May 2, 2020 – by Damien Fisher
As New Hampshire’s community mental health centers made the sudden shift to dealing with the new coronavirus crisis, staff and administrators found an operational foundation was already in place.
“I think that if there is a blessing for the drug and alcohol issue we’ve dealt with, it’s that a lot of agencies that never worked together had to find a way to work together,” said Rik Cornell, vice president for community relations at The Mental Health Center of Greater Manchester.
New Hampshire has 10 community mental health centers in the state, offering a broad range of services for approximately 55,000 people a year, said Jay Couture, president and CEO of Seacoast Mental Health Center Inc.
“We provide prevention services, required seminars for people undergoing divorce, and an entire spectrum of community based clinical services,” she said.
The centers provide help for children in crisis, adults with persistent mental health issues, and a host of other needs, she said. With needs mounting for people now stuck at home, sometimes with children, Couture said the challenges have been great.
“In some ways, this has been more difficult (than the addiction crisis,)” Couture said.
The community mental health centers also became a frontline in the fight against opioid addiction over the past several years. Many people suffering from substance misuse disorders have co-occurring mental health issues. Cornell said the centers had been getting better at working together and sharing information as they all dealt with the addiction crisis.
With COVID-19, the disease caused by the coronavirus, dramatically changing everyday life in all communities, the cooperative structure is being put to good use, he said.
“Working together to get things dealt with in ways that had never happened before,” he said. “That has helped, I really believe that has helped.”
Phil Wyzik, president of Monadnock Family Services, said the centers are sharing ideas and helping each other with what is working and identifying what isn’t working. The centers are also getting a big boost from state agencies with a better flow of information from the Department of Health and Human Services.
“We have had greater communication with the DHHS in the mental health community,” Wyzik said.
When the emergency orders started getting put into place shutting businesses and closing schools, staff at the community health centers knew they would remain open, but they had to figure out how.
“We’re all open, we didn’t close, we’re essential health care providers,” Couture said.
All of the centers quickly moved to a telehealth system, offering therapy and other appointments via internet conferencing tools. Wyzik said while the big push had been to move appointments to telehealth, the centers are open for some types of care and intake.
“We’re still providing face-to-face care, but it’s a far cry from what was done,” he said.
Couture said the centers had to act fast to put the telehealth systems in place so patients could get service at home, and so providers could work from home.
“We had done zero telehealth at my center before that,” Couture said.
Couture said there are clients who cannot use telehealth options, like those who regularly need medications injected during their visits. There are others who need help managing their medication schedules.
“We have some clients who need to have in-person services,” she said.
While the centers can still see people who need in-person services, Cornell said, they are working hard to figure out how to reach different populations. This includes homeless clients who cannot use telehealth.
Most homeless clients use public libraries if they want to access the internet, Wyzik said. With most the libraries shut down, these clients have no internet. Many clients in rural areas also can’t use the internet video service, either. Wyzik found Monadnock Family Services have been holding simple telephone sessions for some of these clients.
“The phone has become a priority,” he said.
Cornell said a lot of centers are working with shelters and first responders to find the homeless clients and check in to make sure they are OK. Cornell’s center also has a mobile-health operation that goes out into the community along with first responders to offer care in some circumstances and to try to connect with homeless clients.
“That’s a very strong concern for us,” Cornell said. “These people are out there, and we want to make sure they’re healthy and being cared for.”
Cornell is also worried the pandemic has created the need for services among a lot of people who never sought them before. The death of a relative, job loss, income loss, stress and depression and anxiety all build as they are locked home, in some cases with their children.
“For the first time in their lives they are experiencing something they hadn’t previously experienced,” he said.
Couture sees telehealth options becoming one way to deploy help to people as quickly as possible, even after the COVID-19 shut downs start to lift. It could be the answer to helping people who haven’t sought help before.
“It’s not going to work with everyone, but, for some people it eliminates barriers to care,” Couture said.