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'It's so much better now'

Grief counselor Cynthia L. Marshall simulates a session with a patient.Seb Foltz/Butler Eagle
Counselors busy during pandemic; challenges remain

The devastating physical impacts associated with COVID-19 are familiar to everyone who has lived through the once-in-a-lifetime pandemic.

The disease has claimed roughly 600,000 lives in the U.S. alone and has had long-term health impacts on thousands more who survived.

But physical impacts aren't the only imprint that COVID-19 has left behind. The impacts to mental health have been wide-ranging, touching people of all ages and in all social strata.

This is particularly true of those coping with mental illness, said Bette Peoples, executive director of the Grapevine Center, an independent nonprofit organization based in Butler County.

“When working with people suffering from grief, loss and trauma, one thing you want them to do is build a community,” she said. “And COVID made that impossible.”

Jim Smith, director of programs for the Center for Community Resources, said for many, the various issues that surfaced during the pandemic — financial worries, food, clothing and shelter concerns — “certainly got amped up for a lot of people.

“Lost jobs, people behind on rent: you can imagine the kind of impact those stressors would have if someone had underlying mental health issues such as anxiety, depression or mood instability,” Smith said. “All of those would be additional factors that would contribute to someone feeling really hopeless.”

Adding to the problem was the fact that those feeling in need of assistance had to rely on something other than face-to-face interaction for the most part, since many mental health providers had to switch to Zoom or phone sessions. For some, that worked well and in fact some providers say that one of the side benefits — if you could call it that — of COVID-19 was the emergence of telehealth as an effective strategy.“I don't think that genie will ever go back in the bottle,” Susan Young, a licensed professional counselor and clinical director for Samaritan Counseling Guidance and Consulting, said. “We will now always offer video therapy as well as face-to-face counseling.”Smith said the resumption of face-to-face interactions among those in need of mental health services has generated a sense of community that had been missing for more than a year. But he also said that telehealth proved to be a credible way to provide mental health services to people without them having to come to a brick-and-mortar office to see someone in-person.“When you think about barriers to access services, not everyone has a car to be able to drive themselves to an appointment,” Smith said. “Not everyone has the flexibility to take off work to utilize mental health support.“But with the advent of telehealth, instantly that transportation barrier has been removed, and you have more flexibility in scheduling. People don't have to take a day or half-day off work to keep their appointment if they're using telehealth.”

Still, technology did not fill the void completely in some cases. Peoples said the Grapevine Center tried to offer some of its services via Zoom or cellphone, but many consumers didn't have the technology skills to access them.“And even if they had a cellphone, they didn't want to use all their minutes for something like that,” she said. “The majority of our consumers want to see the person in-person, and if they did do a video conference, it was very short.”Young agreed with Smith that the pandemic exacerbated existing mental health conditions, and it also led some to begin abusing drugs and/or alcohol: and that in itself created anxiety and depression for those who had no such issues beforehand.People of all ages have been affected in terms of mental health, and that made sense, given the situation, said Cynthia Marshall, a Buddhist chaplain and private practice counselor who is also an English professor at the Community College of Beaver County.“The thing to remember is that everyone suffered,” she said. “This was not necessarily something that only someone who suffered from depression or anxiety experienced. People whom we all consider normal all had issues during the COVID year.”

The numbers back that up. A U.S. Centers for Disease Control and Prevention survey estimated that during late June 2020, 40 percent of all U.S. adults said they were struggling with mental health or substance abuse and more than one in 10 had seriously considered suicide.For many, it was the fear of the unknown: people did not know how they would make out financially, for example, or even if they would simply live through the pandemic.“These were not delusions or fantasy,” Marshall said. “These concerns were based on reality. COVID was killing people and we knew it was being spread through the air. So that was a legitimate anxiety concern for people.”One of the first casualties of the pandemic was people's routines, whether it was attending church services on a weekly basis or working out at the local fitness center or even more basic activities, such as going to work or school. The latter certainly had an impact on the younger demographic.Among children, providers saw an increase in sadness and worrying, along with difficulties focusing and concentrating, and issues with somatic symptoms such as headaches and gastrointestinal woes.

Younger teens also had a difficult time.Lynnette Griffith, supervisor of behavior health programs for Butler Health System, said teens had no sense of stability at a time when they needed it the most. For example, they would be told one day their high school would resume in-person learning and then the next day would find out they were going back online.“There was no predictability,” said Griffith, whose daughter left college because she had difficulty with the switch to online learning.Those in the 18 to 29 age group also suffered, said Brett Shockey, director of inpatient behavior health services and Assertive Community Treatment for Butler Health System, because they're such social people and they were unable to satisfy those social needs during the lockdown.“They really struggled,” Shockey said.Young said that demand for couples counseling “went through the roof” during the height of the pandemic, and it wasn't hard to figure out why. Most married couples have to navigate or negotiate how much time they spend with each other and the family as a whole, but that whole balance was completely disrupted as parents had to work from home while children were attending school at home as well.“For many couples, that created a lot of tension,” Young said. “And if they were already in a troubled relationship, that tension exacerbated.”The tension wasn't just felt between spouses, either.“Stress in a marital relationship doesn't happen in a bubble,” Young said. “It affects everyone in the family system.”

Monica Dunlap, of Dunlap and Associates Counseling in Cranberry Township, said the biggest issue she saw when it came to parents was the stress of trying to be a teacher as well as a parent at home.“Some were struggling and feeling helpless because they couldn't help their children with their schoolwork,” said Dunlap, a licensed professional counselor.Also, parents never got that break that they needed to take care of the house and other things that needed to get done. There was no privacy, no space.”At the older end of the spectrum, seniors were dealing with their own concerns.“The separation from their loved ones — not being able to see their kids and grandkids — was so devastating,” Young said.Dunlap said some seniors were so frustrated that they were willing to risk their health just to spend time with loved ones.“I heard about some older adults saying things like, 'I can't live my life this way: I'd rather be around my family in the last years of my life than to be isolated,'” she said. “But their children would say, 'No, mom, we can't see you. Or we can only see you if it's outside.' A lot of older adults were frustrated.”With the advent of the vaccine, caseloads have dropped, and states including Pennsylvania have lifted restrictions in recent weeks. And while things aren't exactly back to normal, they do appear to be looking up.“It's so much better now,” Peoples said. “The first day we didn't have to wear our masks anymore was like a holiday. It was like a weight was lifted off our shoulders.”Marshall said that while people have shown incredible resilience in fighting through the pandemic, she's noticed that many are still “just a little off.“Everyone is still having some lingering effects,” she said. “They call it languishing. We're still working on our tempos. We haven't gotten up to speed.”Marshall said if she could offer people advice, it would be to just be kind to one another and allow people to get back to their normal schedules, diets, exercise routines: “all those things that help us, it's going to take us a little bit longer to get our energy levels back and our emotional registers back.“One of the things many counselors practice is affirmation,” Marshall added. “The idea is to try to encourage people to be positive and have hope that these things do pass. They really do.”

Monica Dunlap, owner/licensed professional counselor, Dunlap & Associates Counseling.
Monica Dunlap, owner/licensed professional counselor/Dunlap & Associates Counseling.
Cynthia Marshall is a Buddhist chaplain and private practice counselor who is also an English professor at Community College of Beaver County.Submitted photo
Grief counselor Dr. Cynthia L. Marshall.Seb Foltz/Butler Eagle
Monica Dunlap, owner/licensed professional counselor, Dunlap & Associates Counseling.HAROLD AUGHTON/BUTLER EAGLE