- [Woman] WVIA's Mind Over Matter, A Mental Health Initiative is underwritten by Geisinger.

- [Man] There's a feeling in the air.

Like when things are on the move again.

You can tell by the crack of a bat, the smell of pie being served, business in person, kids being kids, together.

You're ready for this.

And so are we.

(gentle music) - [Matisak] The COVID-19 pandemic has been stressful and at times, overwhelming for a lot of us.

Hello everyone.

I'm Tracey Matisak.

Tonight on Mind Over Matter, we're talking about just that.

Mental health in the age of COVID.

The virus has not only threatened our physical health, but has challenged our mental health as well.

Over the next hour, we'll hear from a panel of experts about the toll COVID has taken on our minds and more importantly, what we can do to heal.

But first, a few real life stories of how people around the region have navigated their own mental health challenges.

If you've had these kinds of struggles, please know that you are not alone.

If you need someone to talk to or would like to explore treatment options, dial 211 to speak with a caring person who can help.

So, let's get started.

We hope you'll find these stories and the conversation that follows to be helpful and encouraging.

- I'm La'Quitia Denson.

And this is my story with mental illness.

- My name is Kevin Riley.

I am 59 years old.

Retired jeweler.

Part-time, sometimes photographer.

- My name is Jonathan Blake and I'm a licensed social worker.

- [Denson] I remember when I moved here, and this was before I ended up going to the doctor to get treated.

So when I moved here, I went through blues.

And everybody was like, oh, it's just cause you moved.

You're away from your friends.

You're away from your family.

You're away from everything that you knew.

And at a point like it made sense, but it kept going.

I wasn't leaving the house and it wasn't that like I was lazy.

Cause I would do stuff around the house, you know, here and there, clean, cook, keep myself busy.

But it was like, if I laid in bed, like if I was in bed all day long, it wasn't because I was tired or because I was lazy.

I just, I can't it's, it's, it's so hard to, because I can't explain how I felt because I felt nothing.

- [Riley] When I was young, I went to counseling with my mom because she had had a problem with prescription painkillers.

Most of my parents' friends kind of understood what mom was going through.

Pretty much, anybody else was in the dark about what was happening.

And that was just kind of the way it was back, you know, back in those days.

- [Blake] A lot has changed over the years.

And I mean, if, if we're talking about education, then certainly, the way that information is presented to people who are learning about all this stuff has, has changed.

And also the understanding has changed.

It's presented to a new generation as such, and it's just the way it is.

Certain ideas and certain concepts and relationships of those concepts of what behaviors do people see, have been around for a long time and kind of, part of a certain generation, right?

And we see younger people who might be more willing to hear about somebody's experience, or more willing to hear about somebody's trauma and what they've been to, been through.

And then ultimately not judge just the behavior.

I don't know if it's generational or like specific generations of people, but it's just the way that things have been educated and, and taught to people throughout, you know, however long and things evolve and things change.

And now we see younger generations of people who might be more accepting of things.

But again, I think the older generations kind of come into line with all this stuff.

- [Denson] If they're really young, it's a behavioral thing.

If it's an adult, oh, it's just an attitude adjustment.

You'll be fine.

It'll, it's a phase, you'll get over it, you'll work through it.

And it's just like, no, that's not the case.

And it's, it's, it's I feel, I feel bad for anybody stuck in that, in that cycle.

Especially as a child, if you have, you know, these, these problems that you're struggling with and you have nobody to listen to you, and then you drag that into your adulthood, that's hard.

- [Riley] We lived two houses from the elementary school.

One day, getting out of school with hundreds of kids, leaving this school and walking down the block past my house, my mom is crawling in her nightgown in the front yard, crying, not knowing where she's at.

And me, I was either seven or eight years old having to help her to get back in the house, crawling back in the house.

And you know, this, that's one thing that always stuck in my head.

- [Denson] You know, you have these pep talks with yourself.

Sometimes those pep talks turn into like shaming almost.

You're gonna let everybody down.

You're gonna look like, you know, lazy.

You're gonna look like, you know, you're worthless.

You are worthless.

Look at you, you know, Sitting here doing whatever or, or look at you, you know, thinking about yourself.

- I had other people around me, that gave me support and that's a very important thing to do.

- My friend, her name is Gail.

She gets me through all the points of my life that make me question everything.

The things that she'll say to me, I've learned to say to myself.

I don't know what kind of direction I would have had if I'd never met her.

She kind of gives me a perspective.

- If you're going through any, anything tough like that, a death or a breakup, you don't want to always try to do it on your own.

You need friends or family, if you have them, that you can talk to and turn to.

That's the best thing right there.

- [Woman] Remember, you are not alone.

If you need assistance in talking through a problem or exploring mental health treatment options, call 211 to speak with a live person who can help.

Or for more information and resources visit wvia.org/mindovermatter.

