Mental health service providers in Southwest Colorado are moving to remote work, expanding teletherapy video and phone networks and helping increasingly anxious or depressed clients. They foresee – and, in some cases, have prepared for – an approaching wave of need in response to the coronavirus.

One national model indicates that 68,000 Americans could die from drugs, alcohol or suicide because of coronavirus impacts. In Southwest Colorado, mental health professionals and law enforcement have seen an increase of people seeking services for anxiety, depression and suicidal thoughts, although a spike in need has not yet occurred. Early education could help reduce those numbers.

“I think it’s something we need to be talking about,” said Judy Austin, director of the Grief Center of Southwest Colorado. “I can’t imagine that any of us in the mental health field thinks we won’t see an escalation.”

The Durango Police Department had already noted an increase in suicide-related responses by mid-April, said Cmdr. Ray Shupe, spokesman for the department.

The department responded to 47 mental health calls between March 1 and April 16 in 2019. Of those, five responses were suicide-related, including three attempts. In 2020, the department responded to 41 calls over the same time period. Eleven were suicide-related, including four attempts.

“It’s a pretty significant increase to go from five to 11 in the same time period,” Shupe said. “It’s an impact for sure, and it’s certainly a concern that we all have.”

The Grief Center, and Axis Health System, both of which serve multiple counties in Southwest Colorado, have not seen a significant spike in service requests. The Grief Center reported a steady rise in the number of appointments and referrals and incidents tied to the stress of the crisis, like suicidal ideation, domestic violence and racial tensions.

The Axis team said it has not seen an increase in crisis assessments, substance use detox visits or acute treatment unit stays in the past two months, said Karla Sluis, Axis spokeswoman.

Both organizations have prepared for a surge in behavioral health needs, based on what others around the nation are experiencing.

The national model, released May 8 by Well Being Trust and the Robert Graham Center, estimated the United States could see 27,600 to 154,000 deaths from drugs, alcohol or suicide because of the pandemic. The number depends on how the economy recovers and the impacts of unemployment, which research shows can lead to rising suicides.

At the Grief Center, Austin said she prepared staff for a possible “onslaught” and began evaluating staff capacity.

Axis Health filled open positions and hired additional staff, said Stephanie Allred, senior clinical director with Axis Health System. Almost all services have increased telehealth capacity, including new teletherapy stations with community partners like the La Plata County Jail.

Even with preparation, barriers to access exist. Broadband is often insufficient for video calls in rural areas or for populations without technology access. People who need privacy during an at-home counseling session could find teletherapy challenging. As the economy continues to tumble, finances can be a barrier to resources for both clients and nonprofits, like the Grief Center.

“Our way to addressing barriers is to make sure patients have as many options as possible to access care,” Allred said.

Education and community action around mental health awareness could help people cope during the pandemic, the modeling report and mental health professionals said.

Since March, people have lost jobs, financial security, social connections and control over their daily routines. The complete disruption caused by the country’s response to the pandemic might create feelings of helplessness, uncertainty and a loss of control for people.

These feelings could exacerbate anxiety, depression, grief and trauma, said mental health professionals at Axis Health, the Grief Center, Fort Lewis College and Mountain Mental Health Clinic in Durango.

“Sometimes, depression and anxiety are hard for people to recognize because it’s so overwhelming,” said Sandra Eisemann, clinical psychologist at Mountain Mental Health Clinic in Durango.

Loss of control is part of the textbook definition of trauma, said Brian Burke, a psychology professor at FLC. Those who have previous experience with trauma, including historical trauma, could see mental health impacts.

“It’s permeating life as we know it right now,” Austin said. “One of the biggest things is that we just acknowledge ... this is grief.”

At first, people experienced an acute phase of grief. But the pandemic still has no expiration date and its impacts are expected to be long-lasting. These factors can lead to chronic grief or anticipatory grief – grieving for future losses like jobs, loved ones, beloved restaurants, celebrations or the next school year.

Grief becomes even more complicated when people cannot participate in rituals, like graduation ceremonies and funeral services. Burke urged people to try to continue those rituals as much as possible as a way to cope.

With communitywide factors like chronic grief and a loss of predictability – that’s when mental health professionals start to worry more about increased anxiety or depression.

“It is escalating, and I’m seeing more of it week by week,” Austin said.

Agitation, restlessness and anger could indicate anxiety or depression. Depression could also appear as changes in eating, sleeping and personal hygiene habits.

People are already adjusting to a threat to their own health, safety and security. If an unexpected crisis occurs, people might not be able to handle it emotionally or financially – that’s where Eisemann and other experts become concerned about increased suicides.

“I think it’s going to be a very serious concern for us as a nation, as a community, as therapists, for quite a long time,” Eisemann said. “We have to be aware because it’s not going to go away.”

People with depression might feel embarrassed or ashamed that they are not handling things better. This often results from social stigmas around seeking help. Eisemann said others should feel comfortable starting the conversation to check in on loved ones.

“Sometimes people are very relieved when somebody finally notices. We don’t need to be hesitant about saying, ‘Wait, I’m concerned,’” Eisemann said.

smullane@durangoherald.com