2 years into a pandemic, California mental health experts still face these major challenges

The pandemic has taken a toll on Americans’ mental health.

About 4 in 10 adults in the United States have reported anxiety or depressive disorder symptoms during the pandemic that began in March 2020, according to the U.S. Census Bureau 2020 Household Pulse Survey. That’s up from 1 in 10 adults who had similar symptoms from January to June 2019, according to the Centers of Disease Control and Prevention.

In a live virtual conversation on Oct. 19 (click on the video above to watch), a panel of experts discussed with The Sacramento Bee how Californians are navigating the pandemic from a mental health standpoint. We explored the challenges we face now, and how we can do better this far into the pandemic.

Almost a year before, The Bee discussed this same topic. At that time, we were only nine months into the pandemic. And in that virtual live Q&A discussion, we talked about how calls to local domestic violence organizations across California were surging, and that Black, Latino or mixed race people were reporting symptoms of anxiety or depression at above average rates.

Health professionals continue to navigate the changes that have come with the pandemic. With this in mind, The Bee’s Equity Lab engagement reporter Orizo Hajigurban recently sat down with Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network; Sandra R. Hernández, president and CEO of the California Health Care Foundation; and Vinder Lallian, the counseling director at My Sister’s House, the Central Valley’s only shelter for abused Asian and Pacific Islander women, to discuss this important topic.

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How to get help

If you are seeking help, here are just a few resources:

• Stop Stigma Sacramento lists a range of mental health phone support options, including the Sacramento County Peer Support Call Center at 1-855-502-3224. See a full list here.
• The Sacramento County Department of Health Services has an online service request form as well as a page listing resources to support children, services focused on the Black community and urgent care clinics.
• The National Suicide Prevention Lifeline provides confidential assistance to anyone in crisis and their loved ones through a live chat and free 24-hour hotline: 800-273-8255.
• WellSpace Health operates the Sacramento region’s 24-hour hotline: 916-368-3111 or text HOPE to 916-668-4226.

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Read the key takeaways of the October discussion below, and click on the video above to watch the Q&A in full.

This conversation has been edited for length and readability.

How have you seen a shift in how people are reacting now versus earlier on to the pandemic from a mental health standpoint?

Vinder Lallian: We have seen a shift but we’ve also seen a lot of the same struggles. I think women who are experiencing domestic violence, sexual assault and human trafficking are experiencing a lot of anxiety in addition to that. There are continued challenges with resources and accessing resources, and I think as a staff just being able to balance safety. I think COVID has added another layer, a barrier really, to have a client come in and get that sort of face-to-face.

Although we’re open (at My Sister’s House), we have definitely had to implement protocols that have made it a little bit more challenging, but we’re still able to provide services.

I think COVID In general, and going through the pandemic, it’s just important to realize that it has been very traumatic. I think we’re all very traumatized.

Just by hearing and seeing, even if we ourselves have been healthy and likely to be healthy, it’s just another layer that we’re seeing that’s just making it that much more challenging for clients to get out and for victims and survivors to get out and get help. So we’ve just been trying to be mindful of that and do what we can do to meet them where they are.

Have you seen a correlation between domestic violence trends and mental health since the pandemic started? Were there any specifics you notice in certain communities?

Vinder Lallian: I think what we have really seen specifically in addition to our clients seeking services for domestic violence, is also the anti-Asian (sentiments). That has been a huge addition. Lots of our clients in our shelters, those who come through for other services, share stories about what they have experienced. We hear it in our groups, so that has definitely added to what’s been happening in our community on a political level and at the social justice level.

And I think because we do focus on Asian Pacific Islanders at our agency, we definitely see that spiked, and it does add another layer to life. It’s been really, really difficult for some of these women and survivors to get out and get help. So not only is there the fear of leaving the domestic violence, but in addition, there’s the fear of what’s happening out there in the community — simply because you’re Asian.

Do you have any specific examples of a community-focused solution that was put into place to help support communities affected more than others?

Kiran Savage-Sangwan: We have a COVID-19 pandemic, but for communities of color, we’re also living with generations of structural racism and the impacts, the stress and the trauma on communities. And because of that, it is really important for us to consider this to be not a single-issue crisis for communities of color.

And I think when we look at the pandemic itself ... it forced us all to live in a way that, frankly, is the opposite of what we generally advise people for maintaining mental health and well-being. We told people to stay home and isolate and all of those things are necessary to control a respiratory virus, but really, I think communities had to adapt to figure out how we are going to meet mental health needs.

... What we have to do is build protective factors to be able to maintain a level of mental health and well-being that enables people to continue their lives. I think communities and community-based organizations stepped up with their knowledge of communities across the state and in different populations, really small ethnic populations that we have here in California in a major statewide campaign.