- [K. Rodriguez] So the pandemic changed our life as a family because we had to basically be stuck in our home for months.

It was hard at first, I felt like that this would last forever.

Are we strong enough to get through it?

And honestly, I got strength from my husband and my children because they assured me that we'll all do what is told and we'll work together.

And everyone just, we leaned on each other and got through it together.

So, yes.

But is the anxiety still there a little bit?

Absolutely.

But, I remind myself every day that we take all the precautions we need to, and we do everything that, you know, we do to keep safe.

And we just, day by day.

- My anxiety and, and it was tough.

You know, when it first started coming and you're seeing the numbers growing and growing and, and you realize, oh my God.

And when we went through the shutdown, it was, it was emotionally very hard, you know.

But, you know, like anything else in life, you have to figure out ways to overcome it to make your life better and healthy.

- Well, as far as the family dynamic, I do see a lot of people that are working from home.

A lot of stay at home parents that homeschooling children.

That whole family dynamic has changed.

When things first started closing down, a lot of people had increased anxiety about, you know, getting sick and things like that and having to stay home.

Now that things are opening back up, one thing we're seeing a lot of is, is re-entry anxiety from, from individuals who don't want to go back out into the community because they've kind of become accustomed to that.

- I was scared.

I was nervous.

My job as a mom was trying to protect everybody, making sure no one got sick.

It was a lot to get used to.

- I still wear my mask wherever I go, inside anywhere.

I don't ask other people for respect, but I do like to wear the mask.

They're proven the work.

You know, I haven't gotten sick.

- [K. Rodriguez] I had a hard time with trying to figure out ways to keep everybody busy.

- [G. Rodriguez] It takes a little bit of a mental effect on you, but you know, when you have a family and a family support, the, the, you know, as a, as a structure that you know together, we can get it.

You know, we can do this together and try to do activities and, and just keep, keep doing things that keep your mind occupied.

- [K. Rodriguez] Well, we went back to the basics.

We kind of logged off of the internet because all they did was talk about the pandemic and everything going on.

So, we did like family game night and we'd swim, we'd go fishing.

My husband's very creative with building, or he could pretty much do anything.

So, we stayed in our little yard away from everybody and just made our own little oasis.

You know, I did a lot of cooking, you know, doing different experiments, but mainly I have a team of teenagers.

So, to try to keep them logged off and their mind occupied besides being on the internet was a challenge.

But, I think we came through pretty well.

Well, we started a garden.

My husband does well.

He grows it, I cook it.

And it's been working wonderful for us.

Our daughter just moved to her first apartment and she knows that her dad could build anything.

So, we found stuff on Pinterest and he went and got pallets and built her furniture.

Of course, my son, he helps with all that.

My son pretty much worked on his car.

My husband taught him how to do, like all the normal, change your tires, your brakes, oil changes.

It was wonderful to watch him grow and learn to do all that stuff.

And we just did it all together.

- [G. Rodriguez] You know, it's, it's a nice thing just to, that as a family, we can do things together and share these moments with, you know, with this pandemic going on, and - - [Davis] The best advice I really have is, is just really take everything one day at a time.

One moment at a time.

Break it down if you have to, to smaller, manageable tasks.

It can seem very overwhelming, especially with children and with all the uncertainty and things that are going on.

- [K. Rodriguez] It doesn't have to all be done in a day.

Your day doesn't have to be perfect.

Just cause you see someone else's day looking perfect, doesn't mean yours has to.

But, educate your children on what's going on.

Let them know about what's going on.

And again, go back to the basics, back to family time and doing things.

This was such an opportunity that we can spend time with teenagers that enjoyed hanging out with their parents.

It was a nice breath of fresh air in the midst of a pandemic.

- [Woman] Remember, you are not alone.

If you need assistance in talking through a problem or exploring mental health treatment options, call 211 to speak with a live person who can help.

Or, for more information and resources visit wvia.org/mindovermatter.

- [Daube] I was really sick in February, 2020.

I know that if it weren't for having the telehealth, I needed to be able to be seen by multiple doctors and being able to have the telehealth.

- [Mary] Telehealth has made a huge impact in my progress in mental health.

I've worked with a lot of great counselors through telehealth with anxiety and depression and a few other issues that I've been going through.

And it's helped create a space for me in my own home, where I can be in my own room and I feel safe, but also feel connected to my counselor.

- [Sheth] When COVID hit, nobody knew how long this is going to last.

How are we going to take care of our patients, who frankly speaking, were afraid of even coming into a medical facility?

A lot of patients were actually ignoring their own families, trying to just stay at home, trying to stay away from this unknown fear of getting COVID by just stepping into a medical facility.

- [Daube] It was also just to be able to reach out in the times that it, like struggling during, during COVID and being like, it confined to the home and not able to leave.

