Romano Law Nurse Corner COVID-19 #21
Mental Health Revisited
Are you tired of the “new normal” with the added stress that the COVID-19 pandemic has brought to your life? You are not alone. There are continued rising case numbers, unfathomable death numbers, and new COVID-19 hot spots popping up daily. There are peaceful protests all over the country with some turning violent. We have seen the deployment of federal troops to several cities around the country, some welcoming the assistance, others not. A huge political election, many would say the biggest of our lifetime, is coming up. Mixed messages abound. Our country and our world is surely in turmoil.
This can all be overwhelming. Mental Health is something that is often ignored as we try to survive this crazy time…and this is a crazy time. Inevitably, mental health suffers in times such as these. However, we must not forget to take care of our mental health, it is essential.
According to a Consumer Reports survey conducted in May, of 2,085 U.S. adults, 38% had experienced anxiety or depression as a result of the outbreak of the COVID-19 pandemic. The Census Bureau data from April and May found at least 1/3 of American adults are showing signs of anxiety or depression. Crisis hotlines report huge spikes in calls and frontline healthcare and other essential workers are living with the trauma of long shifts, fighting for safety equipment and watching people die despite their best efforts to keep them alive.
More than 20 million people in the United States have a substance use disorder. So far, experts see signs of relapses, rising overdoses, and other worries. Researchers say it’s too soon to have definitive data on the pandemic’s effects, but early numbers are concerning. So far, alcohol sales have risen by more than 25%. A recent analysis of 500,000 urine drug tests by Millennium Health, a national laboratory service, also showed worrisome trends: an increase of 32% for non-prescribed fentanyl, 20% for methamphetamine, and 10% for cocaine from mid-March through May. And suspected drug overdoses climbed 18% in the same period, according to a national tracking system run out of the University of Baltimore.
People who are recovering from active COVID-19 infection and long hospitalizations are facing a very long road to health. We have already seen that as people recover from COVID-19 infections, there are some lasting negative health effects. The true magnitude of this is unknown, however time will continue to show this as more and more people survive and try to resume normal activities as much as possible. Of course, there is relief with recovery; however just dealing with the trauma of having had this devastating illness along with even more underlying fear about long-term and permanent health effects would deeply concern anyone. All of this is scary stuff.
According to the CDC, it is expected that any national disaster will bring about increased mental health issues such as anxiety and depression. Required public health action such as social distancing can make some people feel lonely and isolated which causes further stress and anxiety. Most everyone feels a certain level of anxiety at this time.
Fear and worry about your own health as well as the health of those you love is part of our current daily life. This type of stress often causes changes in sleeping and/or eating patterns, difficulty concentrating, worsening of both chronic and mental health conditions as well as increased use of tobacco, alcohol, and other substances. We each react differently to stress. However, there is help available.
Psychological support is always an option and is more available now than ever before. As you know, we are in an age of social distancing which has increasingly opened the door to “virtual” life, including telemedicine. Therapists are more accessible now that we are homebound and there is research that teletherapy is just as effective as in person face to face therapy. So, if you are looking for some support, consider virtual therapy by telephone and/or videophone.
How do you go about finding a teletherapist?
According to Lynn Bufka, Ph.D., the senior director of practice and research policy at the American Psychological Association, searching for a virtual therapist now should be the same as you would have done before the pandemic. Dr. Bufka suggests asking your trusted healthcare providers or friends for a referral, looking on your insurer’s website for those covered under your plan, and using the finder tools on websites for the American Psychiatric Association and the American Psychological Association to find providers. Help is out there and more accessible than ever before.
How to pick a therapist
Since it is important to be comfortable with the person you are seeking, you should schedule a call/video to meet the potential therapist(s) so you can get a feel for each other and to see how you relate to each other. You will then be able to ask important questions as well as learn about the therapist’s training and approach to therapy. For instance, you can ask about the person’s years in practice, their specialties, their techniques for therapy, and of course you can discuss the fee they charge as well as insurance coverages that might be available. Of course be sure to ask any other questions that you deem important to you. Most therapists expect these types of questions.
Do not be afraid to talk to several different providers to get an idea of the differences in approaches. See how it feels when you talk to this person. Remember, for therapy to work, you must be very comfortable talking honestly and openly with your chosen therapist. All licensed therapists are bound by patient confidentiality rules, however asking your therapist what safety measures he/she takes to ensure online or telephone privacy is a good idea if you are concerned about confidentiality.
