Dr. Sabrina Hadeed-Duea in her home office where she delivers counseling to her clients using the video conferencing platform Zoom. Credit: Sabrina Hadeed-Duea

Mental health counseling and psychological services are now more accessible than ever, partially thanks to the federal government lifting restrictions on telehealth during the coronavirus pandemic.

It seems like years ago that the first COVID-19 case came to Central Oregon. Over the last two weeks social isolation, fear of illness and job losses are just a few of the “fun” things people in Bend and throughout the U.S. are processing right now. For some, this can escalate into stress and trauma.

Dr. Sabrina Hadeed-Duea in her home office where she delivers counseling to her clients using the video conferencing platform Zoom. Credit: Sabrina Hadeed-Duea

A person with unbearable stress levels may experience wild emotional swings. One minute they could lash out at loved ones, and the next could hide in the bedroom with the shades drawn, wishing this whole thing was one long, bad dream.

For people with the Oregon Health Plan, Deschutes County Behavioral Health is providing almost all of its services, including counseling, online or over the phone.

Many have little access to their normal stress-relief valves like exercise or connecting with others outside the household.ย Combine that with anxiety about the pandemic, and it’s easy to understand how this could lead to destructive coping mechanisms.

But now is a really good time to reach out for mental and emotional support, according a number of counselors and psychologists in Bend I interviewed for this article.

Dr. Ryan Reese of Ecowellness Counseling & Consulting in Bend said some providers now have more room in their schedules as plans continue to shift and change with closures due to the coronavirus.

Send an email blast to five or six local therapists listed on the Psychology Today website, or sign up for free counseling through the OSU-Cascades Counseling Clinic, he said.

For people with the Oregon Health Plan, Deschutes County Behavioral Health is providing almost all of its services, including counseling, online or over the phone. The staff is still answering incoming calls (541-322-7500) and accepting new clients, and runs a 24-hour crisis hotline for anyone in distress (800-875-7364).

Tips for Connecting With Nature

The core of Dr. Ryan Reese’s counseling practice and academic research is the therapeutic aspects of connecting with nature. Credit: Ryan Reese

Reeseโ€™s counseling practice and academic work is based on helping his clients experience the positive effects of getting outside. But in the midst of a global pandemic, suddenly leaving the house presents a moral dilemma.

โ€œIn Central Oregon we do have a lot of opportunities to get out to trails that arenโ€™t super frequented for people that want to be active,โ€ Reese said. โ€œBut we need to pull together and support what the CDC and the government is telling us to do. If you get to a trail and people are there, just leave, donโ€™t mess with it.โ€

As of March 27, even the states in the U.S. with the strictest stay-home orders allow people to go outside for a walk as long as they are 6 feet from other people.

โ€œLetโ€™s say things get more stringent,โ€ Reese said. โ€œPeople can still be strategic by taking nature breaks to center themselves by looking outside the window, focusing on tree, becoming mindful, setting the iPhone aside, engaging with our center as much as we can. Otherwise itโ€™s going to be chronic stress and anxiety if weโ€™re plugged into the news all day.โ€

Reese also suggest carving out time every day to engage with friends, family and peers: plan weekend get-togethers and BBQs over Zoom and Skype, and make a habit of connecting with others outside the home.

Mental Health Online

The majority of Central Oregonโ€™s counselors and psychologists now offer their services online using video conferencing or phone counseling.

Dr. Sean Dodge runs 100% of his psychology practice online in an effort to reach people in rural communities. Dozens of colleagues asked him for help setting up an online practice once the coronavirus hit. Credit: Sean Dodge

Dr. Sean Dodge of Blue Skies Psychological Services in Bend was already running 100% of his practice online when the coronavirus hit Oregon. Then the calls, texts and emails flooded in: his colleagues were eager to learn how he runs his operation, and they needed to learn fast. So he set up a telehealth workshop: 80 mental health professionals โ€œshowed upโ€ to learn how to help their clients online.