- [Shrestha] During pandemic, like it has changed tremendously.

I think this is the technology and the future of the mental health and telemedicine, both combined.

- [Sheth] Telemedicine provided them the necessary way of still staying in touch with their doctor's office, getting the necessary care that they need, even though it is remote, having the ability to see their physician's face when they needed them the most.

- [Daube] Definitely the positives were that I could do it from home.

That I didn't have to go to leave to go out and have those concerns that are there.

To be able to have a more frequent appointment.

- [Sheth] So, one of the things that comes to my mind is behavioral health services.

There's a shortage of psychiatrists in the region, in the state, and nationally.

Psychiatry is a perfect example of where services can be fully rendered through telemedicine.

It is not as a service language.

You require a specific examination or physical exam or touch the patient.

It can fully be delivered indefinitely to telemedicine.

- [Daube] Sometimes, in person, like, it's a little bit more difficult to, to express how, how things are going.

Whereas like over telehealth, it was a little easier, especially if it wasn't like video, if it was actually over like, just the phone.

It was a little easier to kind of share what was happening because I didn't necessarily have that face to face that sometimes inhibits me from sharing more, you know.

- [Sheth] Telemedicine capabilities for our behavioral health service line, 85% plus patients opted to go fully telemedicine.

85% is a huge number.

- [Mary] When traveling to my counselor and when I had to meet with them in person, it, not that it was completely inconvenient, but, it, it's an hour session that including the travel time and parking and traffic, it could increase my time being taken away to almost three hours.

So, with telemedicine, it made it much easier for me to get in connection with my counselor.

Much easier without the travel and without the hassle of having to get to them.

- [Shrestha] You know, there's a lot of barriers, not able to come to appointments, transportation issues, work schedules, personal life.

- [Sheth] What COVID did, is they moved the origin, originating site from a requirement to be at a clinic to any site of patients' choice.

So, patient got a choice to start a telemedicine visit from their car, from their home, from their work.

Now, they don't have to take time off from work to be at the doctor's appointment, where an appointment for an hour requires them to take three hours off from work on a practical note, right?

Patients are now really looking to continue these services because they have seen how this really helps.

- [Daube] There were tons of positives and the ability to be able to reach out, you know, made it a lot easier in some sense, to, to have them in place definitely and then especially in the mental health fields.

I think that was huge to be able to have in place.

- [Woman] Remember, you are not alone.

If you need assistance in talking through a problem or exploring mental health treatment options, call 211 to speak with a live person who can help.

Or for more information and resources visit wvia.org/mindovermatter.

- [Kinney] I never wanted anybody to know what I was doing.

So, I kept it inside and it ate away at me.

And the only way I could quiet it down was drinking.

When I was drinking, I always isolated.

I didn't want to know anybody.

When I would come home, you know, shut the, shut the shades and be my myself.

And, this COVID, for me was really, really something that affected me because I suffer from anxiety and also depression, which I'm being counseled for.

I take my medication.

And when I couldn't go to the bars anymore, I couldn't go shopping like I used to.

I just had to sit home.

And that affected me quite a bit.

I, I had been to the emergency room with anxiety attacks and that also affects my, my breathing because I have chronic asthma.

So I, you know, one affects the other.

For me, you know, the COVID being locked up, just hurt me really bad.

That's, that's not the right way.

I'm in a position right now that I had to, you know, really think about what I wanted to do with, you know, my future.

I got that opportunity.

I thought about maybe moving someplace smaller, but that I can't afford.

For me, COVID work backwards.

It, yeah it did isolate me where I wasn't going out and doing things, but it also kept me away from the bars and drinking.

And, I got to about six months and I noticed a change in myself, how I felt.

It, it just got to a point where things started to change for me.

I, I, isolation got me back on the right track to, I didn't go into more counseling at the VA.

They always made appointments for me, but I always go to the bar instead because drinking was more important.

So I, I never went, you know, my life was just in a big heap of garbage.

And now, I'm taking my meds on time.

I'm going to my doctor's appointments on time.

And, you know, I notice, if, if I'm, something's bothering me and I just call somebody and tell them what's bother, bothering me, it seems like it all goes away.

It doesn't, it doesn't affect me anymore.

I can seek help on the outside.

Whether it's a family member, your best friend, or there is a lot of help out there in the NAMI.

There's help centers, that you can, 800 numbers you could call.

They can tell you where to go for certain help.

And there's groups that you meet.

And also, the number 211, you could call that number and they will, will help you, or guide you to whatever you're looking for.

But, if you're not doing well and you need help tell someone else.

Like I say, family member, best friend, and say, I need help, but don't know what to do.

And they may be able to do something for you to get you guided in the right direction for the help you need.

- [Woman] Remember, you are not alone.

If you need assistance in talking through a problem or exploring mental health treatment options, call 211 to speak with a live person who can help.

