Dr. James Tew, Associate Chief, Inpatient Clinical Services at UPMC Western Psychiatric Hospital discusses the impact of isolation and the pandemic on our mental health, including how to tell if you’re dealing with temporary blues or if it’s a more serious issue for which you should seek help.
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– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider.
The impact of the COVID-19 pandemic on our mental health. Welcome to the UPMC HealthBeat podcast. I’m Tonia Caruso, and joining us right now is Dr. James Tew. He’s the associate chief of Inpatient Clinical Services at UPMC Western Psychiatric Hospital. Doctor, thanks so much for joining us.
– I’m delighted to be here. Thank you for inviting me.
– So let’s really talk about, in general terms, the impact of the pandemic on mental health.
– Well, I can’t think of a mental health condition that’s improved by a pandemic. It’s been significant. People that have never really had problems with depression or anxiety before may be noticing new symptoms, and people that have been having ongoing issues with depression, or anxiety, or substance use disorders may have found that their symptoms are harder to manage or have worsened as their regular schedules and relationships have been affected.
– How do you know the difference between just the blues or whether it’s something more serious?
– Well, you look for your day-to-day functioning. If you are not getting out of bed, not showing up for work or important obligations, if you find that you just aren’t able to do the things that normally make you happy or allow you to meet your obligations to others, it’s usually a sign that this is beyond the blues and you’re starting to experience a possible clinical depression. Ask your friends or your supports for input and see if they’ve noticed changes, too.
– So, doctor, for people who may just have the blues, any ways to cope?
– If there’s any silver lining on the pandemic, it’s been that I do hear more about people talking about self-care and trying to be mindful about their own general health. Try to get back to establishing healthy routines. If you can exercise, please find opportunities to do that. Try to set a regular sleep schedule. Please be mindful about the amount of alcohol you’re drinking. These are sort of the basics, and if you can, find an opportunity to get out of the house and engage in some sort of pleasurable activity once a day, if you can do it.
– What are the signs that someone should seek help or their family members should seek help? And what are the first steps?
– Well, for sure, one of the first things we have to be mindful about is basic safety. If a person is at a point where they’re having thoughts, “If this is what life is going to be like, life isn’t worth living anymore,” or they feel they’re about to do something desperate that is out of character for them, they really need to reach out. And it’s important to, if you already struggle with depression, to have a safety plan in mind. If I get to a desperate point, these are the people I can reach out to for support or these are the crisis lines or hotlines that are available to us. Here in Allegheny County, we have a 24/7 crisis service, the resolve Crisis network. It has a drop-in center. There’s a 24-hour hotline. There’s even a mobile team of professionals who can come out and provide support in the community. And outside of Allegheny County, there are often similar services available. The number for the resolve Crisis Services is 1-888-7-YOU-CAN.
– And what happens when someone calls this number?
– Well, they’ll speak with a crisis clinician, someone who’s professionally trained to receive such calls, and it just starts with a conversation, “What can we do to help you? Tell us what’s happening.” There’s a number of different possibilities. It may just be calling for support when you need it. There’s an offer to come stop by our drop-in center. We may recommend that a mobile therapist come out and meet with you or a member of your family, whomever you’re most concerned about, but it all starts with a conversation.
– So along with resolve, what about the psychiatric emergency services?
– We have a psychiatric emergency evaluation service at Western Psychiatric Hospital. It’s open 24/7. It’s staffed by psychiatrists, therapists, and social workers and nurses who are there to evaluate anyone who presents with a mental health crisis and feels they need emergent assistance. The emergency services are connected with the hospital, but by no means do you have to be hospitalized just by coming in for a visit. In any given month, only about 1/3 of the people that are evaluated will require hospitalization at that time, and it can be an important place where we can link individuals with outpatient providers or clinic appointments. We’re located right on the same site, at 3811 O’Hara Street, as the hospital itself, and the main number for UPFC Western Psychiatric Hospital is 412-624-1000.
