As Hawaii transitions into reopening the economy during the COVID-19 pandemic, it should be acknowledged that we have not even begun to see its long-lasting effects. Many of us have been experiencing feelings of anxiety from fear of the unknown and daily routine changes, depression due to economic hardships and detachment from everyday life, and restlessness from more time on our hands like nothing we have ever faced in our lifetime. The impacts of this crisis will no doubt be challenging and even damaging for many.
Our islanders have proven that we are able to work together, care for each other and create “new norms” for protecting ourselves, our family members whom we love so dearly, and our community as we adjusted to “stay at home” orders and social distancing.
While we aggressively take care of COVID issues medically, we must prioritize mental health.
Mental health service consumers have been deeply affected since the initial stay-at-home order was established. They are in need of more services and support to avoid decompensation, a decline in overall functioning that can result from a lack of access to services and intense feelings of social isolation. Those with poor coping skills have been acting out in various ways and some even relapsing in their substance use due to the lack of structure.
Mental health services, like social and medical services, have changed significantly with the shift from in-person to telehealth, which our consumers stated is “not personable.” They are unable to share about their challenges with their providers due to the lack of privacy in their living situations, which hinders assessments of their mental status and needs, that they have a hard time identifying themselves.
Consumers also have shared that they are not able to access timely services. Some are continually checking themselves in at the hospital emergency room due to feeling unstable. Physical attendance at their programming and going to their treatment centers and support groups, such as AA (Alcoholics Anonymous) and NA (Narcotics Anonymous) have been replaced by online meeting platforms. The pervasive opinion is that these platforms also are not personable enough — and for some, without the necessary technology, participation is not even possible.
All of these changes have become serious barriers to access, which has led to decreased attendance and support. Present services no longer meet consumer needs. Many of them have become so accustomed to the quarantine that it has been difficult to motivate them to leave their homes and participate in their recovery.
Confusion and questions about financial resources and other benefits, coupled with difficulty completing paperwork, pose new problems for consumers, which will become a major challenge for service providers as they attempt to support them with the fallout of the pandemic.
Issues faced by mental health consumers as a result of the pandemic are probably very similar to those of the general public, a growing number of whom will most likely seek mental health services in the form of counseling and treatment for depression or anxiety.
We need to focus on creating a structurally sound mental health system to address the long-lasting impacts of COVID-19 and to ensure that a comprehensive continuum of care is maintained for the health and well-being of our consumers.
We need additional funding for programs to be able to support them as they navigate our increasingly stressful environment and for technology and bandwidth resources. As a community, we came together to “flatten the curve.” We now turn to our legislators as they enter a special session to determine our funding priorities with the hope that they will be invested in “flattening the mental health curve” as well.
This piece was submitted on behalf of Waipahu Aloha Club, Friends of Ko‘olau Clubhouse, Friendship Club and Friends of Hale O Honolulu.
Arlene Yamashiro is board president of Friends of Ko‘olau Clubhouse; Bryan Talisayan is executive director of Mental Health of America of Hawaii; Rachelle Chang is executive director of Samaritan Counseling Center Hawaii.