Or, for more information and resources visit wvia.org/mindovermatter.

- [Foley] We started in '72 after the flood, getting close to 3 million calls since then.

Last year, we answered roughly about 103,000 telephone calls.

That was up 16,000 from the year before.

- My name is Shawn Bly.

I am a previous user of 211, and it's helped me greatly.

I was in a motor vehicle accident.

I was on disability from work.

And during that year, it was really, like really hard, you know.

I wasn't able to pay rent.

I had to move back with my parents.

It was terrible, you know.

So, it really, and I didn't know any - you know, I didn't know what to do.

I was younger then.

And it's like, where do I look for these resources?

- [Ives] Two on one is a program for individuals and families to call in when they need a little bit of help.

- My name is Tom Foley.

I'm the director of PA 211 Northeast and Helpline.

And we are part of Family Services Association of Northeastern Pennsylvania.

- My name is Jessica Ives.

I am the director of case management and community programs at Family Service Association of Northeastern Pennsylvania.

- The majority of the phone calls are for basic needs.

People are looking for help for housing.

They're looking for help for food.

They're looking for help for utility assistance.

- So, if someone calls in asking for help, what we do is assess the situation to find out where they are, what's going on in their life, and what type of resources they may need.

- They gave me a lot of resources, a lot of resources that I didn't even call to ask for, which I, I didn't even know existed.

- A lot of people call us and they don't want to talk to anybody face-to-face.

They feel, they like the anonymous situation of calling in.

- [Ives] It is anonymous, and they don't have to share any type of information.

- [Bly] They were very professional and kept it, you know, anonymous.

They didn't, you know, ask any personal questions or anything like that, which was good.

I mean, if you are, you know, in school or working, or, you know, when you call with, I guess, you know, suicidal or something like that, you really, it's not really something that you want, you know.

Especially, if you're depressed because of something, you know, like your family or something.

It's not really something that you want, you know, to get out.

- Sometimes, people are afraid to reach out to their friends or family for help.

- They're kind of afraid that, you know, people are gonna look at them differently, that it's going to affect how they are treated at home and at work or in the community.

- But when you're in a state where you're very depressed or you're like, even calling for food banks, some people, there's a big stigma around that in especially up in like, Luzerne County in that area, those areas.

There's like a big, there's a big stigma around that.

So, some people would just rather, you know, be anonymous.

- Two on one is anonymous so that, we can help make sure you feel safe when you call in.

- We're gonna keep them anonymous.

So, they feel more comfortable in opening up with us as opposed to friends and family.

People can call us anytime day or night.

And they'll be talking to a live person here.

- Someone's there for them to help them through whatever situation they're going through and know that no one else is gonna know about it.

- It doesn't matter what, any kind of question you have, you call them.

If you think it's important and ask them.

And I mean, no question is stupid.

You know, to them, they're there to help and whatever.

I mean, if they can provide the resource, if they can answer the question, then I'm sure they will.

If they can't answer the question, or if they think you're better off somewhere for, you know, another resource like that, they directed me there.

- When somebody feels like they're getting to the point of a mental health crisis, there's different options we can give them.

We prefer to try to deal with somebody before the crisis hits.

- Everyone's been in difficult situations before, whether it is the lights being shut off or needing a little bit of extra food to get you through the end of the month or even reaching out because you're feeling anxious or depressed.

We're here 24 hours a day.

So, we're here to talk to you and you won't be judged.

- That's nothing to be ashamed of.

The thing is you just have to reach out and ask for that help.

(calming music) - [Matisak] And once again, welcome to Mind Over Matter, Mental Health in the Age of COVID.

Tonight, we'll discuss stigma, isolation, telemedicine, and how families are managing through the latest COVID surge with a panel of experts.

What do you say we meet them?

Denise Carey is a licensed clinical social worker and former suicide prevention coordinator at Wilkes-Barre Veteran Affairs.

Dr. Daniel Jurman serves as the first executive director of Governor Wolf's new Office of Advocacy and Reform where his focus is to create better outcomes for all people whose circumstances have made them vulnerable.

And joining us remotely is Dr. Justin Coffey, the chair of the department of psychiatry and behavioral health at Geisinger.

Dr. Coffey oversees all clinical and academic programs in psychiatry, psychology, and addiction medicine.

He also serves as a professor of psychiatry at Geisinger Commonwealth School of Medicine.

So, welcome to all of our panelists.

And I'd like to jump right in and talk about some of what we saw in the stories that we watched.

I'm going to start with a story about stigma.

And Dr. Justin Coffey, I'd like to begin with you because as I watched that story, I could not help but think of this summer when some high profile athletes like, Simone Biles and Naomi Osaka, kind of put the brakes on things to address their own mental health.

And they sparked a national conversation about mental health in the process.

