weather icon Clear

Coronavirus can isolate people with mental health issues

In the battle against inner demons, Alexis Gonzalez warred her way to a truce.

The business owner and dance instructor, who moved to Las Vegas with her mother in her late teens before relocating to Chicago two years ago, had gained control over her depression, anxiety and addiction, relying in no small part on group therapy.

Last month, she returned to Vegas to visit her mom while en route to India.

Then the coronavirus hit.

Social-distancing measures ended her in-person therapy sessions.

For Gonzalez, and others disinclined to discuss problems or whose mental health issues already involve isolating, that is no small thing.

“This situation is perfect to feed on our insecurities and develop our monologue inside our head because we’re not in contact with other people,” says the 31-year-old.

The support system that she and so many others rely on for mental health treatment was turned on its head almost overnight.

“An entire system (had) to dramatically change the way service is delivered,” says Dr. Jonathan G. Still, a Las Vegas psychiatrist and partner in Focus Mental Health Solutions. “Clinics and clinical entities that weren’t set up to engage patients at home are at a real disadvantage. It’s made our patients very, very isolated.

“There just aren’t enough psychiatrists in town,” says Theresa Noonan, a marriage and family therapist who owns Noonan Psychotherapy in Las Vegas. “The waiting lists are ridiculous.”

According to a 2019 report from the State of Nevada’s Commission on Behavioral Health, Nevada ranks 44th out of 50 states in prevalence of mental illness; 47th in access to care; 32nd in size of mental health workforce; and last in the number of youth suffering from major depression.

While the need for mental health care is high, Nevada’s ability to provide it remains low.

“We’re really struggling with fewer and fewer mental health resources in the community as providers are closing up shop because they haven’t adopted telehealth,” Still says. “It’s put a stress on a system that had very poor resources already.”

Struggles amplified

The last thing they needed was the first thing they got: isolation.

For those battling depression, connection is key. Being around others, even if there’s no direct interaction, helps tether those with mental health issues to a society from which they feel unmoored.

“We try to encourage them as part of their treatment plans to attend group therapy sessions, to attend individual therapy sessions, to get out and socialize,” Still says. “Now, all of a sudden, because of this health crisis, they’re unable to do so. It can definitely exacerbate their mental health conditions.”

“I have folks dealing with depression who are getting triggered because they’re isolated and they’re having a hard time self-motivating,” says Donna Wilburn, a Las Vegas marriage and family therapist. “These are not the ones who can (say), ‘I’ll just go garden’ or ‘I’ll do something crafty,’ ” says Wilburn, who owns Dynamic Integrative Solutions counseling center. “Depression saps your motivation, so when you’re isolated, and there’s no work to force you out of the house, it’s really, really challenging.”

For those with anxiety, uncertainties about the spread of coronoavirus can amplify distress.

“The most trying thing is just hearing my clients’ anxieties and trying to help calm them down when the dissemination of the information — especially in the beginning — has been so murky,” Noonan says.

“I have anxious folks who are washing their hands OCD-style.” Wilburn says. “I literally have some who can’t sleep at night because of this. It’s really triggering a lot.”

And it could trigger more.

President Donald Trump sounded the alarm last week about a potentially dire mental health crisis when he said there would be “suicides by the thousands” should the economy continue to suffer.

While that may be a worst-case scenario, once again, Nevada seems particularly vulnerable.

The state had the 11th-highest suicide rate in the country according to a 2017 report, the most recent year for which data is available from the Department of Health and Human Service’s Office of Suicide Prevention. Suicide was the eighth leading cause of death for Nevadans, and the second leading cause of death for youth, ages 15-24. Nevada seniors over 65 have the fourth-highest suicide rate in the nation — almost double the national average.

People with mental illnesses that are linked to suicidal thoughts, such as depression, high levels of anxiety or more severe conditions, can be at higher risk, says Dr. Krystal Lewis, a clinical psychologist at the National Institute of Mental Health. “Unfortunately, there may be an increase in actual suicide attempts depending on how long this lasts.”

A new kind of therapy

The comfy office couch is gone.

“I have these ugly plastic chairs that I put in instead,” says Dr. Ann Childress, a Vegas-based psychiatrist and member of the Nevada Psychiatric Association. “I’ve moved my toys out of the waiting room. … so that we can minimize things that we needed to clean.”

Childress still is seeing clients in person, but now it’s one family at a time in the waiting room. And, like many in the profession, she is resorting to telemedicine and treating patients via phone.

