Berks County Medical Society Medical Record Winter 2021 - 15

video-based appointments. This may work well for those who are too
afraid to get out or are unable to because of transportation problems
or other circumstance (e.g. childcare needs), but other people who
don't like, trust, or don't have access to technology are most certainly
falling through the proverbial cracks in the mental health system.
I reached out to a few colleagues to get a sense of what they are
experiencing at their facilities during the pandemic. Here is what
they reported:
Dr. Mark Putnam, MD, CPE, Chief Medical Officer at Haven
Behavioral Hospital of Eastern PA and Berkshire Psychiatric , stated:
" Early on in the pandemic for maybe the first month things
seemed a little quieter. On an outpatient side of Berkshire Psychiatric
we have seen an escalation in depression and anxiety and lots stress
for people - frustration, passivity, anger. You will probably want
to comment on the impact on caregivers, especially mental health
caregivers, most of whom had to transition from face-to-face
treatment to telehealth. For some this is been an OK transition, for
others this is been harder. Most people who grow into this field like
the face-to-face contact and feeling a connection with their clients
to be able to help. It actually takes a lot more energy to do telehealth
than it does face-to-face for most people. The focus is different, it's
less gratifying overall for most. It's harder to get things done than if
you're in an office with a number of people and you can just walk
down the hall to connect. It takes a lot of effort to continue to create
community.
On the inpatient side I don't know if this is related to Covid or
not, but we've seen a great increase in the number of people who
are struggling with violence and aggression. A good portion of our
referrals have significant issues with impulse control, anger, and
aggression. This could be simply a reflection of what's happened in
mental health, but to me it seems it has escalated since the Covid
pandemic started. "
Cathy Geissler, MA, LPC, Director of Program Management at
White Sear Run New Perspectives in Lebanon County, stated:
" We have seen an increase in rates of alcohol abuse, meth
[methamphetamine], and cocaine. Our concern is the fentanyl that
is laced in meth and cocaine. We have seen an increase in severity
of comorbidity with the associated mental health and medical issues
related to one's drug of choice. In addition, we have admitted people
starting around June/July who have had 20-plus years of sobriety
and have now relapsed due to an increase in life stressors caused by
furlough from employment, fear of the unknown of COVID-19,
marital stressors that have been unveiled due to being with the
significant other continuously throughout the day, the financial stress
of a partner spending money on unnecessary items due to boredom,
and conflict on parenting while trying to educate one's child. "
Clearly, this pandemic is impacting not only our patients' mental
health, but also the wellness of treatment providers. The mental
health field has moved almost exclusively to telehealth services
(outside of acute inpatient care), so few outpatient providers are
seeing patients in person. My own private practice has remained
steadfast in providing in-person services, but few of my colleagues
in the field are doing the same. I feel that telehealth services are
better than no services at all, but they don't replace the in-person

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connection. I feel that it is particularly difficult for a new patient to
connect via telehealth. This may not be as much of an issue for an
existing patient with whom the therapist already has a connection.
Also, many adjunctive services like support groups or club house
supports may be unavailable during the pandemic, leaving many
mental health consumers without the support that they are
accustomed to receiving.
Penn State Health St. Joseph's Family and Community
Residency program focuses on resident wellness, and we offer a
support group for the residents to air their concerns in a safe and
confidential environment. Of course, even our support group is
virtual now as we try to minimize in-person meetings and groups. I
have offered lectures on the impact of COVID on our patients and
staff and have also reached out to our system's medical students.
One of the challenges is that as medical providers are feeling the
pressure and challenges of COVID in caring for their patients,
they must simultaneously worry about bringing the virus home to
their own families. And those who are single may feel a sense of
isolation, as social activities are minimal or non-existent. Within
the residency program, we are used to sharing lunch together but
now even that most basic form of community is put on hold due to
pandemic risks.

WINTER 2021

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Berks County Medical Society Medical Record Winter 2021

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