SALT LAKE CITY — As a recovering alcoholic and a new mother with a 4-month-old baby, Aliantha Morningstar Valdez, 40, has struggled with the fear, boredom and isolation that have accompanied the coronavirus crisis. But Valdez has been sober for 3½ years. She is much more concerned about those who are still trying to quit and have yet to establish strong support systems.

“It’s a scary time. A lot of recovery homes aren’t taking new residents or patients. It’s harder to find meetings. It’s hard to find what we call ‘your herd’ or ‘your people,’” said Valdez, who lives in San Diego.

As a member of Alcoholics Anonymous, Valdez has been reaching out to newcomers via social media to tell them about the group’s virtual options now that most in-person meetings have been suspended. In a typical week, Valdez attends three AA meetings at churches and meeting centers around San Diego. Now she attends the same number of meetings, but from her own home using Zoom. She said AA can be the difference between life and death for someone who is struggling with addiction.

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“I’m worried about that person who’s walking around right now, trying to figure out how to get sober and they just can’t stop drinking, and now they don’t have a meeting to walk into,” said Valdez.  

While social distancing and quarantine measures are necessary to help protect people from the coronavirus, there are consequences to shutting down the economy and telling people to stay home. Recovering addicts won’t have access to in-person support groups, domestic violence victims could be trapped at home with their abusers, and others facing job loss and isolation could become suicidal. In other words, steps the country is taking to save lives could be deadly for some.

The question is how many?

Shaun Reeve, an associate clinical mental health counselor, counsels a client via telehealth from his office at Grandview Family Counseling in Bountiful on Wednesday, April 1, 2020. | Laura Seitz, Deseret News

The risk of rising despair

Hannah Dismer, 26, was doing well before the coronavirus hit the U.S. Even though she had long suffered from anxiety, depression, PTSD and disordered eating, she was successfully managing her mental health and relying less on therapy.

“Then this happened and my anxiety has started to spin out of control,” said Dismer, who lives in St. Louis and works in health care.

Dismer said increased stress at work and the feeling that she has no control over what’s happening have caused her to experience frequent panic attacks.

“As a health care worker during this, anxiety runs high,” said Dismer “I’m having to adapt to situations for which no modern reference exists.”

Shaun Reeve, a therapist at Grandview Family Counseling in Bountiful, said the coronavirus crisis has been difficult for people because it demonstrates how uncertain our world is.

“We as humans love certainty. We plan things, we predict our future,” said Reeve. “When we want to control things that we don’t have any control over, it leads to all kinds of uncomfortable emotions: overwhelming stress and panic, anxiety, suicidality and depressed mood.”

But Reeve is optimistic that telehealth can help people at a time when meeting face to face is dangerous. He is now providing therapy for all his clients using a confidential video program called Simple Practice.

Michelle Neville, CEO of Highland Ridge Hospital, poses for a photo at the hospital’s Midvale facility on Friday, March 27, 2020. | Scott G Winterton, Deseret News

Michelle Neville, CEO of Highland Ridge Hospital, an inpatient mental health and addiction treatment facility in Midvale, said the hospital will remain open to assist people in crisis. Staff have already made adjustments to accommodate CDC guidelines, include limiting the number of people who gather in one room, keeping distance between patients and rigorous disinfection protocols. Other inpatient treatment centers in Utah are trying to do the same, she said.

“Times of crisis open the door to suffering and we want to ensure that people who are in need of resources, support and treatment are able to receive those services,” Neville said.

President Donald Trump has said repeatedly that the number of suicides will be greater than the death toll from the virus itself if Americans don’t return to work soon. But experts like Richard Dunn, an associate professor of economics at the University of Connecticut, say that may not be true. While it’s almost certain that suicides will increase as more Americans experience financial stress and unemployment, it’s hard to know by how much or how those numbers will compare to coronavirus deaths, said Dunn, who has studied the link between the strength of the economy and mental health.

Already, more than 10,000 Americans have died from the coronavirus, and a University of Washington study predicts that more than 81,000 Americans will die from the coronavirus by August. Keeping social-distancing measures in place until the number of new virus cases starts to decline could prevent as many as 600,000 additional U.S. deaths, Northwestern University economists have estimated.

In contrast, the U.S. Centers for Disease Control and Prevention reports that 47,173 Americans died by suicide in 2017. Considering expected economic decline, there could be an additional 1,500 to 5,000 suicide deaths a year going forward, Dunn said.

