With positive COVID-19 cases topping 2,400 and counting, the physical toll the disease has caused Jefferson County residents is easy to quantify.
The mental toll the pandemic is taking on people – with no apparent end in sight – is less obvious.
Stay-at-home orders, the disruption to business, a decrease in recreational opportunities and worries about whether it’s safe to send children back to school – along with the acrimonious debate over wearing masks – is playing havoc with many people’s mental health, according to those who work in the field.
“We’re hearing from a lot of individuals who are having trouble coping with all this,” said Rachael Bersdale, chief behavioral health officer for Comtrea, which provides mental health and other health-related services around the county. “We’re calling it pandemic fatigue. People are just on overload. They’re tired, stressed and confused.”
Dr. Michael Cooper, a psychiatrist based at Mercy Hospital Jefferson in Crystal City, said he has seen the same negative effects of the pandemic.
“We’re definitely seeing an increase in the number of patients who are seeking our mental health services,” he said. “The primary care physicians who are making referrals to us also are reporting an increase in patients. Anxiety seems to be the No. 1 disorder, but there are lots of instances of depression. There’s been an increase in the amount of medications doctors are prescribing for these problems.”
Cooper attributed the uptick in emotional problems to the lack of mobility people are having to adjust to.
“A study came out just the other day (from the federal Centers for Disease Control and Prevention) that said nearly 41 percent of those polled reported struggling with mental health issues or substance abuse, primarily because they’re having to stay home so much. That’s a big number,” he said. “And we’re seeing that effect across the board. Then when you add financial stress to the equation – which so many families are experiencing – that just adds pressure.”
“I don’t think there’s just one answer to why people are under such stress. There are a lot of factors. There’s job loss, the loss of recreation opportunities, so many things. A lot of people are having to bottle things up because they’re not able to get away with their friends, and that can lead to some problems down the road.”
Bersdale said in its most extreme forms, pandemic fatigue is playing itself out in dangerous ways.
“We’re seeing an increase in attempted suicides,” she said. “Certainly domestic violence and child abuse, which are problems in any time, are amplified when the stress is greater.”
Drug and alcohol abuse also are on the rise, she said.
Bersdale cited statistics from the Missouri Department of Health and Human Services that indicated a 4 percent decrease in drug overdoses statewide from 2018 to 2019, but that trend has reversed itself, with a 30 percent increase in the first half of 2020.
“Those numbers really reflect the effect of COVID on mental health,” she said.
Children also feel pressure
Dr. Pravesh Prabhu Deotale, who specializes in child psychology at Mercy Hospital Jefferson, said pandemic fatigue is also affecting those 18 and younger.
“For children, the biggest challenge has been having to stay at home. We’re all social creatures, but children particularly so. They’re having difficulty adjusting to a new normal. That adjustment has added to the stress level for kids.
“Staying at home when schools were out in the spring was tough for many of them,” Deotale said. “There were changes in expectations. They were used to certain expectations of them at school, and different expectations from their parents. Suddenly, that was all different. Their parents were their school in many cases, and they found it difficult to adapt when all they wanted to do was go out and see their friends.”
Deotale said in his practice, the numbers bear that out.
“At Mercy Jefferson, we were maybe seeing one or two cases (involving children) in a week,” he said. “Starting in April and since, it’s been up to four or five a week at least.”
Schools preparing for
Counselors at Jefferson County schools said they know students, whom they haven’t seen since mid-March, may be returning soon and will be bringing some of that emotional baggage to school. They said they’re ready to help.
“The children are going to need us more now than they ever have,” said Gina Buehner, assistant principal of Fox High School and the head of the Fox C-6 district’s Mental Health Coalition. “This pandemic has been tough on a lot of kids. But like adults, they’re all responding to it differently, and that’s why it’s vital to see them back in school.”
She said Fox C-6 has added an additional counselor at each of its two high schools.
“That’s one more person who will be able to assist,” she said. “While many students come from loving, respectful homes, it’s a sad fact of life that some of them do not. They need to know from us this is a safe place, that there are people at their school they can confide in.
”Schools are traditionally the primary reporters for abuse and neglect, and we haven’t been able to see those signs with virtual learning.”
Steve Williams, a counselor at Festus Intermediate School, said looking out for students’ well-being is a responsibility Festus R-6 School District staff take seriously.
“The Festus district is a trauma-informed school,” he said. “All faculty have gone through trauma training over the past three or four years. We understand the widespread impact of trauma in school-age children.”
Williams said counselors are working with faculty to prepare them for the problems students may bring back with them this school year.
