‘Suffering silently’: The pent-up demand for mental health services in Vermont

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Dr. Robert Emmons, a Burlington psychiatrist, says the undervaluing of his profession is creating a shortage in mental health care and says that years of state healthcare policy is driving private practice out of Vermont.

The suicide rate in Vermont has remained relatively consistent with the five-year average amid the coronavirus pandemic. But mental health professionals say that people are suffering.

According to a report by the Vermont Department of Health, it’s unclear if there has been a statistical change in suicide deaths this year or in the past few weeks.

The report shows a rise in suicide deaths in Vermont in May to 16, compared to the five-year average of nine deaths. However, for April there was a decrease to eight suicide deaths from the five-year average of 13.

The five-year average of suicides for people under the age of 25 between Feb. 15 and July 1 is six. This year, there have been four.

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People are ‘suffering silently’

The number of patients being admitted to Brattleboro Retreat and other psychiatric units in Vermont is about the same as it was before the coronavirus pandemic, Brattleboro Retreat President Louis Josephson said.

“We aren’t seeing overwhelming demand,” he said. “I think part of that is just like with every hospital, people are trying to stay away from hospitals and emergency rooms, but I worry that people are suffering silently and that we will see an uptick.”

What also worries Josephson are the patients that are coming in.

The symptoms new patients exhibit seem to be worse than before, he said. 

“So people seem to be waiting to get care and they are a little bit sicker by the time they get in here,” Josephson said. “I worry about what they call the ‘pent-up demand’ for all health care services during the pandemic and particularly in psychiatric care.”

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The Vermont economy has been in a dire situation amid the pandemic with the number unemployed at 43,744 and the unemployment rate at 12.7% in May, according to the Vermont Department of Labor. In April, unemployment reached as high as 16.5%.

Looking at the relationship of unemployment and deaths of despair, Vermont can expect an extra 50 deaths of despair between 2020 and 2029, according to a report by the Well Being Trust, a foundation dedicated to mental health. 

Deaths of despair are defined as deaths to suicide, drugs or alcohol often associated with socioeconomic factors.

Higher demand for counseling 

Mental health professionals are seeing more anxiety and depression patients, said Susan Hall, member-at-large on the board of directors for the Vermont Mental Health Counselors Association and founder of Golden Earth Associates LLC and Discovering Wellness in Middlesex. 

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Hall has been seeing patients through the telemedicine program, Amwell, which connects patients with doctors over secure video.

Hall said that within two weeks of using the platform, she had over triple the demand for appointments.

“I went from a caseload of 11 to a caseload of 35 in mid-March,” she said. “That was when people were starting to freak out, this is really real. I had no control over it, it just doubled overnight. So that’s reflective of the need without the filter of how many people I accept.”

What’s causing anxiety and depression?

Hall agrees that the economy and the employment of her patients play a huge role in her patients’ levels of anxiety and depression.

Most of Hall’s previous work has been with patients with severe disorders that include persistent symptoms like hearing voices.

“What is curious to me is that although I haven’t seen a lot of those patients with the social isolation, the few that I am in contact with are more prepared for dealing with the vulnerability,” she said.

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Many of her new patients found themselves lost.

“For many of us privileged, white, middle class Americans, we are totally unfamiliar with walking out of our home into a reality of potential harm, potential danger, life-threatening danger,” Hall said.

However, people are finding comfort in the shared trauma of the pandemic.

“It’s really kind of perverse,” she said. “I think of that in the way of if you are standing on a line and then somebody gets behind you in line and you sort of feel a little better. You’re not the last anymore.”

If you are having thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 (TALK). You can find a list of additional resources at SpeakingOfSuicide.com/resources. 

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