– So, doctor, what have you discovered during the pandemic about people’s need to seek care, and particularly, what have you been seeing around children and adolescents?
– Well, I do think that it’s been challenging. The shift to online learning and the change in daily routines and structure has been tough for a lot of young people, and sometimes everybody being home all day under the same roof can create tensions that weren’t in place when everyone was going out and doing their own thing. So I think as we talked about earlier, not having day-to-day structure can be a real challenge for many people, including young people.
– Can you talk about the impact of isolation?
– We’re all creatures of habit, and we benefit from having routines, structure, and schedules. Isolation can make it harder for us to feel like we’re in sync with our own natural rhythms. It can affect our sleep, our ability to focus, and one of the challenges also is we lose day-to-day healthy, sort of benign, and reassuring interactions with people. If we’re not careful, we start getting too much of our information from virtual settings or online, from 24-hour cable news. It can be a setup for developing some distorted thinking about how we’re doing in the world and how we fit into it. So that is something that I’ve seen professionally over the last year, is people that are having too much of their daily social diet replacing human connection with online or virtual connection.
– Right. Are there certain groups that you have seen suffer more from isolation than others?
– I would say people with intellectual disabilities or special needs populations that really do well and thrive with a support group around them, or daily structured activities, drop-in centers, that’s been really tough. People that rely on the day programs have had to get by with a lot less stimulation and outside support. We are seeing some of those individuals go into crisis. We’re also seeing people that maybe needed to come in for emergent services for behavioral health, maybe at times being afraid to go out for fear of being exposed to the virus. So, both problems related to people not going out and then people being afraid to seek out emergency services.
– Right, and you touched on this in the beginning. Even when it comes to folks who may have a pre-existing mental health condition, how has the pandemic impacted them?
– Well, services have shifted. It’s hard to hold group therapy when you’re also trying to control viral spread. So many of our services have shifted to an online or a virtual platform. In some ways, that’s been a real boon, and it was impressive to see society and regulations respond to the pandemic by allowing for our virtual care to move forward, probably advanced years in the span of months in response to the pandemic. It makes access to appointments easier because travel time and distance from providers becomes less of a problem. So it’s expanded access in one regard. The downside is people may not feel as connected over virtual settings as they otherwise would, and especially in group therapy, it’s hard to feel like you’re getting the same sense of human connectedness over a screen that you might be if you’re in a room in touch with others.
– Let’s talk a little bit about the safety precautions that you have in place and how the hospital is operating during COVID.
– We were fully functional throughout this entire pandemic, and people who are admitted to the hospital, we encourage masks at all times; certainly, all of our staff are always masked. We use vigilant hand hygiene. People who are hospitalized with us get their temperatures checked four times a day. Any time we identify a potential problem, we move to test those individuals. We have specific areas of the hospital that are designated red zones that are for people who may need services, that have a positive test for coronavirus. Those are negative air pressure units where the staff are wearing full PPE gowns and N95 masks. We also have some quarantine units for people that are of undetermined status so that we can monitor them safely to make sure that they don’t develop symptoms. So we’ve taken a lot of precautions, and for the most part, we’ve been very pleased with the results.
– So what would you want to say to people watching this about not being afraid to seek help?
– It’s normal to wrestle with some stigma before you reach out for mental health support for the first time. I think people lose sight of just how common and how human it is for people to struggle with stress and anxiety and feeling overwhelmed. You’re not alone, and I would ask you, if you had a friend who was going through the same thing, what would you encourage them to do? And try to take that same advice yourself.
– Well, Dr. James Tew, thank you so much for coming in and spending some time with us today. Some really good information. Thank you for your time.
– It was my pleasure. Thank you for having me.
– And I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat.
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UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. UPMC Western Psychiatric is the hub of UPMC Western Behavioral Health, a network of nearly 60 community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors throughout western Pennsylvania.