Dodge explained many things suddenly fell into place to make it possible for his colleagues to expand their practices. On March 17 Health and Human Services Director Alex Azar announced the department would waive HIPPA (patient privacy standards) penalties for good faith use of telehealth during the coronavirus crisis. Now providers can use any teleconferencing platform and the phone without worrying about HIPPA standards.

Meanwhile, some commercial insurance companies decided to waive co-pays for mental health services during the COVID-19 outbreak.

Dodge said there are a few common challenges when working with clients online, such as internet connection disruptions, video freezes, bumps and lags. Some clients may try to multitask during the session or have children other distractions in the background.

โ€œI encourage providers to listen verbally [during video sessions], because too much silence may make people think theyโ€™ve lost connection,โ€ Dodge said.

What advice would Dodge give to people in the community that are looking for some professional emotional support during this volatile time?

โ€œIt has never been easier to get access to health care; you donโ€™t have to leave your home,โ€ he said. โ€œYou have access to [psychologists and counselors in] the entire state of Oregon.โ€

Group Therapy

Dr. Sabrina Hadeed-Duea is a licensed professional counselor who has put together a group of over 25 willing therapists to provide free group support for healthcare providers and those with family members sick with COVID-19.

โ€œI felt inspired to do something, to reach out to other therapists because I have a mom who works in the healthcare system,โ€ Hadeed-Duea said. โ€œAlso, my brother was one of those rare cases of H1N1 who almost died. He was put on a ventilator and the ICU doctor spent nights in the hospital to keep him alive. If she hadnโ€™t done that and had access to those machines, he would have died.โ€

Hadeed-Dueaโ€™s group for healthcare professionals is open to anyone from janitors to nurses and doctors; people who are risking their own well-being to save lives during the coronavirus outbreak. She said she is particularly concerned about healthcare workerโ€™s exposure to acute stress: if left unattended, this could lead to bigger problems like post-traumatic stress disorder, she said.

It has never been easier to get access to health care; you donโ€™t have to leave your home. You have access to [psychologists and counselors in] the entire state of Oregon. -Dr. Sean Dodge, Blue Skies Psychological Services

Hadeed-Duea is organizing a separate group for those with family members or close friends sick with COVID-19.

Most hospitals in the U.S. have blocked visitors from entering the hospital to help reduce to the spread of the virus.

โ€œI have a friend whose father died of coronavirus in a Seattle hospital and they couldnโ€™t go in to see him,โ€ she said. โ€œA nurse set up a Zoom meeting for him and his family. How devastating and how hardโ€ฆ and so different from my experience with my brother in 2009.โ€

While these groups will take place through video conferencing, the process is the same as normal support groups: It presents a safe and confidential space to express feelings. Counselors will also provide clients with tools to reduce the effects of acute stress.

Contact Bendpandemicgroup@gmail.com to sign up for a group.

Deschutes County Behavioral Health

Deschutes County Behavioral Health has moved almost all of its services online or over the phone, and continues to accept new clients. The clinic mostly serves clients with the Oregon Health Plan, but also accepts commercial insurance and clients without the ability to pay.

โ€œWe had some big snow events and some forced closures last year, so weโ€™ve developed the skills for responding to emergencies,โ€ said Janice Garceau, Deputy Director of DCBH. โ€œWe very quickly mobilized a work-from-home policy as well as protocols and workflows for providing services over the phone and video conferencing.โ€

DCBH is still operating a few core services that must occur in person. This includes its mobile crisis response team, and services to people with mental health disorders who need monitoring and medication management.

โ€œItโ€™s very hard to do this as safely as possible, knowing that there is no adequate supply of personal protective equipment in Central Oregon,โ€ Garceau said.

Garceau encouraged people in the community to visit the DSBH website for tips on maintaining mental and emotional health during a crisis. Reach out to others for support and take care of yourself with sleep, healthy meals and exercise, Garceau said. And remember that staying home and taking precautions is altruistic, because it helps keep other people safe.

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