The COVID-19 pandemic is transforming the landscape for the mental and emotional health professionals of Berkshire County.
With 26 locations across the county, the Brien Center is the region’s largest provider of behavioral health and addiction services. It says it serves over 10,000 — almost a tenth of the Berkshires.
Rebecca Phelps Smith is the director of the center’s emergency services division. The county’s only crisis team assesses and responds to mental health emergencies. Before the pandemic, it rode along with police officers to 911 calls and offered service visits directly to people’s homes.
“Initially, we saw a very drastic decline in people reaching out to us," said Phelps Smith. "It was almost eerily quiet in the beginning.”
Now, those numbers are picking up again – and they include newcomers to the services the Brien Center provides.
“We’re seeing a lot of people with high levels of anxiety and also with depression related to people losing their jobs, no longer being financially stable," Phelps Smith told WAMC. "Also, being isolated within their homes. Some people live alone and don’t have contact with anyone, and also people who do live with others, being in a house together all the time, can add a different level of stress as well.”
Uncertainty leads her to believe that the center’s emergency services will be increasingly relied upon as the pandemic stretches on.
“People are really struggling to know what’s going to happen next, and the unknown I think is scary for people," she told WAMC. "And I think that people are really struggling – they’re not seeing an endpoint and not knowing where that’s going to end.”
Phelps Smith says resources have also become scare for high-level care like inpatient admissions – especially for kids.
“This has really caused a lot of issues with hospitals decreasing their census, which means that there’s less places for us to admit clients to, which has been a real struggle for us, especially with kids because we don’t have any inpatient beds in Berkshire County," she said. "The closest place we have to admit someone is over an hour away.”
The Brien Center’s patients include 4,000 young people. Jim Mucia is the director of its child and adolescent division.
“It ranges from what we might call mild adjustment disorders to severe behavioral problems including suicidal ideation, suicidal behavior, severe acting out, problems coping," he told WAMC. "And we have a lot of referrals that stem from – the problems differ slightly, but they stem from some kind of trauma. And trauma can be equated mostly – not entirely, but mostly – in my world to child abuse.”
Mucia says that the region grapples with two key areas: adolescent substance use and suicide.
“Berkshire County has significantly high levels in both," he told WAMC. "We are one of the hotspots in substance use disorder, kids and adults. We have a very high use of substances with youth, and in the realm of suicide for youth – defined as, I believe, under 25, maybe under 24 – we have some of the highest per population suicide rates in the country, actually.”
He’s bullish about telehealth, which the center had already begun to transition toward before the pandemic. Mucia says for the most part, his division’s work has translated well to the remote format. Though some young people find video conferencing awkward, he thinks it’s the best route forward – though phone meetings have had to make do in some circumstances.
“Not every family has the resources to have the proper device and the proper internet connection, because for video, you’ve got to have a relatively decent internet connection,” said Mucia.
He says numbers dipped initially because of the closure of schools.
“There’s always been a clear data confirmed correlation between school and problems," Mucia told WAMC. "Prior to the virus, prior to any of that kind of stuff, our summers are always slow, Christmas gets slow, but in the middle of the school year it gets really intense and referrals are flying and kids’ symptoms really expand and all that kind of stuff.”
But now, as the months wear on, increased family conflict is exacerbating behavioral issues. Mucia says that the lengthy lockdown has also increased issues for a growing population of young people who have already isolated themselves from the world through social media.
“And at first, that was OK because that’s what they wanted to do anyways," he said. "But over time, it does become an issue and you see increased depression.”
Megan Eldridge Wroldson is the director of the center’s adult and family services division.
“So I oversee our adult outpatient mental health and addiction treatment clinics," she told WAMC. "Along with our medical director Jennifer Michaels. And I also oversee our residential addiction treatment program.”
The crisis stokes triggering conditions for the community she works with.
“Addiction is a disease of isolation, and so when people lack supportive social connections that can contribute to a relapse of drugs and alcohol,” said Eldridge Wroldson.
Her numbers are trending upwards as well.
“We are seeing an increased number of contacts in our outpatient clinics, and we continue to get referrals," she told WAMC. "There have been some fluctuations, and I do have concerns that there may be some fear to reach out for services or people may believe that services aren’t available. However, clinics are open, residential programs are accepting admissions. We’re doing our work differently, but we’re still open for business.”
The possibility of a pandemic surge presents a challenge for the center, where crucial divisions like its emergency services team frequently face staffing shortages.
“It’s just unfortunate that there are not a lot of master’s level clinicians in this community, so we often struggle with staffing issues," said Phelps Smith. "Given the pandemic, we actually scaled back to a skeleton staff because the numbers had dropped so drastically in the beginning. So we’re actually OK right now, but when we start to see the surge of calls for people really struggling, it’s concerning that – will we be able to keep up with that demand?”