What type of therapist
There are several types of mental healthcare providers, including clinical social workers, psychologists, psychiatrists, marriage and family therapists, and mental health counselors. While all are qualified to provide therapy and must be licensed to do so, their educational requirements and the types of services they provide can vary. All licensed providers will be happy to share that information with you.
Most important is the comfort level you feel with the person with whom you will have therapy. Ultimately, that will provide the best atmosphere to help you. Of course, don’t forget to check for any specific insurance considerations that are applicable for your situation. Notably, psychiatrists are M.D.’s, so they are the only ones who can prescribe medication.
Substance Abuse Support and Treatment
There are many resources available to those who seek help for their substance use disorder.
12 Step meetings- free and available worldwide – see
For more formal Substance Abuse Treatment resources – see
Health insurance policies vary on coverage for therapy, your state, and the provider’s license. Some insurance policies do not cover it at all. Some of them require you to see only providers that are on their list, others require that you file your own claim forms for reimbursement. Further, many providers do not participate with insurance companies. Check your individual policy for details on their mental health coverage policy. Therapy can be expensive and a session can cost anywhere from $75-$500.
However, if you are in need, lower cost and even free help out there.
The National Suicide Prevention Lifeline, 1-800-273-8255 [https://suicidepreventionlifeline.org/], is a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. They can always provide a referral to a local resource or provider as well as connecting you to their non emergency line to talk to a trained professional at no cost.
If you prefer texting, message the Crisis Text Line [https://www.crisistextline.org/] at 741741, which also provides free confidential support via text message day or night.
Another useful tool is 211. You can either call or text 211 or go to the website at https://www.211.org/, and you will be referred to a provider who offers no cost or amounts on a sliding scale based on your budget.
Other options include online platforms that match people with licensed mental health providers such as Talkspace [https://www.talkspace.com/], Amwell [https://amwell.com/cm/] and BetterHelp [https://www.betterhelp.com/] . These can be good options because they tend to cost less than traditional therapy, ranging from $40-$100 per visit. Some of these programs do also accept insurance.
Since therapists are licensed by the state where they practice, they typically cannot treat you if you are in a different state at the time of therapy. It is important to note that during the pandemic, some states have created temporary exemptions so that therapists who see patients from bordering states can continue to treat their clients remotely. Be sure to check the rules in your state. Advocates believe this flexibility should continue into the future and most likely will ensure access to those who need it.
Awareness of our own coping skills and using them to care for ourselves balanced with the assistance that we can be to each other will only strengthen us as a society to get through this pandemic. Help is available more than ever. If you are struggling, reach out. Use these resources.
You are not alone.
We are Susan Ramsey and Amie Goldberg, both practicing attorneys and nurses here at the Romano Law Group. Here is a little more about each of us:
Susan Ramsey is both an attorney and an RN. Ms. Ramsey’s professional experience began as a Registered Nurse in the Intensive Care Unit at Yale New Haven Hospital. While pursuing her Bachelor’s Degree, she was a counselor with the New Haven Rape Crisis Program. During her time with the Program, Ms. Ramsey counseled sexual assault survivors and performed seminars for local police departments, universities, and high schools. During her time working as a registered nurse, Ms. Ramsey decided to attend law school. Ms. Ramsey graduated from CUNY Law School, and has practiced law in several different State and Federal Courts. She is a Florida Heath Care Risk Manager and a member of the Palm Beach County Sober Home Task Force. Ms. Ramsey actively litigates cases involving catastrophic injuries and wrongful death on behalf of survivors, cases include injuries suffered by victims of professional negligence, product liability and medical negligence.
Amie Goldberg is both an attorney and a certified APRN. After completing a Bachelor of Arts Degree at Whittier College, Ms. Goldberg attended nursing school at Emory University. Ms. Goldberg’s professional experience started as a Registered Nurse at Egleston Children’s Hospital taking care of children with congenital heart disease. After a few years, she continued working in all areas of the hospital while attending Kennesaw State University on weekends in order to get her Master’s Degree in Nursing with a specialty of Primary Care Nurse Practitioner/Family Nurse Practitioner. During her time as an APRN, Ms. Goldberg decided to attend law school at St. Thomas University in Miami, Florida. Since graduating, she has mainly practiced in the areas of personal injury and worker’s compensation, fighting for the rights of injured people. Since joining the Romano Law Group, Ms. Goldberg has been the Director of the Opioid Litigation Project. Ms. Goldberg also practices in the area of medical malpractice and nursing home negligence, bringing an inside perspective and knowledge to help get justice for our clients.
Containing this virus is our common mission. Remember, we are all in this together.