are suicidal, this same number can connect you to emergency response services. It really does run the gamut.”

According to Muhammad, some of the most common stressors individuals call about are related to job loss or a reduction in income. Because this hotline is tied to United Way’s network, callers can be instantly connected with a network of professionals that can provide information on a wide array of services. This includes applying supplemental food and nutrition programs, shelter and housing options, veterans’ resources and more.

“There’s a lot of anxiety around the economic impact of [COVID-19], and people are calling because of that,” Muhammad said.

In fact, according to Muhammad, the hotline had seen a considerable spike in calls during the pandemic.

“The important thing for people to realize is that this impacts everyone, so there is no individual that isn’t feeling something different as a result of having their whole life shift in the past few months,” Muhammad said.

According to other medical professionals, this increased interest in examining mental health resources coincides with an increasing number of individuals scheduling visits to explore remediation opportunities at home or starting the process of finding a therapist or psychologist.

And adults are not the only ones asking for help.

The impact of anxiety on kids

After the closure of schools due to COVID-19, students of all ages suddenly found themselves adapting to a new form of classroom learning while remaining socially isolated from friends and peers.

According to Dr. Keith Moll, a pediatrician at SSM Health in St. Charles, there has been an increase in his patients’ desire to specifically discuss their mental health at doctor’s visits.

“There has been a slight increase in parents either suggesting [themselves] or being more receptive to my suggestion, ‘Maybe you’re at the point where you can talk with a psychologist or someone that can specifically help with stress and anxiety for your child, or anyone at all ages,’” Moll said.

According to Moll, individuals of all ages respond differently to stress; children are no exception.

Some common signs that a young child could be experiencing abnormal levels of situation-based stress include repeated instances of increased aggression or seeming abnormally despondent or quiet.

According to Moll, stress in young children can also physically manifest in the form of frequent complaints of aches or pains. A visit to a pediatrician or doctor can help determine the difference between a medical issue and physical manifestations of anxiety. One way to determine these abnormal levels of anxiety in young children, especially when there is communicative dissonance, is to watch for heightened levels of aggression or abnormal behavior that increase in frequency.

“Think of their normal disposition and how they normally approach things,” Moll said. “Now, this is a completely different situation that none of us have been through … this quarantine. But how do they normally respond? Have they maybe had a death in the family of someone they were close to? How did they respond to that? You have to kind of take what is their norm, how they respond to things, and then we can really start to get a picture of, ‘This is abnormal for them.’”

This advice also applies to preteens or individuals that may be experiencing changes in mood or stress levels because of puberty. However, unlike younger children, preteens and teenagers often display an increased awareness of the global situation and may experience anxiety based on that heightened awareness.

“They might have other fears,” Moll said. “I have had, for example, patients when we had certain flu epidemics really worry that if they got the flu that they would die. We had to talk through that and decide how to approach that.”

Regardless of a child’s or teenager’s age, Moll said an important factor to consider is that parents often serve as the first point of reference for how to respond to stress.

“Children of all ages will pick up on the parents’ stress and anxiety,” Moll said. “The more you can do for yourself, meaning the parents, to reduce that, I think you’re going to eliminate that to children in general.”

Simple things like maintaining a consistent bedtime and meal schedule can help restore a feeling of normalcy in a household.

“I think doing those basic things leads to a sense of stability and comfort,” Moll said.

Personal mental health check-ups

According to Muhammad, there are multiple measures individuals of all ages can take at home to help minimize stress.

The first recommendation is to get outside.

“The first thing you should try to do, if you can do it safely, is get out in nature,” Muhammad said. “Whether you’re just outside in your yard or you’re taking a walk, it does have a significant impact on your mental health and not just your physical health.”

Muhammad also recommends that people try to be more cognizant of any emotional patterns, especially negative ones.

“Document it every day,” Muhammad said. “‘These are the things I’m worried about, these are the things that upset and worry me’ and start to look for patterns.”

Individuals of all ages, especially those in complete isolation, should also find ways to reach out to loved ones via phone or video-conferencing applications for safe human contact.

“Figuring out if you can carve out a few minutes a day to chat with that person over the phone is a good way to keep your mental health intact,” Muhammad said. “Finally, if you’ve done all those things and you still feel overwhelmed, we really suggest that you call 211 and tell them what’s going on and see what kind of support they can offer.”

Whether an individual ultimately decides to schedule a doctor’s visit for themselves or a loved one or reach out to a hotline, the act of speaking with a mental health professional can help maintain an open dialogue about personal wellness for the remainder of the COVID-19 quarantine and beyond.

“We don’t talk about mental health enough in our culture, and this pandemic has really given us the opportunity to all be mental health advocates,” Muhammad said. “It’s one thing to read about what’s it’s like to feel anxious or depressed, but it’s another thing to experience it.”

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