I'm wondering what you think about how celebrities and high profile athletes are maybe beginning to change the conversation about mental health in America.

- And what an important conversation that is for our society, our communities to be having right now.

If, if there's a silver lining, in my opinion, to the pandemic, it has been the level of discourse that has started to take place in our neighborhoods and on our television screens about the importance of mental health and wellbeing.

Celebrities have played, at times, a very meaningful role in that conversation.

And I think it should be admired for taking part in it and encouraging others to participate in.

- Denise Carey, we were talking about the fact that there has been a stigma attached to mental health for as long as most of us can remember.

How do you think that that stigma has affected people's willingness to seek treatment?

- Well, I think, it's the number one barrier actually for heading for treatment.

We still, you know, suicide is like a sh, S word.

Still, even in the obituaries, you won't find someone's obituary saying suicide where you'll see someone else who died by a heart attack or diabetes.

We're still not, still scared to talk about it.

And, and, just the fact that the athletes this past summer were able to have the courage to say, I really need to work on this and treat it as the public health issue that it is.

I think that's very positive and hopefully that's going to make a difference in treatment.

- Dr. Daniel Jurman, you have talked throughout your career about stigma and from your own personal experience.

Talk a little bit about what it's like to be on the receiving end of stigma.

- Sure.

Well, it, it's, it's a powerful force, you know.

I am, am an eight out of 10 on the adverse childhood experiences survey.

So, I've experienced eight of the, the 10 measured childhood traumas and was diagnosed with PTSD as a result of being in a home with domestic violence for 10 years of my childhood.

But, I didn't reach out for help formally until I was into, into my forties.

And stigma was a big part of that.

You know, you have this attitude that you can get through it.

You can just tough it out.

That's what you're supposed to do, right?

That's kind of our American mythos that we're supposed to just tough it out.

And the truth is, I'm finally getting to a place where I knew I had to get help, where I knew I couldn't be as good a father, a spouse, or an employee if I didn't.

It was one of the best things I've ever done in my life.

Just having someone to guide you through ways to heal.

And to help you recognize the things that you're just too close to, to see for yourself.

And so, therapy was very, very powerful.

And so, I speak very openly about that because I struggled and suffered, and so did the people around me for way too long, when I could've been getting help a long, long time ago.

- And speaking of that, let me just take a moment to remind our audience that if you are struggling with any of these issues, there is help available.

Don't wait, call 211.

There are caring people there who can help point you in the right direction.

They're there if you just need somebody to talk to.

It's a wonderful resource.

So, remember that number, 211.

Before we move on, Denise Carey, I want to ask you about something that we saw in the piece on stigma.

And that was La'Quitia when she was talking about, not only the importance of having a supportive person in her life, but she talked about self-talk and how she would give herself these pep talks to almost try to shame the depression away.

And then, she learned that there are other and more effective ways of self-talk.

Can you talk a little bit about the importance of self-talk and how it can maximize or minimize our mental health?

- Absolutely.

So, self-affirmation, self-talk is one of the therapeutic modalities that we use a lot of time in talk therapy because the brain is sending so many negative messages all day long, and it's sometimes very hard to decipher anything positive when you're in a very depressed state.

Everything kind of comes out negative.

So, that positive self-talk, alternate ways of thinking, alternate messages to oneself is, is extremely valid to change that narrative.

- We move on now and talk a little bit about the impact of COVID on families.

And we saw the Rodriguez family and the creative ways that they've managed their way through the worst of the pandemic.

And Dr. Justin Coffey, I want to come back to you for this.

Because, one of the decisions that the Rodriguez family made was to take a break from their devices and to get away from social media and technology.

I'd love for you to talk about how making an intentional decision like that can impact our mental health for the better.

- I love the peace and admire the family for their approach, which I'm sure many of the viewers can resonate with.

The three reflections I would share and the first is whether or not they were taking away time from screens, they were taking time with one another.

And, that was strengthening the bonds between the family members, bringing us back to some of the things that we find most fulfilling and most wholesome.

And number one.

Number two, it can be detrimental to spend too much time in our screens.

There are a whole host of reasons why screen time can be challenging.

Sometimes, it can be a positive, but in many cases, when we lose control over it and lose moderation, it can be, be a problem.

So, that's the second thing.

And then the third thing, there was the actual intention to do something together.

Talking about what the priorities for the family are, centering one another on those priorities, and really committing oneself as a family member to pursuing those priorities.

So, all three of those reflections came to mind when I watched that piece.

- Denise Carey, another decision that the family made and Krystal Rodriguez, the mom made, was to manage expectations.

You know, she said something about not trying to do everything all the time.

And I wonder if you would talk a little bit about the importance of being able to do that, to maybe change our expectations, maybe manage them and give ourselves a little bit of grace in difficult situations.

- Absolutely.