I think communities really showed their ability to develop innovative solutions to prevent and to meet those critical needs. Some of the things that we saw: People being really intentional in their communities about developing culturally specific ways to reach out to our older adult population who are among some of the most isolated; developing mutual aid systems of reaching out; making sure that people stayed connected and making sure that people were able to stay connected with people in our community who had a better understanding of what they were dealing with. Also, anti-Asian sentiment was mentioned.

Communities and community-based organizations were really able to adapt in some of those ways to meet some of the needs, although I don’t want to underestimate the amount of unmet needs that do continue.

Now that we’re this far into the pandemic, what is on your radar for the future of mental health?

Sandra R. Hernández: There’s been a number of improvements on a state level in terms of investments and in terms of policy changes. I think there’s been a lot of progress. But I do think ... we need to be looking to move forward.

So the first one is, I agree with the comments that were made that there’s an increased recognition that everybody has mental health and sometimes many of us need help with our mental health. That’s not uncommon, and it should be far less stigmatized than it is. One thing that we’re thinking about is how do we have a system where people have a more regular connection to behavioral health care, in the same way that we strive to make sure that everybody has a primary care provider? How do we make sure that everybody has a behavioral health home is how we think the better place where you can go, that’s a part of your health care that’s regularly available to you whether you need one-time assistance, maybe therapy, something like that, or whether you need more intensive care.

In order to make that happen (people having access just like access to primary care physicians), we need really significant investments and changes in our workforce because we don’t have the workforce to make that possible right now. So what we look at when we think about the behavioral health workforce, is how do we better engage providers for our nontraditional providers: Thinking beyond your psychiatrist and your psychologist and thinking about people who have their own lived experience with mental health challenges are incredibly effective at assisting others with their recovery. Thinking about community health workers, for people from communities, who speak the same language, who understand the culture, who can, again, be really effective mental health ambassadors. I think that’s going to be critical.

What are you looking at with respect to racial equity going into 2022, and how can we be better?

Vinder Lallian: One of the things that come up for me is looking into the future is that we need people who are passionate and people who are willing to help.

At our agency, we have so many volunteers who go through our trainings and they are moved to do this work. And they bring so much whether it’s their own life experience, whether it’s their culture, whether it’s their religion, whether it’s their ability to speak another language, whether it’s because they’ve spent five years in Japan and they have a passion for Japanese culture, whatever it might be, it is so, so important that if you’re home, and you have that passion, share it.

There are so many opportunities for you in the community, not just at our agency, but all around. And I think what people need is, when you finally take that step, and you’re vulnerable and you go somewhere or you pick up that phone to make a call or you go into an agency or you go to that group, even if it’s virtual, you want to feel like you fit in — that people understand you, they get you and you feel comfortable.

So we need people who are representative of our community. Just here in Sacramento, there’s so much diversity, and that’s one of the most powerful experiences we have and is what clients remember that they come back for.

It’s so nice to know that there are others that are amazing volunteers who can bring that and I think that’s something that’s really important and I hope to continue to incorporate that into the future years, especially with all of those inequities that we’re experiencing.

Kiran Savage-Sangwan: I think it’s important for folks to know, we have documented through medical research that exposure to racism is a significant risk factor, both for mental health challenges, but also for physical symptoms and challenges.

That it’s something that impacts people and their mind and body. And as long as we continue to have a society that’s very much built on this foundation, structural racism is something we have to grapple with. I think the point about the resiliency and assets of our community is so important because, again, that’s the protective factor that we have, that really enables us to support communities and our own mental health.

The pandemic has caused severe levels of burnout for professionals within the mental health field; how will mental health service programs address this crisis?

Sandra R. Hernández: It starts with a recognition that we’re all human first, and we’re all members of our family first. This notion that you just show up and go on and move on because you’re a health care provider and mental health provider really does not serve us well.

I think what we need to be able to do is acknowledge when you’re exhausted and acknowledge when you need a break, acknowledge when you need a timeout, acknowledge when you actually need more formal health.

We’re in a post-traumatic stress disorder type of environment, and we have a lot of evidence about how to address that kind of stress. The first is to acknowledge that you are burned out, and that there are many tools and assessments that you can look at to do that. And then really to do what it takes to step back and care for yourself, including if that means stepping out for a period of time, and rejuvenating. There are all kinds of programs about self-care, walking, exercise, yoga and hydration.

There’s this enormous need for fun. One of the things that we spend a lot of time thinking about is how we can put joy and fun back in our life in virtual parties, virtual celebrations and virtual potlucks.

First and foremost, it is recognizing how you’re feeling and being willing to do something about it.

This is something that is true for the mental health workforce, and for our entire workforce across the board. It’s been an exhausting period of time to see so much suffering.

... Anytime I interface in any way, shape or form, whether it’s at Walgreens to get a flu vaccine, or whatever it might be, I always make it a point just to thank the people who show up there who are working to these COVID policies, and they’re trying to keep up with all of the information that’s out there.

Just as a show of appreciation for what that workforce has been doing.

You can watch the full conversation and learn more about the panelists at the event page here.