Telemedicine was developed to serve rural communities with no doctors. Patients were required to visit a medical office, where they would consult with a physician in another city via teleconference.

With the coronavirus outbreak, the federal government removed restrictions this month, allowing telemedicine to be covered by Medicare and Medicaid.

“It seems to be going pretty well,” says Still, after using telemedicine for a week and a half. Insurance companies his staff has contacted said they will reimburse such visits.

Local support groups are heading online as well.

While all the in-person meetings at NAMI (National Alliance of Mental Health) Southern Nevada have been canceled, executive director Trinh Dang says, beginning next week, some support groups will take place on Zoom.

“Even though, physically, we’re distancing ourselves,”,Dang says, “socially, emotionally, mentally, we’re hoping that we’ll be able to connect the community together again.”

Gonzalez says that online therapy sessions have helped.

“It’s a total change to go from the in-person to the digital world, but it’s amazing to have all the resources that we have right now,” she says. “I’ve heard so many people in meetings actually say, ‘This is my first Zoom meeting and I was hesitant about it. I didn’t think it was going to work.’ And then, at the end, they’re like, ‘I’m glad I did it, even if it’s not the same.’ I am physically alone in my mom’s apartment at the moment, but through these meetings, I know that I’m not alone.”

For some people, however, using technology creates a barrier to care.

“There’s a lot of people out there in the valley who aren’t able to connect to a mental health professional just because of the technology piece alone,” says Dr. Sheldon Jacobs, a Las Vegas mental health therapist and board member of NAMI Southern Nevada. “Some clinicians might get more creative or do some sessions over the phone, but how sufficient is that, not having that face-to-face?”

“It’s ending up being very heavily telephone (based), because a lot of people with mental illness are disabled and they don’t have enough money to buy a lot of data time,” says Dr. Joe Parks, vice president of practice improvement and medical director at the National Council for Behavioral Health. “They don’t have Wi-Fi hook-ups. A number of them don’t have computers. And often, people who have mental illness have cognitive problems that make it harder to use things like that. We tried to use Zoom, but we found that the patients really weren’t up to using it.”

“For some, the video platform is really uncomfortable,” says Wilburn, explaining why she still takes some in-person clients. “When I do have to see somebody face-to-face, we go through a whole sanitizing process. We’re able to keep our distance. But it’s hard with kids. How do you play with a kid six feet away? I don’t want to leave kids without help.”

How to cope?

“I think a lot of what I’m doing with children, and adults as well, is (asking), ‘OK, what is within our control?’ ” Krystal Lewis says. “For us, it’s having a schedule or structure,” such as working from home or doing online schoolwork. “It’s also integrating your general family time, time outside, exercise, making sure that there are these things that we know are good for our mental and physical health,” she adds. “This is what I can control right now: my day.”

Lewis and her peers have to navigate these turbulent emotional waters while coping with their own stress.

And, while therapists usually are able to balance patient needs, Wilburn says, “now everybody needs you.”

“I’m kind of caught between the pressure to help — so many people need my help right now — but I’m also trying to take care of my family, and (I’m) worried about not spreading this virus,” she says.

For mental health professionals who work in hospitals, there’s the heightened risk of being exposed to the coronavirus.

“I’m wearing personal protective equipment,” Still says. “I’m much more cautious in the hospital. … there’s some trepidation there. There are a lot of physicians who are afraid to work in hospitals knowing that we’re probably all getting exposed every day.

“I go home, and I can’t hug my family before I change and shower,” he continues. “Even with that, you never know what you’re bringing into the house. This has been a life-changer for everybody.”

So is it normal to feel anything but normal now?

“Feeling anxious, feeling uncertain, even feeling threatened is understandable,” says UNLV assistant professor of psychology Stephen D. Benning, who directs the university’s Psychophysiology of Emotion and Personality laboratory. “It is a realistic response to what’s happening.”

Unfortunately for some, that response might not end when social distancing does.

“There may be lingering echoes of this that ring for people for weeks or months afterward as they struggle to get back to a normal life,” Benning says. “This is the challenge we all face as a society after we return to normal: How do we get these people back in the swing with us?”

“I think that there’s a light at the end of the tunnel that isn’t a train,” Noonan says. “I’m hoping that we’re nearing it. It’s something that we’re going to get through.”