And one thing that I, I talk about with families often is go back to the days where we used to all sit at the dinner table, where we used to all have chores to do and just cooperatively live together in the houses.

When the pandemic hit, I think it forced a lot of us to have to relook at, oh my goodness, we used to do this a long time ago.

And now, I'm gonna ask you to, you know, not expect everything from me, but let's share the, let's share the wealth and try to cooperatively live together.

And, I think we learned a lot about each other again.

Putting away the devices and looking at each other face-to-face and not looking down at something where I'm seeing only the foreheads.

It's been really enlightening, I think, in a lot of families.

- Dr. Jurman, there has been a real uptick in violence in schools since school has started again.

And there have been reports from teachers all over the country.

I'm just gonna give you a sampling.

A Florida middle school reported 87 students getting into physical fights since the beginning of the school year, Kentucky elementary school counselor is assessing more than two dozen, eight to 10 year olds, for suicide risk, students are taking up these TikTok challenges to attack teachers, to commit acts of vandalism, and then post their actions online.

And counselors are saying that some of this is a by-product of COVID related stresses.

Can you talk about it?

What do we make of this and how do we move forward from here?

- Yeah, one of the things that the governor has tasked my office with is making Pennsylvania a trauma informed state.

And in looking at things like trauma, chronic stress, toxic stress, at one point, we all liked to pretend we were talking about some other group of people.

And the truth is that since COVID, it's all of us.

And, when we get to a place where we have way too many stressors, and not just kind of, you know, I had a bad day at work, it's a stressful drive home, but stresses that just won't let up.

Acute stresses that just keep weighing on us.

Then over time, it, it overwhelms our capacity to take anything else.

We all end up sort of living out of our brainstem, which has kind of taken over.

We go, we'd become hypersensitized to sort of fight, flight, or freeze responses.

And so, you have this whole populous, I would say 13 million Pennsylvanians, who are experiencing at least chronic stress, if not full-blown trauma throughout the course of the last 20 months.

And so, some of the symptoms include things like irritability and, you know, shorter tempers, sleeplessness.

All, all of these different things that, that sort of wear on us, so that, you know, we, we get this sort of hair-trigger in terms of how we relate to each other.

I find myself, as a parent, sometimes snapping over things that aren't a big deal and it has nothing to do with what my children are doing.

It's everything else.

And so, if you combine the pandemic with the social justice issues we've been immersed in, and the political unrest that we find ourselves in, and this, this polarization.

All of these things are stresses that won't let up.

And each of us has a different capacity for how much we can take, but a limited capacity before it becomes overwhelming.

- Yeah, it is cumulative.

And once again, just want to remind our audience that if you are struggling, perhaps you see that your children are struggling, from the long-term effects of the stress that all of us have been under since the beginning of COVID, there is help available.

And all it takes is a quick phone call to 211.

There are caring people on the other end of that line who can help you.

They can talk you through it.

They can also recommend some great and helpful resources.

So, we want you to make sure that you remember the number 211.

We'll move on now and talk a little bit about telehealth.

Because we have certainly seen, and Dr. Coffey, I want to start with you on this, a huge rise in telehealth and particularly online therapy.

We saw that in the piece.

That has skyrocketed since COVID began.

So, the question Dr. Coffey is, is telehealth here to stay?

- The genie's out of the bottle, in my opinion.

And, I think it's actually a long time coming.

Here at Geisinger, we were providing virtual care right into patients' homes as part of an effort to bring better health directly closer to the home.

And, that was always part of our mission.

And so, when the pandemic hit, we were able to take our entire enterprise into a virtual first approach.

And, and that was absolutely welcomed by our patients, their families, and their loved ones.

Our no-show rates across our department have been cut in half, and it's, and it's sustained reduction, since really taking this virtual first approach.

And I think the convenience, the ability to respond to patient preference, the ability to provide more confidentiality, and really to meet people where they're at are all reasons why many, many patients are preferring this mode of care.

And of course, it's not for everybody.

We are still providing some in-person care and especially where clinical situations indicate that that's necessary.

But really, a lot of behavioral health care can be provided over virtual care and virtual platforms.

And the science is really there to support the equal efficacy between in-person care and telehealth.

- Denise, you're a therapist and you also do online therapy with your clients.

We heard in the story about how patients love it, clients love it, because it saves time.

For some, it feels much safer to be in their own home.

Dr. Coffey just told us that people show up much more frequently.

As a therapist, what is the experience like for you and are there any downsides to it?

- For the adults, I would say zero downsides there.

You don't have to worry about transportation, childcare issues.

Some literally roll over in bed and around in their towel.

So it's very, the convenience is, is really making a difference.

Kids, a little different.

Kids, sometimes their attention span, they don't want to be bothered with it, they're, you know, they're kind of like wondering what else we're gonna do.

Cause I do a lot of hands on things with kids.

