Staying Healthy: Mental health care during lockdown

Editor’s note: If you or somebody you know are in crisis, contact Crisis Support Services of Alameda County’s 24-hour confidential crisis line at 800-309-2131 or CrisisSupport.org, or the National Suicide Prevention Lifeline at 800-273-8255, via text at 800-799-4889, chat or at SuicidePreventionLifeline.org.

Much like the practice of wearing masks when venturing out in the world, feelings of anxiety, isolation and depression have become commonplace due to the ongoing coronavirus pandemic, and local mental health professionals want residents who are experiencing these issues to know that they are not alone and help is available.

As the Bay Area’s shelter-in-place order stretches on into its fourth month, health care professionals in the Tri-Valley continue to document increases of certain mental health issues and have expressed a desire for local leaders to not neglect the negative mental health effects brought on by the pandemic.

“While I think it’s important and critical to have infection control during times of global pandemic, we need to maintain a wide-angle view of what is going on for the overall health of the individual and our community. The inclusion of mental health in that view is essential,” said Dr. Daniel Jon Kostalnick, MD, FAPA, who operates an independent psychiatric medical practice in Pleasanton.

According to Kostalnick, as a result of the pandemic and subsequent isolating shelter-in-place order, many patients have had recurring feelings of depression and anxiety — among both children and adults. These issues are compounded by other safety concerns such as an increasing number of patients who are having thoughts of suicide and increasing occurrences of domestic violence in homes.

In some cases certain patients have been required to shelter-in-place with their abuser.

“A concern that is a very clear interest to me is the person’s mental health,” he added. “One of the things that I am very concerned about at this time is the suicidal patient, the patient that is isolated and alone, the patient who is not available and able to access community resources, perhaps because they are older and shut in and they don’t know how to access care.”

Kostalnick encouraged county health officials to take these issues into account when crafting policies related to the shelter-in-place order and to consider the full health of a resident, both physical and mental.

“In my view, (for coronavirus coverage) there’s been very rare occasions that I’ve seen any reference to mental health, especially in the news and media,” he said.

When it comes to the practicality of meeting with patients, while he does provide telehealth services for patients who are comfortable with meeting online, Kostalnick is still able to meet with patients in-person as an essential business but he did implement certain safety precautions outlined by the U.S. Centers for Disease Control and Prevention.

The precautions include the extensive use of bleach on all contact surfaces and using social distancing practices when meeting with patients. He also has open windows to the outdoors with fresh air that enabled him to decrease the potential for infection.

The National Alliance for Mental Illness (NAMI) — which has a Tri-Valley affiliation located in Pleasanton — has recommended that individuals who are concerned with the spread of the coronavirus contact their health care provider about teletherapy or mental health services online, a practice that has been adopted by many mental healthcare providers throughout the Tri-Valley.

Any patients worried about access to prescribed medications are also encouraged to ask their health care providers about getting 90-day supplies as opposed to a 60- or 30-day supply.

“It’s common to feel stressed or anxious during this time. It may be especially hard for people who already manage feelings of anxiety or emotional distress. For example, for those of us with obsessive-compulsive disorder (OCD), public health recommendations about contamination and hand washing may make it more difficult to manage our symptoms,” NAMI officials said.

“Recognizing how you’re feeling can help you care for yourself, manage your stress and cope with difficult situations. Even when you don’t have full control of a situation, there are things you can do,” NAMI added.

Local groups such as the Community Presbyterian Counseling Center (CPCC) and Discovery Counseling Center of the San Ramon Valley, for example, provide extensive teletherapy services for patients.

“There have been studies done (on therapy sessions) that telehealth therapy is just as effective as in-person therapy,” Brent Robery, director of the CPCC, told the Weekly. “Some therapists since the shelter in place have gone exclusively to (teletherapy).”

Depending on the mental health situation a patient is dealing with, teleconferencing is not necessarily right for everyone; however, Robery explained that teletherapy still offers patients a beneficial, and socially-distancing conscious, experience.

“It is different. For example, you’re not in the same room with each other so you might not be able to see some physical responses. However, there is also the opportunity that if you are not in the same room as each other; people have the ability to feel more open because they are not feeling judged,” he said.

Robery explained that while at first patients and even many therapists were hesitant to try telehealth, recently individuals have become more receptive to the idea. In fact, after first seeing a drastic drop in referrals, over the past couple of weeks more and more patients have begun seeking out therapy and counseling, he said.

Adding that as the shelter-in-place order continues to stretch on, he has also documented increased feelings of isolation, depression and anxiety, as well as abuse among individuals.

“When this first came out, I think people kind of pulled back from therapy because they didn’t know exactly how long this was going to be and so they thought that this will just be a couple weeks and we’ll be back at it. But what we’re finding now is just that people are getting a little stir crazy and they’re willing to come back and some of the people that have not been willing to do the telehealth are willing to jump into it,” Robery said.

He further added the financial strains are another source of anxiety for many, and while his counseling center will aim to assist patients in whatever way they can, therapists also need to be compensated in order continue their work.

Residents interested in learning more about how to receive care or being put into contact with a mental health professional can reach out to Crisis Support Services of Alameda County’s 24-hour confidential crisis line at 800-309-2131 or CrisisSupport.org, or the National Suicide Prevention Lifeline at 800-273-8255, via text at 800-799-4889, chat or at SuicidePreventionLifeline.org.

“Some people feel that crisis lines are only to be used in a crisis. The accessible and free mental health crisis services that these centers offer are especially vital during these times of social-distancing and are a vital service,” Dr. Kostalnick added. “They can help overcome the barriers of access to service.”