More than two years in recovery from addiction to opioids and alcohol taught Robyn Hantelman the importance of group therapy sessions. A big part of treating her addiction has been meeting with others to know she’s not alone.
But the coronavirus means many people in recovery or people being treated for mental health issues are staying home, isolated, their meetings postponed or shifted to phone calls and online video chats.
“We’re already dealing with the disease of addiction,” said Hantelman, a peer recovery specialist at the Substance Abuse and Addiction Recovery Alliance (SAARA) of Virginia. “Then you bring in coronavirus and quarantines and kids out of school and not being able to find toilet paper.”
The isolation can be especially challenging for already vulnerable people. Public and private groups that provide mental health and substance abuse treatment are now holding meetings and therapy sessions online or by phone. And they’re screening for coronavirus symptoms any clients who need to meet in person with a provider — for example, people who need shots to combat opioid addiction.
The added stress and anxiety could lead to relapses, sending lives spiraling further downward during a pandemic. Being poor or homeless and also isolated can be deadly for people who can no longer see others in person for treatment or therapy.
For people in recovery, there’s a higher risk of returning to substance abuse, according to mental health experts.
“One alumni killed himself last week,” said John Shinholser, who heads The McShin Foundation, a private foundation founded in 2004 to help people recovering from substance abuse. “I am quite certain it was definitely related in part to the crisis.”
“You’re going to see a lot more suicides. I guarantee you that,” he said. “We are holding the line. … We are at battle station emergency right now. But even holding the line, there’s still going to be cracks in the line.”
Hantelman’s organization usually holds group meetings five days a week on such topics as anger management, co-dependency and mental health. Usually, 10 to 25 people attend.
They switched this week to an online videoconference, which Hantelman said is a blessing.
“The fear now with the coronavirus scare is that, isolation, for example, is a trigger for a lot of people in recovery,” she said. “If we isolate, we become more vulnerable to relapse or to going off of our plan. So by addressing the fear of isolation, for example, we can talk about what we can do and use the tools that we already had in place for addiction recovery to apply those to a pandemic.”
At The McShin Foundation, no newcomer is turned away since the crisis started, Shinholser said.
“We’ve taken a hell of a financial hit, though,” Shinholser said. “Donations have plummeted. Our ability to raise money is nonexistent. Financially, we’re digging into our savings, but we think we can weather the storm in the long run.”
“We’ve been saving money for 16 years just for this very crisis, and it’s hit us.”
One in five adults in America experiences mental illness, according to the National Alliance on Mental Illness. The group estimates that more than a million adults in Virginia deal with mental illness, with up to 305,000 of those being serious mental illnesses that substantially impair their ability to function. And about a quarter-million adults in Virginia struggle with both mental illness and substance abuse, according to NAMI estimates.
Drug overdoses killed about 1,500 people a year in Virginia in 2017 and 2018, and figures for the first three quarters of 2019 show a similar pace.
More than 120 people live in the McShin recovery houses, many of whom worked in the service industry and lost their jobs. They’re among the more than 46,000 people who filed for unemployment in Virginia for the week ending March 21, up from 2,706 the week before.
Local jails were forced to cut off visitors, and the foundation can’t provide the regular services it provides in jails. McShin laid off five full-time workers and 10 part-time workers, Shinholser said.
Many newcomers to the foundation do not have a laptop or the ability to get online, he said.
That’s also a problem for many clients of Virginia’s community services boards, the public agencies that provide mental health and substance abuse services and served 219,785 people in fiscal 2019.
They rushed to set up therapy sessions through videoconferences and enhance coronavirus screenings of people receiving services.
The Richmond Behavioral Health Authority is among public agencies that set up an office space for clients to use a computer to consult with staff by video, hoping to accommodate the many people who don’t have a computer, smartphone or internet. Thirty percent of the people the authority helps do not have health insurance.
“Like any disaster, socioeconomics come into play,” said Dr. John Lindstrom, the authority CEO. “And while everybody is impacted by this situation, those that were already disadvantaged in our society have the impact of this play out for them exponentially.”
The offices closed Monday and Tuesday so staff could prepare to minimize face-to-face contact. Offices reopened, but only by appointment. A program that serves 70 to 80 people with mental illness, many of whom live in assisted living, is now done by making phone calls to the people receiving help, Lindstrom said.
The Richmond Behavioral Health Authority’s downtown office includes a primary care clinic, psychiatric clinic and pharmacy. Like hospitals, they are low on gloves and masks and other personal protective equipment for professionals to wear when they must give someone an injection, health screening or medical procedure.
Similarly, a private agency, Daily Planet Health Services, is moving to videoconferencing for appointments for the people it serves, many of whom are poor or homeless. That includes a room at its location downtown where someone without a phone or computer can get online to speak with a therapist.
“One of the major risks for people with mental illness is to disconnect from other people and from services,” said Charlotte Watts, the behavioral health director at Daily Planet.
The website for the Richmond branch of Alcoholics Anonymous now provides information on logging into meetings online through the videoconference service Zoom instead of heading to churches or hospitals for meetings.
Sally L., who asked that her full name not be published to honor a tradition of anonymity in Alcoholics Anonymous, is 26 and an active, sober member of AA from Midlothian. She said Zoom is working well for AA meetings. If someone doesn’t have internet or a computer, she said, she holds meetings by telephone. Some meetings still happen outdoors with attendees at a safe distance.
“Sitting at home all day is a big-time trigger for people with mental illness and addiction,” she said. “But we are not alone. There’s a huge Richmond community.”
Private counseling agencies such as Thriveworks have also moved to videoconference for appointments. Not having access to normal human interaction is hard on anyone, said Rhiannon Alley, a counselor in Richmond who works for the company.
“I think that’s been hard for a lot of people — not having access to their normal coping skills combined with an overall surreal feeling about the outside world.”