A homemade sign on Route 22 in Gorham urges police and ambulance first responders to "stay strong" amid the coronavirus pandemic.

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Calls to Maine’s mental health help and crisis lines have increased since the COVID-19 pandemic hit Maine two months ago. But experts worry the true psychological toll of this disaster is one that could linger for months — if not years — especially for frontline health care providers and other essential workers who are at higher risk for the development of post-traumatic stress disorder.

“If you think about the situation that our service members face when they’re in a combat zone — obviously no one is shooting at our nurses — but it’s the fear of the unknown,” said National Alliance on Mental Illness Maine Executive Director Jenna Mehnert. “The constant risk of personal safety — that is a significant concern for us. The kind of factors that really set people up for the development of post-traumatic stress syndrome.”

[Our COVID-19 tracker contains the most recent information on Maine cases by county]

Maine recently established a helpline specifically for the pandemic’s frontline workers. But mental health experts say there likely will be an increase in anxiety for others too, along with heightened risks for depression and suicidal thoughts.

Isolation is inherently problematic for people’s mental well-being. With a stay-at-home order aimed at slowing the spread of COVID-19 extending into its second month, Mainers have largely been isolated from family, friends and other support systems.

Mental health experts anticipate the day-to-day uncertainties from this are the tip of the iceberg.

Maine Department of Health and Human Services Office of Behavioral Health Director Dr. Jessica Pollard said when a disaster or traumatic event occurs, historically there has been a heightened level of stress during that time. But “disaster-related stress can become more acute in the five to eight months after a disaster” and even longer, she said.

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Pollard referred to this as the “reconstruction period,” when society is attempting to process its grief and return to normal.

“We want to continue to keep an eye on [the mental health crisis] over time… But the psychological impacts it can have on people down the road are the ones we’re going to be watching for and trying to proactively prevent,” she said. “[A pandemic] is a different kind of disaster than past disasters in that it’s really prolonged, it’s not just a single incident.”

Additionally, Pollard said she’s concerned that people will develop substance-use disorders as they turn to alcohol and drugs to cope with stress.

Groups: Recover Together, a statewide organization that works with people recovering from substance-use disorder, has seen an increase in people calling their 24-hour hotline, according to executive director Cooper Zelnick.

“I think there is always a worry in times of struggle that recovery seems harder,” Zelnick said. “It’s not a secret, nor is it a surprise, that drug use in America is correlated with times of economic hardship.”

People looking for help

DHHS officials say a perfect storm has triggered an increase in calls to the mental health help and crisis hotlines that the department manages.

There’s been a significant increase in call volume to Maine’s Warmline, which people can call if their mental health state falls short of a “crisis” but are in need of help to cope with what they’re feeling.

Since March, call volume has increased 56 percent, with call duration up about 9 percent. Maine DHHS has hired more staff to keep up with the volume and allow for more meaningful conversations, according to spokesperson Jackie Farwell.

So far this month, Maine’s Frontline Warmline has received 41 calls.

There’s also been a slight increase in the number of calls originating from Maine to the National Suicide Prevention Lifeline. Pollard said the increase is not “extremely significant” but could signal a gradual trend upward.

“What we’re hearing is people are feeling afraid. They don’t know if they’re going to get sick or if their loved ones are going to get sick. People are struggling even with being at home, not being able to feel as connected to others,” she said.

The silver linings

However, experts have seen some positive outcomes from the pandemic in regards to mental health.

With in-person visits being restricted, the switch to telehealth has increased accessibility to counseling and recovery services.

Mehnert said people who were on a wellness path prior to the pandemic have been able to continue their therapy via videoconferencing. Psychologists in the field are indicating that they’re actually seeing a larger number of clients during the pandemic, she said, because video counseling can be more flexible than in-person appointments.

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“We have seen an enormous pivot to telehealth from our behavioral health providers,” Pollard said. “That has really been helpful in staving off more crises.”

Groups: Recover Together has seen more participation in virtual group and individual counseling sessions, according to Zelnick, likely because people can participate from their own homes.

Additionally, they are seeing more people seek treatment for the first time, especially in the population of inmates who were released due to the pandemic.

“What we’re seeing is a lot of folks who have been in quarantine for two weeks, four weeks, six weeks and suddenly you’re getting a real mirror held up to your behavior,” Zelnick said.

While all of this time alone can hinder someone’s mental state, Mehnert said it is also an opportunity to try to understand what you’re feeling and why you’re feeling it.

“What I hope the message can be for people throughout this challenge is paying attention to your mental health. When you’re feeling frustrated or anxious, pause and become mindful of those feelings,” Mehnert said. “My dream or wish is that people take the opportunity to be with themselves more and to question ‘why am I feeling this way, what can I do about what I feel?’”

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