‘We are here to help’: Mental health agencies form coalition to support community through COVID | News

Editor’s note: The following is the second installment in Aspen Daily News’ ongoing series on mental health.

In early March, COVID-19 community spread was confirmed in Pitkin County. Nonessential businesses were ordered to shut down, and ski resorts statewide closed. Visitors were asked to leave, and many winter workers — just a month from the end of their season, anyway — also left. Empty buses circulated town. Streets were free of cars, bicycles and people. Nights were dark and quiet.

Among the fear of an unknown and contagious virus, children learning from home, the loss of jobs and uncertainty of where rent or meals would come from, the local professional mental health ­community knew their resources would be more needed than ever.

Almost immediately, Pitkin County Health and Human Services formed a mental health coordination team, bringing together nonprofits and private clinicians. The group is organized by Matt McGaugh, adult and family services manager.

“We saw an opportunity to have a coordinated effort on how we can respond to a situation like this to best support community mental health needs,” he said.

Through the ongoing collaborative meetings, each organization is able to point people to the best landing spot for their specific needs.

“A general mental health response does not fit for everyone. There are different needs for seniors; there are different needs for families who have children. There’s different needs for those who have disabilities or health concerns right now, ­people experiencing homelessness,” he said.

Jackie Skramstad, clinical operations manager with Mind Springs Health, said in times of disaster, people are so focused on immediate reactions and survival that mental health can take a back seat.

“People need to know, ‘I have a home; I have a place to live.’ Those are all the priorities. It’s not until later that that settles, they take the breath and go, ‘Oh my gosh, I’m really struggling emotionally,’” Skramstad said.

Now, six months later, the demand for mental health services is on the rise.

“We see the spike in demand traditionally after the disaster,” she said. “There is stress in our community.”

Compounding interest

As the novelty of the coronavirus became the reality of COVID-19, the local community began to settle into the new normal of public health orders restricting retail, dining, group gatherings and requiring the wearing of masks. But a sense of calm never emerged. In fact, things got more tense.

“I think we can feel it collectively. I think we walk around, and we know it is there,” Skramstad said.

After the lull of empty streets, Aspen experienced the opposite. Visitors came in droves. And they stayed. Cultural rifts emerged between locals and tourists, and tensions mounted over inconsistent adherence to public health orders.

Then things started to burn.

The Grizzly Creek Fire threatened property west of Glenwood Springs, shutting down Interstate 70 through the canyon for two weeks, which then led to accidents and closures on Independence Pass. Additionally, the blaze created unsafe air quality in the valley that further restricted outdoor recreation options.

“Every time we start to get what feels like breathing room … you are trying to make something happen, and then all of a sudden, it drops off again,” Skramstad said.

MJ Faas, executive director of Aspen Strong, said the closure of Highway 82 between Aspen and Leadville was a particular breaking point, exacerbating the fears around the virus, natural disasters and the contrast between locals and visitors.

“When this thing happened with the fire — and I-70 is closed and the pass was closed — we were stuck,” she said. “We’ve got the fires, we’ve got a lot of people in town. There [were] just all kinds of extra added pressures, [feeling] we are trapped here with these people that we don’t know.”

Mental health help, at a distance

Aspen Strong serves as a one-stop shop by coordinating resources for people seeking therapy and offering a mental health screening tool tool on its website and in workplaces.

Faas said when COVID-19 shut down workplaces, her organization continued to check in with employers and business chambers “just to get a pulse on what that real need is, and that was changing weekly,” she said.

As the community figured out things out in real time, the information about the disease kept getting updated — and subsequently, the rules kept changing.

“It’s a lot to adjust to, there are a lot of unexpected things popping up,” she said.

As the public adjusted to learning and working virtually, so did the mental health community. Funding from the city and county allowed Mind Springs Health to outfit doctors with the technology needed to provide counseling from their own homes.

“It’s been a huge shift for our clinicians. We didn’t get into this field to talk to people via a TV screen. We want to connect with people and walk side-by-side with them as they are managing whatever challenges they are facing. That feels harder via Zoom,” Skramstad said.

McGaugh has been collecting data from all of the mental health coordination team partners. And, he said, the most striking change since the pandemic has been the switch to virtual counseling.

“The biggest thing we learned is that there is a lot less face-to-face mental health services happening right now. A lot of this is happening through telehealth virtual meetings now.

And so I don’t know if that is impacting the quality of services, but that’s definitely a big change,” he said.

Along with checking in with partners to add county support to their needs, he also works to support the providers with their new role and increasing caseloads.

“Agencies and community leaders need to remember to talk about self-care. It is going to be important to address the needs in our community so that we are able to respond to these situations in a healthy way,” he said.

Rising temps and boiling points

The other data point that McGaugh has noticed is the type of help clients are seeking. After a lull in March, the demand for services has grown each month as new and returning clients turn to professional mental health care.

“Another big takeaway is there is a definite increase in symptoms like depression and anxiety and stress from the clients that are being seen,” McGaugh said.

