It was, in many ways, expected that the pandemic – and the isolation, fear and death it brought – would lead to an increase in people seeking treatment for mental health conditions such as depression and anxiety.
That has certainly been the case in Northeast Tennessee, where behavioral health and primary care providers have seen a marked increase in the number of people reporting symptoms of mental illness and seeking treatment for them. For some, that increase was greater than what they had expected and prepared for.
“We were kind of bracing because we knew you knew the conditions were right for an increase in need,” said Frontier Health’s Chief Operating Officer Diane Bowen, “so we weren’t surprised, but is actually in some ways more than we thought it would be. ”
Bowen said during Frontier’s 2018-19 fiscal year it saw 1,520 people seek treatment. That total is expected to be more than double this fiscal year, on pace to be 3,294 patients in FY2021-22. Brown attributed the increase to several factors, including isolation, change in routine, fear, concern for loved ones and death.
“I think it has really taken a toll on people,” Bowen said.
The World Health Organization earlier this month reported that the pandemic has caused a 25% increase in the prevalence of anxiety and depression worldwide, and that young people are at a disproportionately high risk for suicide and self-harm. A study published in the Journal of the American Medical Association in September 2020 found the prevalence of depression symptoms in US adults increased from 8.5% before the pandemic to 27.8% from March 31 to April 13, 2020.
A subsequent study, published in the Lancet Regional Health Journal in January 2022, found the prevalence of depression symptoms has continued to increase since the 2020 study, up from 27.8% in March-April 2020 to 32.8% in March-April 2021.
State of Franklin Healthcare Associates’ Medical Director of Quality Dr. David Moulton said in an interview earlier this month that they’ve seen an increase in patients coming in with mental health issues, and that treating mental health issues has become “more of a factor in primary care visits.” Moulton said part of the increase can be attributed directly to COVID-19 and the lingering effects of the virus, but noted the impact is being felt in the general public and not just among those who have had the virus.
“You’re finding primary care having to do a lot of behavioral health assessments and (prescribe) medications,” Moulton said.
Moulton said SoFHA has implemented a pre-visit questionnaire to screen patients for signs of major depression and generalized anxiety disorder, which has helped identify those patients more quickly and get them started on medication or referred to cognitive behavioral health therapy.
Dr. Kevin Metzger, a primary care physician with Holston Medical Group, said he has seen a “huge increase” in people being diagnosed or needing treatment for mental health issues. Metzger said he’s gotten a lot of “on-the-job” training in the last two years addressing mental health concerns, and has had to stay on top of treatments, medications and help connect people with counselors and other resources.
“It’s been a huge part of my practice, it’s mental health,” Metzger said.
Bowen said Frontier has worked to increase its presence in primary care offices for several years, and caregivers have also been using telehealth services – both in an attempt to help destigmatize mental health issues and make people feel more comfortable speaking with a doctor about them. Frontier is also working to address the mental health impacts of the pandemic on children, deploying nearly enough school-based counselors to have one in every school in Northeast Tennessee.
While the need in the region has increased, staffing has not – further straining a mental health care system dealing with what Bowen described as a crisis. Bowen said Frontier has increased salaries to retain and attract employees, and has been advocating for increased funding for community mental health centers from the state legislature.
“I will say this: We are in a crisis that we have never experienced before,” Bowen said.
If you or someone you know is in crisis, Frontier Health has a 24/7 crisis hotline at (877) 928-9062. You can also call the National Suicide Prevention Lifeline at (800) 273-8255 or text “HOME” to 741741.
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