Lingering effects of the pandemic are keeping local therapists busy as they help clients cope with the losses of last year and transition back to normal as COVID-19 restrictions subside.
“Many of the therapists in Maui that I have talked with reported a surge in psychiatric symptoms in people with and without a history of mental illness during 2020, during the COVID-19 pandemic, and it has been taking a toll on residents’ financial and emotional well-being,” said Dr. David Wittenberg of Behavioral Health Services of Maui LLC. “I saw an increase in fear of the future, poverty with multiple family members working for resorts and certain people leaving the island.”
Maui Behavioral Health Resources encompasses three agencies — Aloha House, Malama Family Recovery Center and Maui Youth and Family Services.
Wittenberg, who co-manages Aloha House’s crisis services, case management services, Maui Counseling Group and intensive in-home therapy services for youth, said that he consulted with many psychiatrists and psychologists, as well as other licensed and non-licensed providers on the issue.
They cited an overall increase in anxiety, depression, substance abuse, insomnia, weight gain and other conditions this past year, some of which may linger as the pandemic subsides.
Maui Counseling Group therapists served 1,067 clients in April, increasing by about 10 calls per month since February. The crisis team conducts about 100 mobile outreach calls per month through the state crisis line, and case management staff have over 400 clients with a severe mental illness who are provided services.
Adult crisis calls increased each month during the pandemic, with February and March calls the highest in the four years during those months. Youth crisis calls decreased, partially because many of the calls that Aloha House would handle were from the state Department of Education. Since DOE schools were closed, calls dropped.
However, calls are starting to increase again and “we are concerned that these numbers might rise quite a bit,” Wittenberg said last month.
“The nature and scale of this unprecedented pandemic has impacted so many people in Maui County,” he added. “There are still many families that have stayed in a type of extended isolation.”
Clients who already had a therapist prior to the pandemic are “generally doing better” since they have been able to use the support that was already in place, “which underlies the importance of starting and maintaining therapy for vulnerable people,” Wittenberg said.
Fortunately for some, mental health effects of the pandemic were mitigated by government support programs like the stimulus checks, eviction moratorium and mortgage forbearance.
“When and if these programs are lifted, we anticipate the mental health landscape might change again,” he said.
Many families are still recovering from the struggles of last year as parents go back to their jobs and students prepare to head back to daily in-person instruction.
The pandemic took its toll on youth who endured online classes and had to miss out on social and extracurricular activities.
Students who were previously receiving A’s were dropping to D’s while distance learning, which “became a blow to their sense of self, and the process of losing faith in their abilities,” Wittenberg said.
Heather Long of Maui Youth and Family Services, who’s also a counselor for Baldwin High School and other kids in the Wailuku area and Hawaiian Homes communities, noticed a decline in some of her clients’ mental well-being.
“Kids complained that they hated virtual learning and they wanted to go back to school,” Long said last month. “Some of my clients gained a lot of weight because of sitting and being online for over six hours a day.”
Long has been reaching out to Baldwin students and homeless teens in Wailuku during the last 15 months, providing in-person support services or telehealth counseling sessions to 14- to 18- year-olds as well as clients who graduated in 2020.
“I felt kids felt disconnected from their community of support,” she said.
Long anticipates that the community will see lingering impacts on youth.
“I think when teens start back to in-person learning they will have to get up every day and wear clothes other than their pajamas,” she said. “Teens will have to get back into a schedule that they have not had for the last 16 months.”
According to Barry Taghavi, a Maui Counseling Group psychiatrist, these age groups are more “emotionally susceptible to the effects of limited social interactions.”
While many are welcoming a return to the classroom or workplace, the return may cause some level of discomfort as well, which can prolong any mental illness or substance use disorders.
Despite the increase in social interactions, the adjustment back to work or school can sometimes lower moods due to the “stress of uncertainty and having to make new decisions that they are no longer used to or haven’t had to make before,” Wittenberg said.
There were also many families that had to balance multiple responsibilities throughout the pandemic, like returning to work or trying to find a job, finding child care, raising young children while navigating virtual learning, maintaining relationships and so on. That balancing act may still exist or worsen once regular schedules resume.