The last month has brought the stress of natural disasters, economic hits and worries surrounding back-to-school protocols — all on top of the pandemic. Skramstad said the layers of stress take their toll.

“For all of us, it just compounds. And for some people, they are going to start to hit their breaking point. We all have a point of, ‘I don’t know what to do with this level of stress, it’s beyond what I am used to coping with,’” she said.

And while the community has faced collective grief in the past when there have been fires or closures or loss of life, this year, the hits just keep on coming.

“We’ve had one at a time, but not this multitude of these big challenges all at once,” she said.

With so much tension, Skramstad said a rising caseload is not a bad thing.

“I would welcome increased numbers. We are prepared for increased numbers.

This is a situation unlike any that we’ve been in,” she said. “I don’t know that we’ve had a disaster that will continue to last as long as this one has. I don’t know that there is a really good playbook for this.”

In a way, Faas said, new clients may mean a better overall understanding of the importance of valuing mental health and opening up the community dialogue around self care.

“Everyone is experiencing anxiety, depression, anger, confusion, frustration,” she said. It’s bringing up the importance of mental hygiene in our community.”

This is playing out in the workplace clients she helps coach.

“Some of the employers that ­maybe before didn’t see the value in mental health days are seeing now that it’s valuable. When they do give the time off, give the COVID time, they see, ‘Wow, this person actually was able to take that time and came back refreshed, and that is better for my bottom line and productivity,’” Faas continued. “Before this, some people didn’t realize the importance of that because they had never experienced it. And now we all are.”

Mental isolation

The more individuals take the time to check in with themselves and others, the more the community as a whole can begin to normalize seeking assistance for mental health, McGaugh said.

“We know there is a stigma related to mental health, and at times people feel shame when they have these issues,” he said. “You are not alone. I think people try to take things on. We are trained to be tough and work hard, and those are positive attributes, but then we forget about our mental health.”

He emphasized the importance of awareness when it comes to rising stress levels and taking the time to check in with oneself outside of stressful situations.

“I think a lot of times, it just sneaks up on people — and then they start experiencing problems at a point where it’s hard to know what to do,” he said.

The pandemic has shown the importance of social networks and community support, both of which are lacking, as common institutions such as schools are closed down.

Through his work with the Pitkin Area Co-Responder Team, McGaugh checks in regularly with area law enforcement. He said that while incident reports are down, it may be a sign that people are falling through the cracks. Prior to the shutdown, law enforcement might learn of an unsafe domestic situation through a school counselor or a probation officer.

“Pitkin County really values prevention services,” he said. “During this pandemic, there has been a decrease in people being seen in these ways. They aren’t at summer camps or day cares, so we are seeing things that are reaching more of a boiling point, as opposed to catching it when things are starting to get a little sideways.”

Faas echoed the sentiment, adding that people of any age are feeling the impacts of the social disconnection.

“Isolation is a really big issue for a lot of folks here,” she said.

And though it’s not uncommon to feel cut off while living in rural mountain towns, she said locals are able to brace for the seasonal isolation. This time, it caught us off-guard. And it doesn’t help that working locals feel like they are following all the rules and missing out on social time while the customers they serve live it up.

“They all come here on vacation. They are out there partying, and we are like, ‘We are working — we have to get up tomorrow,’” Faas said.

Breathe in, breathe out

The mounting stressors mean on any given day, you might run into someone who has snapped. Or you might be the one to throw a nasty comment out.

“There’s a lot of confrontation out there,” Faas said. “It is what it is. To escalate the situation is not going to resolve it.”

Being the bigger person needs to come from a place of compassion for yourself and others, said Skramstad.

“It is normal for us to be a little more short tempered or angry or frustrated because of the stress,” she said. “Everybody is doing the best that they can.”

She said when a stranger is rude or confrontation starts, it is a sign that a person needs support.

“The best they can, at the moment, clearly appears to be struggling. How do we have some compassion for that instead of feeling the need to engage and get that ugly back?” Skramstad posed.

She emphasized that there is a lot to be gained from taking a few good, deep breaths. Now that the smoke is getting clearer at times, she also suggests going into nature.

And, as impossible as it seems in an ever-changing world, creating structure is also good for your health.

“When we don’t have structure, it’s just one more way that things feel out of control,” she said.

Skramstad assured it doesn’t have to be too rigid, but setting windows of hours for going to bed and waking up and for work and free time can help keep minds at ease. She also recommends maintaining a healthy diet and other habits.

“There is a lot of sense of, ‘I’m out of control because I don’t control the pandemic, and I don’t control wildfires, and I cannot control what’s going to happen in the ski season, and I can’t control whether tourists are going to come to town,’” she said. “There are many things we don’t have control over right now, but we have control over how we create some sort of routine for ourselves.”

And it doesn’t have to be done alone. The mental health coordination team is prepared to send anyone seeking assistance to any of the agencies involved. She said the pandemic has strengthened the collaboration between the many public, private and nonprofit agencies providing mental health support in the valley.

“People getting help is the most important thing,” Skramstad said.“There is no wrong door for people. We are going to help you get what you need.”