Last year – Lisa Hughes can’t remember exactly when – she sat on her stair landing. Then she lay down.
That day, she had spent hours in back-to-back therapy sessions and rushed to the hospital after one of her clients attempted suicide. As she rested on the floor, her phone exploding with messages from more people who needed her help, she wondered for one of the few times in her career if she should quit.
Remembering that moment makes Hughes sad because she loves her job. But during the pandemic, Hughes – a clinical social worker and therapist in Frederick and Hagerstown – saw her case count skyrocket from 50 clients to 80. She was spending six to nine hours sitting per day and had started working on the day. weekends to adapt to schedules. doctors and nurses. Her phone kept ringing with people asking for admission appointments. Sometimes when a friend asked her how she was, she would cry.
Lying at the top of the stairs that night, Hughes felt so lonely.
“I just felt like, ‘There is literally no way for me to wear it all,'” she recalled. âI just wanted to be like, ‘I’m done. I do not do it anymore.'”
Over the past year and a half, the emergence of mental health issues in the United States has erupted, with young people, people of color and essential workers most affected. This avalanche of needs quickly became evident to Hughes and other Frederick social workers, counselors, psychologists and therapists as they watched their call volumes soar to levels they had never seen before. They were tasked with guiding their community through a fog of uncertainty in which they themselves had difficulty navigating.
Even before the pandemic, mental health workers were strained. The demand for mental health services has increased in recent years, although the long-standing shortage of mental health providers nationwide persists. Last year, a survey of more than 2,000 North American psychiatrists found that 78 percent had scores suggesting high levels of burnout and 16 percent had symptoms of major depressive disorder.
Now, with coronavirus cases declining and restrictions being lifted during the pandemic, the job is far from over for Hughes and his colleagues. Many are still juggling increased demand for their services, and some are working with waiting lists of several months. Additionally, as life returns to normal, their clients face a new cycle of anxiety.
âThere is no break. There is no fence. There is no time to breathe, âsaid Hughes. “It’s just kind of the next wave of problems that have come this way of life for a while.”
Katie Frazee started Guiding Paths Counseling six years ago because she wanted to cut down on her hours to spend more time with her newborn baby. For five years, it seemed her plan was working – she was working about 25 hours a week.
Then the pandemic struck. Suddenly, she worked up to 45 hours a week. All the while, she was helping her son through virtual kindergarten and later grade one.
A few weeks ago, Frazee said she had to finally give up and stop accepting new clients. She knew she was coming to a point where she could no longer be fully present with them. She estimates that she needs to refer around 20 people a day – a huge increase from the five people she turned away each day before the pandemic. She recently spent an entire Saturday calling people back and trying to help them find therapists who could fit them into their schedule.
This has been difficult, especially since many of the therapists she generally refers people to are no longer accepting new clients. She advises people who contact her to get on a therapist’s waiting list, even if it lasts a month or two. That way, if they can’t find someone else in that time, at least they have a date scheduled.
âIt’s disheartening because people usually reach out at a time in their lives when they don’t know what else to do or who to talk to,â she said. âNow we’re in a situation where people have to wait a month and a half. And after a month and a half, maybe that initial problem went away or they lost motivation.
Monique Harris, a licensed professional counselor who runs the Blu Haven Wellness Center in Urbana Pike, has also seen an increase in service requests during the pandemic. To keep up with the demand – and to be able to see all of her old clients who needed help again – she hired a virtual assistant and two additional therapists.
At the start of the pandemic in particular, Harris faced feelings of loneliness. She was relatively new to the Frederick area – having recently moved from Montgomery County – and had yet to build a local network of therapists to draw on. But she deeply appreciated the bonds she has forged with her clients and feels grateful for having been able to contribute to her community.
She recently joined a peer support group, where she learned a new way to end counseling sessions.
âAfter each session, you just put your hand on your heart and you just send love to that client,â she said. âAnd you end by simply leaving the session there. So don’t take it with you to your other room or take it with you anywhere – just leave your session there, but send it lovingly too.
