Long after COVID-19 virus is tamed, its behavioral health impacts will remain in Eagle County
A slow-rolling behavioral health crisis has tested those on the front lines
At his Vail Public Safety Communications Center workstation, dispatcher Fernando Almanza has learned what despair sounds like.
During 2020, the five-year dispatch veteran got a front-line education about how a year of COVID-19 has impacted behavioral health in Eagle County. As Almanza reported for his dispatch shifts during the past 12 months, he heard an evolution of desperation. At first, he noted, people were confused and fearful. They needed help and didn’t know where to turn. Then, as time rolled on, there were waves of anger and depression. Engulfing everything was a haze of fatigue.
“It’s crazy. It has been a year already and it’s been exhausting,” Almanza said. “As a first responder, I am personally getting more calls about how tired people are. It’s hard to keep living this way.”
What’s kept Almanza going through this year of pandemic challenges? It’s been the knowledge that he can actually offer help. When he fields a 911 call from an individual grasping at his or her last hope, Almanza knows he can make a difference.
“I know there is more than one person willing to lend a hand. There are organizations in Eagle County that are more than willing to help,” Almanza said.
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He is right. A couple of years ago, behavioral health issues bubbled to the forefront in Eagle County. Vail Health launched Eagle Valley Behavioral Health and voters approved a tax on marijuana products to fund behavioral health services. The Hope Center of the Eagle River Valley was created to provide crisis response and school-based counselors were deployed to work with local students.
Back in 2018, everyone talked about how much behavioral health work needed to happen in Eagle County. Then the global pandemic hit.
It wasn’t that local professionals and programs were wrong about the pre-existing need. It was more a case that they had no framework to contemplate the job that was headed their way. Today, a year after COVID-19 really hit Eagle County, local behavioral health professionals are profoundly grateful that resources were in place to assist local residents weather a radically difficult year. Today, they know that their work is far from done.
Hope at the doorstep
“In terms of the crisis volume there has always been, even in this year, some ebb and flow,” said Teresa Haynes, the clinical director for the Hope Center of the Eagle River Valley. “But we are seeing lots more people in crisis and the severity of that crisis is elevated.”
The Hope Center provides counseling on the go. Its response model includes sending counselors directly to people at the moment of crisis to help them weather an immediate emergency. Then the center connects clients with community resources to provide ongoing support.
“In the beginning of the pandemic, we saw a jump in anxiety and panic,” Haynes said. “Then were was something of a settling in that I think we can all relate to.”
Recently the Hope Center has seen an uptick in activity and Haynes believes it’s likely tied to the stress of coping with COVID-19 over the long haul. People have been isolated from one another for months now, dealing with financial insecurities and deprived of their normal emotional support systems. Stressed people are turning to substance abuse and neglecting self-care.
“If you are not sure how you can pay for your family’s dinner tonight, you are not thinking about how you need to get out and take a walk today,” she said. “The things we used to do to feel good about our lives after a hard day are gone.”
The simple act of connecting with someone, talking about how hard it has been to find life-sustaining joy during COVID-19, can help dial back crisis, Haynes said. “One of the things we always say at the Hope Center is that people understand that life is hard, life is challenging at this time and you don’t have to do it alone.”
But under the center’s model, you have to ask for help before you will get it. The Hope Center won’t initiate a contact.
“You don’t have to do much, but you do have to reach out,” Haynes said. That initial decision — to ask for help — can make all the difference.
“When you support someone through a moment of crisis, they can be so thankful that you helped them through. A week later, life can look so different,” Haynes said.
The Hope Center doesn’t promise to solve every caller’s worries. What the program can do is link people to a network of community resources — counselors, assistance programs, government services — that offer residents tools to manage their crisis.
“While we are seeing an increase in call volume and we know that people are struggling, I think that also demonstrates that people know about us and are reaching out for support,” Haynes said. “People want to get through their struggles to the other side. This takes strength and courage and shows resiliency.”
‘Everybody is struggling’
As a whole, the community needed every scrap of resilience it could muster, just to navigate the past 12 months. COVID-19 was only one of the trials that residents faced.
From the Grizzly Creek Fire, to a home explosion that claimed the life of a Gypsum woman, to a murder/suicide in Dotsero, to the loss of three Eagle men in an avalanche, Haynes said the past 12 months have slammed residents with huge emotional blows. The majority of the county’s residents won’t reach out to the Hope Center for crisis assistance, but that doesn’t mean they don’t need help from some source.
“Of course people feel like they can’t take one more thing. Who could?” Haynes said. “Everybody is struggling, across the board, regardless of where you come from our what your economic situation is.”
And it isn’t just grownups who have to cope with COVID-19 impacts.
Level of urgency
“For younger people, their cries for help seem to be reaching more of a level of urgency,” Haynes said. “The younger kids aren’t as aware but the older kids are impacted. They feel the difference.”
Since 2018, the Hope Center has worked with Eagle County School District to place behavioral health counselors in local schools. Emily Smith, whose name has been changed in this story to protect student privacy, is one of those school-based professionals.
Before she joined the school program, Smith was a therapist for 11 years. Since 2018, she has worked with middle school kids.
Like other educators, Smith and the school-based counselors did their work remotely to finish out the 2019-2020 school year. Although there have been class quarantines and other difficulties, local schools have remained open this school year.
“Kids definitely felt the stress. In the early days of the pandemic, during the stay-at-home order, we worked really hard to provide support for students as best we could,” she said. “But there were some kids we just couldn’t keep in contact with. Just knowing that, for some of our students, school can feel like a place of safety and that we couldn’t check on them with our own eyes, it was difficult.”
Smith echoed Haynes’ comments about how, as the months pass, the tragedies kept piling on.
“In our community, we have gone through a lot in addition to COVID,” she said. “This has just been a really rough year.”