Studies also show that while suicides increase when there’s an economic downturn, most other fatalities decrease. People aren’t driving as much, so there are fewer car accidents. People don’t go out and spread germs, so they don’t get sick. Even the number of heart attacks and strokes goes down because people are spending less money on things like cigarettes and alcohol and spending more time being physically active, according to Dunn.

“This is a whole new world that we’re dealing with here, so it’s hart to predict what will happen,” said Dunn. “But when it comes to suicide, all factors are pushing in the same direction now. Lack of income, lack of job security, isolation, reduced access to mental health services will all increase suicide risk. I’m confident of that.”

Fighting addiction in isolation

Participants in support groups like Alcoholics Anonymous or Narcotics Anonymous say that virtual meetings are helpful, but it’s hard to replicate the sense of community that comes from gathering in person.

Some of the most important parts of AA meetings are the one-on-one conversations that happen before and after, said Valdez. In addition, most meetings end with the group holding hands in prayer.

Jimmy, 45, lives in Layton and has been drug-free for 13 years. For the past few weeks, he has been attending multiple Narcotics Anonymous meetings every week via Zoom and participating in a daily discussion group on the Marco Polo app. He said there’s usually “a lot of hugging” at regular meetings.

“Because of the nature of addiction, you never know if you are going to see someone again,” said Jimmy, who asked that his last name be withheld to protect his privacy.

Jimmy said the online format could be challenging for some Narcotics Anonymous members, especially older ones who might not have access to a computer or be as comfortable with the technology. But at the same time, going virtual could make the group more accessible to people who would be hesitant to show up to an in-person meeting.

“Of course. The disease of addiction doesn’t discriminate. It’s a killer,” said Jimmy.

According to a study by the National Bureau of Economic Research, a 1% increase in the country’s unemployment rate is correlated with a 3.6% rise in opioid deaths.

“What we try to focus on is making sure people can hear the message that there is hope, it’s possible to have freedom from active addiction,” Jimmy said.  

Trouble at home

When natural disasters strike, domestic abuse tends to get worse as well. Researchers at Texas A&M University found that after Hurricane Andrew hit Florida in 1992, spousal-abuse calls to Miami’s helpline increased by 50%. Another study from the University of Mississippi showed that after Hurricane Katrina, reporting of psychological victimization by a partner jumped from 33.6% to 45.2% among a sample of women from the state.

Job-loss, stress and feelings of lack of control can cause people with abusive tendencies to lash out more against their partners or children, said Martina Bailey, a therapist at Healing Pathways, a counseling center with locations in Utah and Salt Lake counties. Confined to their homes, abusers and victims may lack access to traditional coping mechanisms, she said.

Research shows homicides related to domestic violence are already on the rise with 2,237 victims killed in 2017. As quarantine measures have been implemented across the country, the National Domestic Violence Hotline has received a high number of distressing calls, the Los Angeles Times reported. Salt Lake City police reported a 33% increase in domestic abuse calls over the past few weeks.

Bailey, who specializes in trauma and is based in Millcreek, said telehealth is a strong alternative to drop-in counseling centers that have closed their doors and in-person support groups have been canceled. But some insurance companies don’t cover telehealth and clients might not have enough privacy in their home to be able to make a call, Bailey said. (In those cases, free online chat services can be useful.)

In addition, some nonverbal communication can be lost in transmission.

“A person’s body language says a lot, more than their words usually,” Bailey said. “The inability to read their body language, make eye contact and really establish that warm connection is a great disadvantage.”

David Rosmarin, an assistant professor at Harvard Medical School and the director of the Center for Anxiety in Boston, is a big proponent of telehealth, despite its drawbacks. His primary recommendation for individuals who are worried about their own mental health and safety is to reach out and ask for help.

“Suffering is not as bad when you realize you’re not alone,” said Rosmarin.  

“Mental health therapy offices are still open,” urged Reeve. “Sometimes that process takes a little time and you have to wait to get in to someone. Don’t give up on that process. You matter and what you are experiencing matters — reach out for support because it’s really there.”

National Suicide Prevention Lifeline: 1-800-273-8255, https://suicidepreventionlifeline.org/

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Psychology Today therapist search: https://www.psychologytoday.com/us/therapists

Alcoholics Anonymous: https://www.aa.org/pages/en_US/find-aa-resources

Narcotics Anonymous: https://www.na.org/

Domestic abuse hotline: 1-800-799-SAFE (7233), https://www.thehotline.org/help/

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