Contact Jason Bracelin at jbracelin@reviewjournal.com or 702-383-0476. Follow @JasonBracelin on Twitter.

Don't miss the big stories. Like us on Facebook.
Entertainment Videos
Las Vegas performers adapt to pandemic restrictions - Video
The coronavirus pandemic has forced creative people in Las Vegas, a city that thrives on live performance, to adapt to new or changed ways to entertain. (Rachel Aston/Las Vegas Review-Journal)
Las Vegas woman brings Blue Angel to life - Video
When Las Vegas shut down during the coronavirus pandemic, Victoria Hogan created the Blue Angel costume and performance, emulating the statue locals know and love in order to connect with others in a time when connection isn’t as possible. (Rachel Aston/Las Vegas Review-Journal)
‘Hamilton’ postponed as Smith Center remains dark indefinitely - VIDEO
The hit musical 'Hamilton' was supposed to run from September through October at The Smith Center’s Reynolds Hall has been postponed due to the COVID-19 pandemic. (Las Vegas Review-Journal)
ZZ Top frontman Billy Gibbons rides a bicycle on the Strip with Kats
Las Vegas resident and ZZ Top frontman Billy Gibbons rides down the Strip with his wife Gilligan Stillwater GIbbons and Las Vegas Review-Journal columnist John Katsilometes Wednesday, May 20, 2020. (K.M. Cannon/Las Vegas Review-Journal) @KMCannonPhoto
ZZ Top frontman Billy Gibbons rides a bicycle on the Las Vegas Strip with Kats - Video
Las Vegas resident and ZZ Top frontman Billy Gibbons rides down the Strip with his wife, Gilligan Stillwater Gibbons, and Las Vegas Review-Journal columnist John Katsilometes on Wednesday, May 20, 2020. (K.M. Cannon/Las Vegas Review-Journal) @KMCannonPhoto
Ex-WWE star Shad Gaspard found dead on beach - Video
Shad Gaspard, 39, the former WWE wrestler, was found dead Wednesday morning on the shoreline of Venice Beach in California. Gaspard went missing over the weekend. (Las Vegas Review-Journal)
Buffets won’t reopen soon, but they may return eventually - VIDEO
In a Tuesday earnings call, Frank Fertitta III, CEO of Station Casinos parent company Red Rock Resorts, said buffets won’t be among the amenities included in the early stages of the resorts’ reopenings. (James Schaeffer / Las Vegas Review-Journal)
'Hamilton' to debut on Disney+ in July - Video
The film version of Lin-Manuel Miranda’s popular musical was originally set for theatrical release in October. The musical’s director, Tommy Kail, shot three live performances featuring the original Broadway cast. (Las Vegas Review-Journal)
Little Richard dead at 87 - VIDEO
Little Richard, the pioneer and rock 'n' roll originator, died on Saturday, May 9. His son, Danny Penniman, confirmed the news but the cause of death is unknown. (Las Vegas Review-Journal)
Jerry Stiller, actor and comedian, dies at 92 - VIDEO
Jerry Stiller's son, actor and director Ben Stiller, announced his father's death via Twitter. Jerry Stiller became widely known with a recurring role on "Seinfeld" as Frank Costanza, George's hot-headed father. He also starred on "King of Queens." (Las Vegas Review-Journal)
Wolfgang Puck's Players Locker opens in Downtown Summerlin along with others - VIDEO
Under the governor's orders a few restaurants were able to open their dining rooms in Downtown Summerlin Saturday, May 9. (Las Vegas Review-Journal)
Nicolas Cage to portray Joe Exotic in ‘Tiger King’ TV adaption - VIDEO
Nicolas Cage is headed to television to take on the role of Joe Exotic, the iconic character from the Netflix docuseries "Tiger King." (Las Vegas Review-Journal)
Quarantined! 'The Ghost Adventures' miniseries by Zak Bagans - VIDEO
The four-part miniseries “Ghost Adventures: Quarantine” by Zak Bagans will debut in June on the Travel Channel. (Las Vegas Review-Journal)
10 facts about Cinco de Mayo - VIDEO
The holiday celebrates the Battle of Puebla in 1862. Mexico began the holiday in 1862, but does not recognize it nationally anymore. (Las Vegas Review-Journal)
Kristin Cavallari has already filed for divorce - VIDEO
Kristin Cavallari, the "Very Cavallari" star, announced she and her husband, former NFL quarterback Jay Cutler, have separated after seven years of marriage and 10 years together. (Las Vegas Review-Journal)