But Smith believes having the structure of a school year, even one beset with the disruptions that COVID-19 presented, has been an important educational and emotional touchstone for kids.
“That’s why we have kids at school. We know they learn best there,” she said. Those lessons extend beyond the set curriculum and the simple act of being together is one of school’s most important tutorials
Social contact is lifeblood for many kids, especially for preteens and teens. When they were cut off from physical contact, they turned to social media to connect with peers. Smith acknowledged that led to a whole other set of issues.
“Cyber issues were a difficulty before COVID and they have continued to be a difficulty,” she said.
Some kids embraced remote learning, Smith added. “But students weren’t mastering some social skills that way. I had one student say she likes wearing her mask because she is not so self-conscious around her peers. But what is that going to look like in the future?”
COVID-19 meant a whole slew of new challenges for kids, teachers and counselors, but as she looks back on the past year, Smith is proud of the work educators have done.
“From last March to now, we have all been in this together. It isn’t like one student is dealing with it and another isn’t,” Smith said. “We have had a great team. We have all pulled together and everyone showed up for kids.”
Smith hopes that when COVID-19 becomes part of our past instead of our present, that level of commitment will have made all the difference.
“I always try to come from that place of hope. I believe kids are resilient,” she said.
Local behavioral health professionals hope the community, as a whole, is as resilient as its youngest members.
COVID-19 touched everything
During the past 12 months, COVID-19 has affected virtually every part of our lives, noted Casey Wolfington, the community behavioral health director for Eagle Valley Behavioral Health.
“It touched our schools and touched our work and even touched how we engage in the grocery store,” she said. “Then we started to realize that everything we were doing to protect ourselves from the virus was impacting our behavioral health.”
“When there is an acute trauma, like COVID-19, what we do is respond to the immediate threat,” Wolfington said. “But the more we find out about COVID, the more we see its behavioral health impacts. Although all this COVID progress has been made, it’s been made in all these other areas.”
Engaging with other people, having a social support system, enjoying collective experiences, spending time with friends — those are all vital activities that help people manage their stress. COVID-19 meant those vital activities became taboo.
“Over the past 12 months, we have had more admissions at Vail Health for issues related to substance abuse and addiction than we have had for COVID-19,” Wolfington said. “That is the fallout of isolation. That also shows us this (substance abuse) is an epidemic that is so prevalent in our community that it could not even be surpassed by a pandemic.”
That’s just one of the disturbing trends associated with life during COVID-19.
“We are seeing dramatic increases in cases of domestic violence and financial hardships in families, and also a significant decrease in rates of child abuse, when historically those three things all rise and fall together,” Wolfington said.
If child abuse numbers fall when domestic abuse and family financial hardship number rise, it’s very unlikely that fewer kids are being abused or neglected, Wolfington explained. Instead, the likely scenario is that child abuse incidents are not being discovered and reported. That’s been one of Wolfington’s most pervasive worries during the past year.
“It’s just been so tense, all around,” said Wolfington. “People are still anxious. They are hesitant and they don’t want to be blindsided by some other surprise out there.”
Last spring, officials at Vail Health knew they needed to step up and help locals navigate the COVID-19 misery miasma. So, they decided to remove one of the biggest obstacles for people who need behavioral health services and, months before its intended rollout, Olivia’s Fund debuted.
Hope Center of the Eagle River Valley
1,482 — Total number of mobile crisis calls in 2019
2,172 — Total number of mobile crisis calls in 2020
469 — Total number of mobile crisis calls year-to-date in 2021
School Based Counselors
2,969 — Total number of interactions through March 1 during the 2019-2020 term
4,314 — Total number of interactions through March 1 during thee 2020-21 term
96 — Total number of COVID-19 patients admitted since the pandemic began
495 — Number of emergency room substance abuse patients in 2020
91 — Number of emergency room substance abuse patients year-to-date in 2021
237 — Number of people who have participated in the program since its debut in June 2020
490 — Number of therapy sessions to date
Named in honor of a local 13-year old girl who died by suicide in 2018, Olivia’s Fund provides financial assistance to anyone who lives or works in Eagle County to help pay for mental health and/or substance abuse services for up to six sessions per person per year. During the past 12 months, 237 local residents have participated in the program.
“What I have heard is Olivia’s Fund made one thing certain for our community. People could access behavioral health services without worrying about their ability to pay,” Wolfington said. “There is nothing more difficult than when a person needs help but can’t get it because of a financial barrier. What I keep hearing from colleagues who aren’t in Eagle County is they see there is need, but they just continue to see barriers to access.”
Wolfington noted there’s another area where aggressive local response is helping to stem not only the behavioral health impacts of COVID-19 but also the virus itself — the expansive local vaccination effort.
As of this week — more than 25,000 doses of Pfizer, Moderna and Johnson & Johnson COVID-19 vaccine have been shot into local arms.
“My favorite part of working the vaccination clinics is hearing what hope that vaccine is bringing,” Wolfington said. “People say things like ‘This will allow me to see my granddaughter for the first time in a year.’ It is bringing us the possibility that those contacts can happen. We didn’t know when that was going to be possible before vaccine distribution.”
In it together
On the day, hopefully in the not-too-distant future, when COVID-19 ceases to be a public health threat, Wolfington knows that the behavioral health effects of the disease will linger. The long-term impacts of the pandemic on our mental well-being is a challenge for today and for our future, she noted, but she also believes the challenge of addressing COVID-19 itself has set up the means to move forward.
“I feel like there is more interconnection in our community than ever before,” Wolfington said. “Collectively we feel like we are truly a community.”
Back at the dispatch center, Almanza agrees. He shares that assurance immediately when he makes contact with a caller in distress.
“I tell them we are in this together,” he said.