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Apr 10, 2020

Illinoisans experiencing mental illness have had to face a new world in the pandemic.

Most -- except for those in residential or emergency situations – have had to make the choice between not having therapy or having to do it by phone or computer screen.

For this week’s Illinois Issues in-depth report, Maureen McKinney looked into how the transition is working.

Mark Hicks has been a therapist since the 1970s. Once upon a time, it would have been inconceivable that he would work with his clients via a computer screen.  

But then came the pandemic and the stay-at-home order.

Though he’s 82 and semi-retired, the Chicagoan has tried to keep up with technology. So, when the need came to use a telehealth platform, he did it. He and his clients have learned to adjust the screen and the volume.

“Initially, the thing that was the big topic of any session we were having was about the pandemic, but over time that's gradually taken a backseat. It's still there. But then the other issues like people's depression and anxiety and mixed moods, those kinds of things, come back to the front,” he said.

Throughout the state, people who struggle with mental health issues have had to deal with a new normal. In fact,  Marvin Lindsey, CEO of the Community Behavioral Healthcare Association of Illinois estimates that a few weeks ago, only about five to ten percent of the services were provided by phone or computer. The remainder of sessions were in person. Since the spread of COVID-19, the opposite is true.  

A few of the services at Centerstone, a national mental provider with offices in southern Illinois have had to remain open – most with a skeleton staff.

“Every other service was provided to virtual care... One (way) is by telehealth, which means that you can use you know, a video, a video to interact with your provider, either from your smartphone from a tablet or from a home computer,’’ said Ashley Newton, an executive with Centerstone who deals with technology. Within six days, 1,600 staff members were trained in telehealth, she said.

Andy Wade is the executive director of the National Alliance on Mental Illness in Illinois. He says there is reason to believe video therapy works

“The research shows tools can be very helpful. And this is a time where there's a lot of anxiety and a lot of fear and a lot of unknowns in the world, and it's okay to ask for help, and it's okay to get help however you can get it,’’ he said. “You would be surprised how useful it can be to talk to somebody on a video screen.”

The change came at a rapid-fire pace, said Patrick Phelan, who the president and CEO of Sinnissippi Centers in northwestern Illinois. 

“A couple of weeks ago, we were making some preliminary plans for some slight modifications. Just looking at how can we begin to reduce some nonessential travel,’’ he said.  “That was right about the middle of March… Over that weekend, things escalated quite a bit. And by the following Monday…we were really changing the way that we do absolutely everything.’

Anne Tyree a regional director of Centerstone, a national healthcare provider that provides multiple services in five southern Illinois counties. 

The pandemic is not only a problem for clients who use teletherapy. It’s created problems in treating those who are the most seriously ill.

“With the outbreak and the pandemic and the stay at home order the array of services and the amount of contact that we've been able to offer has been more limited… to protect the client as well as our staff,” she said. “And I think that's difficult and challenging for people who have a serious mental illness who already tend to isolate. And when they're ill, this is certainly not helping.” 

As she points out, it’s not always easy to switch to phone or computer to communicate. Sometimes there is no way to avoid human contact. There are residential patients or those who must be given medication like injections or those who are in a crisis state.

Many of their clients are lower income and lack available minutes on their phone, so teletherapy is not an option. Tyree says. And others lack access to high-speed internet, which means they can’t use the telehealth platform for video Centerstone offers.

Katie Mitchell is a Byron resident and Sinnissippi Centers social worker whose clients are of all ages. 

She says she likes to think of the teletherapy as an opportunity rather than a barrier.

Social worker Katie Mitchell is doing tele therapy from her Byron home.
Credit Katie Mitchell

 “Especially for a lot of my kid clients and adolescent clients – I have a different type of relationship with them, where I could see them in their home and create a very safe and secure space for them that they had that we didn't have access to in the office,” she said.

She recognizes what is lost.

What we know in our profession is that connection, whether it's a handshake, eye contact, touch on the shoulder, that really provides the brain to kind of get some type of increased dopamine We need connection as humans.’’