A client at The Neighborhood Center in Utica had to go into inpatient treatment for alcohol dependence during the pandemic, according to the client’s counselor.
Shawn Johnston, clinic director for the behavioral health clinic at the center, sees the admission as a symptom of the pandemic, which has brought an overall increase in substance use — particularly of alcohol, she said.
“It is interesting,” she noted in an email, “that liquor stores remained essential, but not (Alcoholics Anonymous).”
Both data and anecdotal evidence from behavioral health treatment providers show that the COVID-19 pandemic is creating something of a mental health pandemic, as more Americans reach out for help to deal with isolation, grief, anxiety and other consequences of the major disruption to everyone’s lives.
Telephone assessments by the Mobile Crisis Assessment Team and the Neighborhood Center increased by 60 percent for kids and by 36 percent for adults between April 1 and June 30 this year compared to the same period last year, said team Director Kristin Sauerbier.
On a broader level, the National Suicide Prevention Lifeline has not so far seen an increase in calls, but calls to the Disaster Distress Helpline, which provides emotional support in times of natural or human-caused disasters, rose 697 percent in June over the previous June, said Hannah Collins, senior marketing and communications manager for the helpline, the lifeline and Vibrant Emotional Health.
“Although we cannot be certain of the number of Disaster Distress Helpline calls and texts that are specifically related to the COVID-19 outbreak, helpline counselors have reported callers expressing feelings of isolation and interpersonal concerns related to physical distancing such as being cut off from social supports, limited access to care, and canceled milestone events,” Collins said via email. “Callers have also expressed concerns around financial stability and managing stress related to work/life balance and home schooling.”
But the pandemic has also walloped the state budget and now the impact is being felt in the mental health field. So the state has decided to withhold some of the money it was supposed to give counties to help support some local treatment providers. It is cutting funding for behavioral health services by 20 percent —in line with threatened, across-the-board cuts — and for addiction services by 31 percent.
“There has been no permanent reduction in support for these services at this time, said Freeman Klopott, spokesman for the New York State Division of the Budget, in an emailed statement. “Instead, the state is holding back a portion of payments as it contends with a cash crunch caused by a 14 percent drop in revenue due entirely to the pandemic and the federal decision to delay income tax payments by three months; and the state needs the federal government to deliver much-delayed funding to cover this revenue loss so that we can continue to provide support for the most vulnerable New Yorkers.”
In the absence of federal money, the state has cut spending by $6.3 billion since the fiscal year began in April by freezing hiring, new contracts and pay raises, and by holding back portions of payments, he said.
“Anywhere we don’t slow spending means lower spending for another program,” Klopott continued, “and in addition to support for our vulnerable neighbors, the state funds schools, health care, roads, and courts, among other critical services that New Yorkers rely upon every day.”
Oneida County Executive Anthony Picente Jr. is not a fan of the withholds.
“When they say they’re withholding the money, it’s not a cut (the state says). If it looks like a cut,” he said, pausing to find the right words. “It’s a cut — especially (during) this time. Those are serious amounts for services that we still have to provide with a reduction of all of our other revenue streams.”
Picente said he understands that the state has to make up for its budget shortfalls somewhere and said he wouldn’t question cuts or withholding to most funding streams.
“But when you’re withholding health and mental health money during a pandemic,” he said, “that’s pretty harsh.”
Meanwhile, the opioid epidemic has not gone away during the pandemic, Picente pointed out. There were 41 overdoses, seven of them fatal, in April, he said.
“These are services that we still have to provide,” he said.
But overall, the state is behind in reimbursements to the county by about $7.6 million this year, Picente said. That, he said, is on top of a $5 million drop in sales tax revenues and a $7 million lost in gambling revenues from the Oneida Indian Nation.
Whether it’s data-driven or anecdotal, there is evidence from counties around the state showing that overdoses have increased, said Jeremy Klemanski, president and CEO of Helio Health, a Syracuse-based agency that provides both substance use disorder and behavioral health services in the region, including in Oneida County.
It makes sense that substance use and overdoses would go up during the pandemic, he said.
“Part of treatment and recovery is building community with other people, getting mutual support,” Kelmanski said. “Isolation is one of the worst things you can actually do to a person with a substance use disorder or a mental health condition.
It exacerbates loneliness and the feeling that no one is there for the person, he said. So people get bored, they’re all alone and they relapse, he said. And sometimes those relapses prove fatal, in part because they are less likely to overdose with another person who can provide naloxone, the drug that reverses opioid overdoses, and call for help, Klemanski said.
“We’re seeing a surge of overdoses, yet we’re seeing a reduction in our resources to deal with it,” he said. “It’s just frankly hard to comprehend how it’s not going to make things worse.”
Denise Cavanaugh, executive director of Catholic Charities of Oneida & Madison Counties, said her agency was just informed of the money to be withheld on Friday.
“Of course, it will have an impact on our services,” she said. “We are planning to sit down at the early part of next week and re-adjust our budgets to determine how we can manage. We had expected some concerning reductions, but were anticipating that they would hit in early 2021.”
Local agencies believe that the behavioral health withholding will affect rent subsidies for people with chronic mental health issues.
“If agencies don’t have the money, there could be a situation where they have to withhold paying rent,” Klemanski said.
Helio Health runs some mental health housing programs in Oneida County.
If rents aren’t paid, people can’t actually be evicted right now because the state has put a moratorium on evictions during the pandemic. But that doesn’t mean unpaid or partially paid rents wouldn’t have an impact on someone with a mental illness, Klemanski said.
“That could significantly increase their anxiety, exacerbate their symptoms and that could destabilize them,” he said.
And down the road, if the money never gets paid, there could eventually be an eviction when the moratorium ends, Klemanski said.
“What is New York State’s plan,” he asked, “if there is no federal bailout?”
If the money withheld becomes a permanent cut, agencies will start to cut services or lay off staff, Klemanski predicted.
“It’s frankly a mind-boggling policy decision,” he said. “There is a concern in the substance abuse prevention, treatment and recovery system that if these become cuts, we could see closure and collapse of parts of the system. It’s a very real possibility.”
Picente, too, wondered how well agencies can keep providing services and paying their workers if the county can’t give them the money they’re owed. And what will happen then, he wondered, to the people they serve.
“Do we leave the people with mental health issues unattended and the opiate numbers go up and mental illness issues go up and hospitals can’t deal with or nobody can?” Picente asked. “We’re not in the business of denying help. It’s not what we do.”