So that poses a challenge for telehealth I think, sometimes.

But, in most experience, most of my experiences are very positive with it.

- And I would think too, as a therapist, that the one thing about it, about telehealth is that you can't see the whole person, you can't see if they're tapping their toe or sort of read their body language that can help sort of supplement the information that you're getting from them.

- Definitely, in a crisis situation, I would much rather have them face-to-face so I could get a clear picture.

- Dr. Jurman, as helpful as telehealth is, what about those who just don't have access?

There's still lots of people who don't have internet, don't have wifi, don't have access to take advantage of services like that.

- Yeah, we, we have to do a better job in general with that.

We, we knew before the pandemic hit from the governor's Reach Out PA initiative, that transportation was one of the biggest barriers to people for care.

They didn't have a therapist near them that they could get to.

And so, it's a, it's an equity issue that we, that telehealth can help us solve.

But we, we do know that before the, the current infrastructure package that's being debated now in Washington, DC, there was already an investment within the last administration where the governor has announced over $300,000,000 in Pennsylvania over the next 10 years for more rural broadband access.

We're hoping that there'll be even more in the infrastructure package that eventually comes through Congress.

So, we've got a lot of work to do, and we need to invest to make sure that everybody has equal access to care.

- Denise, so many online therapy options have been made available since COVID.

There are so many that have sprung up over the last 18 or 19 months that I, I think it can be a little bit overwhelming for somebody who is interested in pursuing online therapy to sort of vet all those different sources and figure out, you know, how to find the right therapist out of all of the choices that there are.

What guidance do you have for people who are considering online therapy?

- Well, first it's cost.

A lot of the online therapy formats are taking, they pay by month in a contract.

One particular insurance company does do like, an EAP, three visits, and then you're on your own.

But most of the, the ones that you see online are not covered by insurance.

So they have, there's a cost to it.

So, that's something to obviously consider.

Those people who have insurance and, you know, any of the community mental health centers or the private community mental health centers, take insurance and can still do telehealth.

- Dr. Coffey, I want to come back to you before we move on to our next topic.

And that is just to ask about the shortage of mental health professionals, because one of the professionals in one of the pieces we saw talked about that and said that there is a nationwide shortage of psychiatrists, at least, is that what you're seeing as well?

And how concerned are you about that as we, kind of make our way through the after effects of COVID?

- Not only are we seeing it, we feel it every day.

And the data support those thoughts and feelings.

Every spring, the Substance Abuse and Mental Health Services Administration in Washington, DC, publishes a behavioral health workforce report.

And this year, the good news is that there was a slight increase in the number of behavioral health providers of all disciplines in our country.

The bad news is that the total number still amounts to only 13% of what the country needs.

And so, when you think about having only 13% of what we need about anything, of whether it's primary care providers, postal workers, school teachers, airplanes, there's a huge, huge gap there.

And one of the things I think, that the healthcare delivery system has as an opportunity is to really partner with communities and agencies in those communities to develop more innovative ways of delivering healthcare.

- [Matisak] We just want to remind our audience once again, that if you are considering perhaps online therapy, if you think you want to just begin some sort of treatment process, and you're not sure where to begin, 211 is the resource that you need to have.

You may not even have internet access, but if you've got a phone, you can call 211, and you can get some great advice.

There are some great resources.

They can point you in the direction of people who can help.

So, we want you to make sure that you remember that number, 211.

I want to move on and talk a little bit about isolation.

We saw in the, the video on isolation, the story of George Kinney.

And, his has had a happy ending because he ended up going in the right direction.

But as I was watching that story, Dr. Jurman, I couldn't help but think how many George Kinney's are there out here.

There are so many older adults who live alone, who may be vulnerable to loneliness, to depression, to anxiety, to even substance abuse as George talked about.

How widespread a, a problem is this?

- It's incredibly widespread, and it's not just our seniors who live alone.

It's also our seniors who were in long-term care.

My office also connects to the office of the long-term care ombudsman.

And we spent a lot of time during this pandemic, struggling with the balance between physical safety, from the virus and isolation from having no contact with friends, family, even staff were, were hesitant to make contact with people for very long, especially when we didn't know much in the beginning.

And so the, the, the behavioral health impacts on our senior population have been profound.

Although, one of the things that may be is a source of hope, is that when we had the opportunity to connect with those seniors, all throughout the pandemic, some of them are so resilient and talked about things like surviving Korea or Vietnam, and, you know, and all the things that they've survived in their lives.

And, and that attitude I'm gonna, I'm gonna get through this too, was something that gave us hope.

They were cheering us up.

But it is profound.

And we do have to continue to find ways to try and heal from that damage that's been done.

- They call them the greatest generation for a reason, right?

Denise, it is not just older adults though.

You and I had an earlier conversation about some information that I was reading that said that among 18 to 22 year olds, we see some of the highest loneliness scores and that young people and their mental health has been particularly impacted by COVID.