Jess Albright was overcome with emotion when she walked into her office a few weeks ago for the first time since the start of the pandemic.
âI sat there and cried for a few minutes,â said Albright, who runs Counseling with Jess at Frederick. “Because it’s been a year, you know? “
During the pandemic, Albright missed the safe space her office provided for her and her clients. Working from a bedside table in her bedroom, it was difficult to maintain clear lines between her job as a counselor and her job as a mother of two – a 3-year-old and a future second-grader, who she was homeschooled last. year.
The transition to telehealth was stressful. Watching a screen all day was exhausting, she said, and found herself leaning more in her chair and making more dramatic facial expressions to show her clients that she was listening. Now she has frown lines and back to prove it, she said with a chuckle.
It was difficult to avoid burnout, but Albright developed some strategies. She walked a lot, watched insane TV shows and sometimes just sat and stared at the wall – a method of coping that may not have been the most effective, she admitted with a laugh. .
She also turned to an analogy that she often shares with her friends. We all juggle a lot of balls, she tells them, some rubber and some glass. If you drop the rubber ones, they’ll bounce back and you can pick them up later when you’re ready, she says. But if you drop the glass balls, they will shatter. The trick, Albright said, is figuring out this distinction for yourself: what is a glass ball in your life and what is a rubber ball?
For Albright, her relationship with her children and her husband is a glass ball. When her daughter remembers 2020 and the first half of 2021, she said, she doesn’t want her to think of it as the days when mum was a freak and they were arguing about stupid things to do with it. school.
Instead, she wants her to remember it as the time âwe laughed and we made play dough,â she said. “And we played in the creek because the pool wasn’t open, and we went to some restaurants driving and ate it in the back of the car – we called it a ‘picnic by car “. [we tried] chasing away joy because joy was so rare.
During the pandemic, the six-person Frederick County Health Department team that provides mental health services to people in the county who use Medicaid and Medicare faced many of the same challenges faced by private providers.
With around 400 clients already on their clinical workload, Joyce May – a clinical social worker specialist for the county health department – said she and her colleagues found themselves making more and more referrals. Similar to Albright, May has struggled to neatly compartmentalize her family and professional life while working out of her family room.
But in a recent interview, May focused more on the positives of what has been a pretty dark year and a half. During the pandemic, Medicare and Medicaid began to offer more flexibility in teletherapy coverage than before. Without the added burden of finding transportation to the office, clients have also started scheduling appointments more regularly, May said. And as many logged in to sessions from spaces they felt comfortable in, May and her colleagues noticed that many of their clients shared more than they had ever done before. Many have made progress on their healing journey thanks to the new framework, May said.
Alicia Dacey, a licensed clinical marriage and family therapist who runs the Frederick Center for Marriage and Family Therapy, has noticed similar benefits to teletherapy. The online transition and increased demand for counseling have doubled the business of Dacey’s center. She has hired more staff and now sees clients from all parts of Maryland, including areas that do not have marriage therapists.
âI have clients with young children who could not have had a babysitter during the pandemic,â she said. âI have clients with disabilities who are in too much pain and are physically unable to leave their homes. I have clients who work from home and can take a short hour-long break from their work day to receive mental health services.
And Hugues? She didn’t give in to the idea of ââquitting, even after that night when her feelings of isolation became impossible to ignore. She hates seeing people in pain and doesn’t think she could have gotten through it. The relationships she maintains with the people with whom she works are “close and dear” to her.
Yet it sometimes feels like mental health workers are a âlost group,â Hughes said. Although she has seen so many of her colleagues working tirelessly to meet the needs of others – sometimes to the detriment of their own sanity – she wonders if the wider community just assumes that they are still doing well.
Nobody takes care of the mental health of therapists because, well, that’s their job, Hughes said.
âIf you know of one, if you’re friends with one, if you have a family member who is, just ask them how this year has treated them. Ask them how they are doing – check with them.