“Every student, and really everyone in general, has a fear of the unknown,” he said. “We try to talk it through and let the student know they are not alone.”
For more advanced cases, Williams said, the district may call in outside counselors, Comtrea or other resources, and Buehner said the Fox C-6 Mental Health Coalition works in much the same way.
Shannon Helms, a counselor at Festus Intermediate, said the first priority once school resumes is re-establishing connections with students.
“If you know someone, you’re better able to help them than you could a stranger,” she said.
“That’s why it’s important that we all work together at a school,” Williams said. “The administrators, the counselors, the teachers who see the students all day, and even the bus drivers.”
The personal approach is vital, Helms added.
“Not all children respond to trauma in the same way,” she said. “Some will lash out, some will isolate themselves, and some will act like they haven’t been affected until some trigger happens.”
Buehner said officials in the Fox district also know parents are going through a tough time, struggling with what some see as possible life-or-death decisions about whether to send their children to school or keep them at home in front of a computer.
“My heart goes out to our families,” she said. “They’re worried about the people they love and care about the most – their kids.”
She said the district will work to provide parents with some assistance, too.
“Once we get settled (into the new school year), we will point out to them resources on our school websites – and those sites have age-appropriate resources for our students as well. They’ll be able to watch videos that will help them and find links to places they may find helpful. Our parents need to know they’re not alone in this.”
Williams, too, said communication with parents is the key.
“We’re trying to get information to our parents and their students as quickly as we can,” he said. “We want them to know we intend to keep our students and staff as safe as possible.”
Strategies to help
Bersdale has several recommendations to help people keep their stress under control.
“Try to get enough sleep,” she said. “Don’t spend half the night bingeing on Netflix. Try to get into and maintain a healthy routine. If you’re working from home, don’t work all day in your pajamas. Get dressed and get cleaned up. As always, use alcohol in moderation. Reach out to a support system. We’re all in the same situation, and we all need each other. Make connections, but know that at times, it’s OK to disconnect, too.
“And parents, we need to model this for our children. And talk to them about their concerns. Let them know their feelings are real.
“As we go on with this, it’s really up to us to embrace a new normal,” she said. “What kind of recreation is out there you can safely do that makes you happy? You’ll find a lot less stress if you can figure that out.”
Deotale said it’s important for those who are under a physician’s care to make sure they are taking prescribed medications properly and according to schedule.
Cooper has an addition to the list.
“I really want to stress getting outside once a day,” he said. “Get some fresh air and some sunshine. It provides a different perspective.”
Bersdale encourages those who are feeling stressed – or exhibiting deeper symptoms of depression, feeling suicidal, falling into a pattern of misusing drugs or alcohol or are victims of abuse – to seek help. (See accompanying story above for ways to seek assistance.)
Cooper said even though the pandemic – and pandemic fatigue – feel like they’re here to stay, that’s not the case.
“Know this isn’t going to be forever. Keep that in mind,” he said. “This, too, shall pass.”
Help is a phone call away
Rachael Bersdale, chief behavioral health officer of Comtrea, said the isolation resulting from taking precautions against the spread of COVID-19 can take a toll on people’s mental health, but there is help – often at the other end of a telephone line.
“For those who are feeling isolated, reach out to family or friends. Pick up the phone and call someone,” she said.
For those who need additional help, a number of resources are available.
The Missouri Department of Mental Health runs a Disaster Help Line available around the clock at 1-800-985-5990.
The state and the Federal Emergency Management agencies also are running the Show-Me Hope Cares program.
“Anyone with any concerns about COVID can call,” Bersdale said. “It doesn’t have to be directly connected with the virus. Anything at all, because the way life is now, everything is related to it.”
That phone number is 1-636-321-0124.
Comtrea maintains a Crisis and Resource Information Hotline available from 9 a.m. to 5 p.m. weekdays at 877-COMTREA.
“We provide some individual support and can point people in the right direction to the resources available. Call if you’re feeling overwhelmed or distressed,” Bersdale said.
She said Comtrea also works with Behavioral Health Response, which has a 24-hour hotline at 1-800-811-4760. “Some people don’t like to talk on the phone,” she said. “You can text ‘hello’ to 741741 and get connected with people who can help.”
Women who are in an abusive situation are urged to call Comtrea’s A Safe Place hotline at 636-232-2301 or the National Domestic Violence Hotline at 1-800-799-7233.
The National Child Abuse Hotline can be reached at 1-800-392-3738.
The Substance Abuse and Mental Health Services Administration runs a hotline for those who have concerns about drug and alcohol misuse; it’s available around the clock at 1-800-662-4357.