What are you seeing?

- For sure.

I think that that's where there was a lot of inward mobility, lot of social media.

Where they were not out with going to school.

Cause you know, when the, during the times where the schools were closed and you couldn't really go out to do anything, they only had Facebook and to talk and, and Snapchat where a lot of the self-esteem issues begin to really be seen, is in social media.

And, as it becomes isolating, it becomes, you know, how many likes did I get today and measuring your worth against the likes on Facebook or TikTok or Snapchat.

I think we are seeing, certainly, that loneliness and that isolation that was coming among the COVID, definitely played a huge role.

Hopefully now we're coming out of it a bit.

Schools are opened up again and very hopeful that we can continue in that direction.

- Dr. Coffey, one of the things that George Kinney talked about was having panic attacks.

And for anyone who has not had that particular experience, can you explain what a panic attack is and what to do if you find yourself in the midst of one?

- Yeah, George's description was powerful and in terms of how these symptoms can become overwhelming and, and not only affect the way that we think and feel and perceive the world, but how our physical body feels.

A panic attack is, as Dr. Jurman mentioned a few moments ago, an intensified reaction that we think of as the fight or flight, where our brainstem triggers a fear response that gets our body ready to activate or to retreat.

And sometimes that response goes awry and changes the way our breathing is regulated.

And so, what happens during a panic attack is a sense of either hyperventilation or sometimes suffocation, a sense that there's an impending doom happening, something bad, terribly wrong is happening to me right now.

People can feel their heart racing, their hands, getting sweaty.

And the most important thing to do if you recognize it as a panic attack, is to first understand that it is a panic attack and it will pass.

If you've never had it happen before, try to find someone to be around you right away.

And to make sure that if you need help seeking medical attention, that you get the help to do that.

But assuming that, you know, it's a panic attack, breathing exercises and muscle relaxation exercises are powerful techniques that each of us can use the same way that we use to relax during a stressful period of time, those techniques can be helpful to, to stop panic attack.

- Most important thing is to remember, you are not going to die.

I say that from personal experience.

It may feel like it, but, you're not going to die.

We want to take a moment to just remind you about that number 211.

Perhaps you've experienced a panic attack yourself and didn't know what it was.

You're just feeling the effects of anxiety.

211 is the number to call.

There are people there who can talk you through all of that.

Dr. Jurman, in the case of George Kinney, his story had a happy ending because even though it did not start off so well, particularly during COVID, ultimately, the way that things played out, pushed him in the right direction.

He went to the VA, he kept up with his appointments, he took his medication he's been doing all of the right things and seeing the results of that.

We've been telling people about 211 all throughout the program.

But talk to that person right now, who is struggling.

They know they're struggling.

And they just can't seem to figure out where to go or to, to work up the motivation, to get help, to start taking steps in a different direction.

- Yeah, it can be insidious because it can sneak up on you.

You could think you're feeling fine and then just bit by bit in, in, in dribs and drabs, you, you get to this place where suddenly you're at the bottom.

And again, it can feel like that's somehow a weakness or that there's something wrong with you.

And that's an important, an important message for everybody out there who's struggling with something right now.

And that is, when horrible things are happening all around you, it is okay not to be okay.

There are more and more researchers and therapists who are reaching the conclusion that many of the things that we've called disorders aren't really disorders at all, but are the way that a healthy brain responds to horrific events and tries to compensate for terrible things.

And so, we should, all, I think in this moment, recognize that none of us feel our best right now And this is all of us.

And so, recognizing that we're all gonna need some help.

We're gonna need each other.

It's that dinner table again, right?

We're, we're gonna need to connect with each other to heal.

We're gonna need to be willing to reach out a hand to somebody who looks like they're having a hard time.

And we're gonna have to have some grace for ourselves, that when we're having a hard time, it's okay to accept that hand from someone else.

211, you know, is a great way to connect with a lot of organizations in your community, wherever you are in the state to, to be able to connect with the resources you need to feel better.

- Well, I think that is the perfect note for us to end on for our program.

Dr. Justin Coffey, Dr. Daniel Jurman, therapist Denise Carey, thank you all for being part of tonight's program and for your ongoing work in the area of mental health.

And remember, if you need assistance talking through a problem or exploring treatment options, dial 211 to speak with someone who can help.

For more information, visit wvia.org/mindovermatter.

And remember, you are not alone.

On behalf of WVIA, I'm Tracey Matisak.

Thanks so much for watching.

- [Woman] WVIA's Mind Over Matter, A Mental Health Initiative is underwritten by Geisinger.

- [Man] There's a feeling in the air.

Like when things are on the move, again.

You can tell by the crack of a bat, the smell of pie being served, business in person, kids, being kids together.

You're ready for this.

And so are we.

(calming music)