This is the second installment in a series about how the community has turned to social service providers during the pandemic and how those organizations have stretched resources to meet the unique demand. — Eds.
After a long couple of months away, therapists at the Jackson Hole Community Counseling Center are back at the office.
The only hitch? Their clients are still at home.
Counselors are back, but they’re maintaining social distance by holding sessions over telehealth, aka medical videoconferencing. The image of counselors in cubicles hunched over computers may not evoke the connection of an in-person session, but Counseling Center Executive Director Deidre Ashley said it helps to have everyone in one place.
“If we were just a private practice, I would say that we could probably continue to do remote stuff,” she said. “But a large portion of what we do is crisis and outreach and case management, and a huge part of that wraparound service is communication.”
Providing mental health services during a global pandemic is a daunting and necessary task. A Kaiser Family Foundation poll in April found 45% of American adults reported additional stress due to the virus, and that number could conceivably grow if the outbreak and its associated economic hardship persist.
Reaching people who need help is hard when everyone is being told to avoid close interactions with those outside their immediate circle. So therapists, crisis workers and emergency services have adjusted.
“We just had to do it and, I would say, be more creative and focused more on what we consider to be essential services,” said Andy Cavallaro, executive director of the Community Safety Network.
New ways of doing business
Ashley noticed an interesting trend at the height of the pandemic. The abrupt societal shifts didn’t seem to greatly exacerbate the struggles of the Counseling Center’s highest-needs clients. She guessed it was because they live with so much stress already.
“In talking with some of the staff, what they’ve kind of noticed is that was kind of the world that they were living in anyway,” she said. “So, you know, having something external that was causing that was actually a little bit easier.”
For people who may not have used therapy before or haven’t needed crisis services, the pandemic was a new external stressor. However, during the initial part of the lockdown, Ashley said, they weren’t seeking out counseling services.
Unfamiliarity with Zoom may have added to their hesitance. Now that videoconferencing has become the norm for both therapy and socializing, people have gotten used to it, and requests for intake are increasing. On the other hand, for crisis services, which Ashley and Cavallaro’s organizations provide, the pandemic has forced changes.
Community Safety Network works with victims of domestic violence, letting them stay at its shelter and providing other sorts of support. However, the pandemic made it difficult to connect with victims, even as the conditions of social distancing made it easier for offenders to abuse them.
The New York Times reported that domestic violence has risen worldwide during the outbreak, with some places in England seeing a 20% spike. In Jackson, Cavallaro’s organization saw a downturn in calls, in part because victims were stuck at home with abusers.
“Victims and survivors aren’t able to create their own space,” he said. “That power and control that offender is using to isolate the victim, it’s harder for that victim to create five minutes here or an hour here or some time to come to Community Safety Network.”
Now that movement restrictions have been lifted, Cavallaro is seeing an increase in victims seeking services, something Ashley also finds to be true at the Counseling Center. Both have still had to shift some of their practices.
Community Safety Network runs a victim shelter, but social distancing requirements have led it to run the facility at half capacity. So the organization is paying for more expensive, off-site housing when the shelter is full.
For clients in crisis the Counseling Center is running the same playbook it has used for years for its 24-hour crisis hotline. Therapists are available to talk with people in crisis, but since they have to use Zoom, there can be a “delay,” Ashley said.
Using telehealth to meet with new clients and those in crisis poses another challenge: It can be more difficult for a counselor to build rapport.
“You don’t get a feel for the person,” Ashley said. “It’s a little bit harder for people to feel as free in a Zoom situation, especially new people.”
Keeping rescuers resilient
On April 1 a spring powder day drew skiers and snowboarders to the backcountry, as resorts had closed due to the coronavirus. Late in the day an avalanche on the south aspect of Taylor Mountain killed Trace Carrillo, drawing hordes of rescuers to the Coal Creek parking lot and the slopes above it.
The rescue was a reminder that first responders don’t have the luxury of social distancing.
“Everyone has sort of said, ‘You know, this is kind of part of the job, and we’re going to do the best we can,’” said Stephanie Thomas, executive director of the Teton County Search and Rescue Foundation. “We’re gonna, you know, be as safe as we possibly can, but our main focus is our patients.”
The rescue was also a reminder that emergency services professionals are often the ones responding to traumatic situations, and living in this community involves unique mental health challenges, pandemic or not. For Search and Rescue volunteers and their families, the foundation offers free trauma counseling to help them process the role’s high stress.
In recent months Search and Rescue has also trained volunteers to manage bystanders’ mental health. For instance, Carrillo’s ski partner was dealing with grief and shock in the moment, which volunteers are now better equipped to handle.
Though the training is not specifically COVID-related, addressing survivor trauma early can help keep it from compounding the stress caused by the pandemic.
“If those bystanders don’t have ways to process that, then they can do more lifelong damage than potentially the person who’s injured themselves,” Thomas said.
Like Search and Rescue volunteers, law enforcement officers often find themselves first on the scene of traumatic situations. The twin societal crises of COVID-19 and the racial reckoning that erupted after the death of George Floyd have cast that reality in a new light.
Teton County Sheriff Matt Carr is all for bowing out from taking the lead in such crisis environments, but right now no alternative is waiting to take the place of the police.
“Part of the greater conversation that’s coming out nationwide is should law enforcement be responding to these,” Carr said. “I know we shouldn’t. Please take that off our plate, but we don’t have anything in place to fill that in.”
Checking in with yourself
During the height of the pandemic lockdown, law enforcement saw a decrease in mental health calls, just as crisis services organizations did. With the lockdown lifting, Carr said, they are also seeing an uptick, especially as coronavirus cases are starting to climb again, a fact not lost on first responders.
“It’s a scary environment to be doing that job, which is a tough job in the first place,” Carr said.
For those who deal with mental health challenges, whether first responders who are on scene for moments of crisis or counselors who work with clients long term, the coronavirus has been another wrinkle in an already difficult realm. It has forced adaptation and a focus on self-awareness.
Carr and Thomas said the mental health of emergency services workers is paramount, which is why organizations across the county have pooled resources to offer counseling to those employees and volunteers. Beyond structured counseling, rescuers and law enforcement officers have focused on checking in with each other more often in an effort to build emotional resilience ahead of crises like a global pandemic.
“We’ve been really focusing on things like closing out a rescue,” Thomas said. “Stress is kind of circular. You know, you get really stressed, and then you have to come out of that stress, and you have to tell your body you’re OK.”
For laypeople, accessing mental health services doesn’t have to be the first step. The Counseling Center offers a program called My Strength, a behavioral health app that can help people manage stress and emotions through meditation, as well as other tools like tobacco cessation. Using a program like that can create the kind of resilience needed to weather turbulent times.
“It can be available for, you know, somebody at three o’clock in the morning if they have a panic attack or whatever,” Ashley said. “We try to make it easier for people to slip into it a little bit.”