“Some high-functioning folks that have embraced reentering the workforce or more social interactions have become overstimulated by changing things too quickly,” Wittenberg said. “Sometimes they are experiencing anxiety in public situations and feeling very awkward and not sure how to proceed in certain instances.”
Psychiatrists and therapists have also noticed a divide in the community opinions about COVID-19, which may cause fear and suspicion.
“People sometimes do not know how to approach each other after the pandemic,” Wittenberg said. “Some people were never concerned about it and some people were highly attuned to it. Some students were told to stay away from others and this message is antithetical from seeking out others for help, which was before the pandemic.”
The pandemic also worsened some problems that existed long before, such as substance abuse or addiction. Adults dealing with addiction often feel that they will be stigmatized for seeking treatment or that they can “handle it on their own,” said Jud Cunningham, chief executive officer of Maui Behavioral Health Resources.
“The prevailing and scientifically supported theory is that addiction is, for many people, a chronic, relapse-prone disease,” Cunningham said. “There is no shame in seeking professional help to seek or sustain recovery from addiction. It is said that addiction is ‘a pandemic within the pandemic,’ that resorting to substance abuse is a maladaptive means of coping with the negative effects of the COVID pandemic.”
Cunningham said that it’s quite likely that once the pandemic subsides, there will be an “even greater need” for substance abuse and mental health treatment.
“For those needing treatment and for those in recovery, stay connected to social networks, support groups and friends who foster healthy alternatives to coping with stress,” he added. “Seeking professional counseling/intervention is a strength, not a weakness.”
Connecting with others, getting outdoors, staying active, setting small goals, limiting screen time and eating nutritious meals are just some of the ways to boost mood and overall well-being.
“Remember that many of us are anxious and sometimes awkward in new social situations, and unpacking some of these feelings with each other, and what purpose they serve, is a great way to get started to handling the new normal,” Wittenberg said.
While youth and keiki need peers for developmental needs, those who are feeling anxious about being in crowds again should take things slow as life returns to the new normal.
“Try to take a deep breath in new social situations, perhaps ask open-ended questions, and listen,” Wittenberg said. “It is also OK if you are not ready to hang out — do not try to take on too much all at once. People have only a certain amount of social energy, and try to be aware of it so you do not cause yourself to burn out and become sick.”
Long suggested that parents assist their teens and keiki with getting back into a familiar routine. Families could also get kids involved with activities that they enjoyed before the pandemic and “expose them to new healthy activities.”
“I think we will see an increase in anxiety because of the demands of going to in-person school. Kids have formed some bad habits and that will take some time to change,” she said. “I also think kids are really going to need safe adults in their life so they can again feel connected to their community.”
Educators may have a challenging time during the 2021-22 school year, but if “we practice true aloha and malama our keiki, we will see healing in our schools,” she said.
Therapists emphasized the importance of reaching out to family and friends for support, doing more wellness check-ins and searching for resources available across Maui County for individuals struggling with mental health and/or substance use.
“We need to do more to educate the public that isolation is unhealthy, and that being outdoors at the parks and beaches are greatly beneficial for both physical and mental health,” Wittenberg said.
Many people found a silver lining during the pandemic — the opportunity to reevaluate their life’s purpose and to place more emphasis on family, friends, hobbies and health.
“There were also some families that were so busy before the pandemic that they realized that they do not spend enough quality time with each other and would not have done that if the pandemic did not occur,” Wittenberg said. “The pandemic has added a healthy perspective to what really matters in life.”
For crisis help or access to mental health resources, call Hawaii CARES for free 24/7 support at (800) 753-6879 or contact the Crisis Text Line by texting ALOHA to 741741.
To access the 24-hour Emergency Shelter Hotline, call Maui Youth and Family Services at 579-8406 or email Services@MYFS.org.
For more information and resources through Aloha House, visit mbhr.org/about-aloha-house/.
* Dakota Grossman can be reached at firstname.lastname@example.org.