Brad Pitt portrays Dr. Anthony Fauci on ‘Saturday Night Live’ - VIDEO
"Saturday Night Live’ aired their second socially distanced episode of the COVID-19 pandemic on April 25. The episode’s cold open featured actor Brad Pitt portraying Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease. (Las Vegas Review-Journal)
Brian Dennehy, 'Tommy Boy' and 'First Blood' star, dies at 81 - VIDEO
Actor Brian Dennehy died Wednesday in New Haven, Connecticut. Dennehy's acting career spanned more than four decades, working in television, film and theater. (Las Vegas Review-Journal)
Bishop Gorman 'Guys and Dolls' virtual performance
Bishop Gorman's virtual opening of "Guys and Dolls." (Bishop Gorman High School)
John Prine, country-folk singer, dies at 73 - VIDEO
John Prine died due to complications caused by COVID-19 at Vanderbilt University Hospital in Nashville, Tennessee on April 7. The singer-songwriter is counted as one the favorite artists by the likes of Bob Dylan and Kris Kristofferson. (Las Vegas Review-Journal)
Caesars furloughing about 90% of US workers
The furloughs come amid the COVID-19 pandemic, which has prompted all U.S. commercial casinos to temporarily shut their doors.
Bill Withers, soul legend and 'Lean on Me' singer, dead at 81 - VIDEO
Bill Withers' family said he died of heart complications on Monday in Los Angeles. Withers was a three-time Grammy winner. His other major hits include “Ain’t No Sunshine" and “Lovely Day.” (Las Vegas Review-Journal)
Vegas KatsWalk: From the Mandalay Bay to Excalibur - VIDEO
Review-Journal columnist John Katsilometes walks and talks along the Las Vegas Strip, from Mandalay Bay to Excalibur. (John Katsilometes and Kevin Cannon / Las Vegas Review-Journal)
Make Ivan Grant's Quarantini - VIDEO
Ivan Grant, a flair bartender at Long Bar at The D Las Vegas, makes his Quarantini. (Ivan Grant)
Fountains of Wayne's Adam Schlesinger dies from coronavirus - VIDEO
According to Variety, 52-year-old frontman and songwriter Adam Schlesinger has died, following a short battle with the respiratory illness, coronavirus. (Las Vegas Review-Journal)
KATS WALK: A walking tour on south Las Vegas Strip – VIDEO
RJ columnist John Katsiometes takes a walking tour of the south end of the Las Vegas Strip. (John Katsiometes and Kevin Cannon/Las Vegas Review-Journal)
Tiger King character has Las Vegas connection - VIDEO
Entertainment reporter John Katsilometes talks about the popular "Tiger King" and Jeff Lowe, a central figure in the Netflix documentary phenomenon who wanted to do business with the last Las Vegas Strip entertainer to use wild tigers in his act. (Renee Summerour/Las Vegas Review-Journal)
Coranavirus victim Howard Berman playing the harmonica in April 2014 - VIDEO
Howard Berman, 66, playing the harmonica at a jam session in April 2014. Berman, who was active in the Las Vegas music community, died on March 24, 2020, from COVID-19. (Diana Andriola)
Boarded-up businesses in the Arts District add some color - VIDEO
Businesses in the Arts District have commissioned local artists to paint murals on the boards covering their doors and windows. When the boards are removed, they will be auctioned off to raise money for those affected by the coronavirus shutdowns. (K.M. Cannon/Las Vegas Review-Journal) @KMCannonPhoto
Sold-out Electric Daisy Carnival still scheduled for May - VIDEO
In a post on his social media platforms, festival founder Pasquale Rotella confirmed that EDC remains scheduled for May 15-17 at Las Vegas Motor Speedway despite coronavirus concerns that have sideline scads of other live music events. (Michael Quine/Las Vegas Review-Journal)
City of Las Vegas responds to calls to allow restaurants offering curbside pickup
Alcohol is now allowed in curbside meal pickups in Las Vegas. The city of Las Vegas has responded to calls to allow restaurants offering curbside pickup service to include alcohol in those meals. (Las Vegas Review-Journal)
Half of Americans would get a COVID-19 vaccine, poll shows

Only about half of Americans say they would get a COVID-19 vaccine if the scientists working furiously to create one succeed, according to a new poll from The Associated Press-NORC Center for Public Affairs Research.