MONTEREY — Calls to the Suicide Prevention Service of the Central Coast have risen dramatically in the wake of an extremely difficult year and local officials are taking note.
The increased caller volume is an indication of the toll the coronavirus has taken on the public, say mental health experts, so local organizations are expanding their resources to help.
When people go through a series of stressful life events, they can get to a point where they’re not seeing a way out, said Dana Edgull, prevention manager at Monterey County Department of Behavioral Health.
“They want things to change and be different, but they don’t have the tools and the resources,” she said, so they’ll end up in a “really really hopeless and in a really dark place.”
The Suicide Prevention Service of the Central Coast recently said they are receiving double the number of calls to their crisis hotline than they typically do this time of year. Also, they are receiving more youth callers (ages 10 to 30) and a higher number of calls graded as “severe” — meaning the caller is in immediate danger and first responders are contacted.
The Suicide Prevention Service is run by the Family Service Agency of the Central Coast, a private nonprofit that has been providing mental health services to San Benito, Monterey and Santa Cruz Counties since 1957. Their crisis hotline is free, open 24/7 and multilingual.
Specially trained volunteers from a variety of backgrounds — from graduate students to retired nurses — answer the phones, said Nancy Fash, assistant program director of the Suicide Prevention Service.
“It’s really important that we have people on the hotline that can talk to people no matter what age or what stage they’re in — and can relate to what it is that they’re going through,” said Fash.
When someone calls the hotline, volunteers determine whether the caller is in immediate danger and then help them work out how to safely get through the next 24 hours, said Fash. Most importantly, they let the caller know they are not alone.
“If the situation is dangerous, we don’t hesitate to work with the caller to call 911 and get immediate help to them,” said Fash. “Before we conclude any calls, we let them know that we’re here 24/7 and that they can call back if they need to.” She said the hotline may even check back in with the caller in a few hours.
The hotline isn’t limited to situations involving suicide. It’s available for anyone struggling, including people experiencing anxiety, depression, grief, hopelessness, and substance abuse.
The service is completely confidential — and completely free.
“We always emphasize that,” said Fash. “People are always concerned that there may be a cost. There is no cost.”
People interested in volunteering with the hotline can email firstname.lastname@example.org.
Staff at the Monterey County Department of Behavioral Health also know the pandemic has created a new set of challenges for community members and they’re adjusting their resources to better meet those challenges. Last week, they launched a redesign of their website (www.mtyhd.org/bh) to make it easier to quickly find services and information. The new website also expands its suite of Spanish content.
This week, they’re starting a new initiative called “Forward Together,” which is designed to strengthen the community by building (socially distant) connections between people who are struggling. Starting Tuesday, there will be a series of free online sessions targeted at different groups, including teens, new mothers, seniors and families.
“Some are more like classes,” said Edgull, while others are more like support groups. Each session will meet weekly at a regularly scheduled time over Zoom and will be facilitated by Behavioral Health staff.
Behavioral Health has a number of other resources tailored to other vulnerable populations, including veterans, the LGBTQ+ community and people struggling with addiction.
Caring for seniors
Although social distancing is an important way to stop the spread of COVID-19, months of social isolation have been especially difficult for seniors, said Nan Heflin and Erika Olivarez, who are licensed marriage and family therapists who supervise the senior peer counseling program at the Alliance on Aging, a nonprofit based in Salinas.
“Is this how I’m going to live out the last few years of my life?” they’ve asked Heflin. “These are my years when I would be enjoying my grandchildren, and I can’t touch my grandchildren — I can only see them on FaceTime and on Zoom.”
Not only have seniors not been able to visit with family, but many who had rich social lives within their communities or senior centers are unable to see their friends or participate in activities they used to enjoy, Heflin said. Seniors also bear the added stress of knowing they are one of the most at-risk populations for contracting COVID-19.
As much of life has shifted online, many seniors who are unfamiliar or uncomfortable with technology have struggled to keep up.
Olivarez, who works with Hispanic seniors, said language barriers and socio-economic disparities add an additional layer of isolation for her clients.
While some people are getting tired of living life through video calls, others don’t even have access to smartphones, she said.
“Isolation has made a huge impact on our clients’ mental health,” said Olivarez, whose clients keep asking her when they’ll be able to meet in person again. “It’s really devastating to just hear them need that social engagement.”
To combat isolation while keeping the technology simple, the Alliance on Aging has shifted their in-person senior peer counseling program to be accessible by phone. Specially trained peer volunteers (ages 55 and up) make regular phone calls to struggling seniors, said Heflin.
“Basically what our senior peer counselors do is help other seniors strategize rough spots and different ways of coping,” she said, as well as offering information about community resources that are available to support them. People interested in receiving senior peer counseling should contact Nan Heflin at 831-646-4921.
Olivarez said the Alliance is always looking for more volunteers to help with the peer counseling and their other programs. Although peer counselors are 55 and up, the other programs that accept adult volunteers of all ages.
“I truly feel that it is the time right now that we’re coming together as a community,” said Olivarez, “and trying to see what and where we can help.”
Caring for our teens
The physical and social isolation during the pandemic has also been particularly challenging for teens and young adults, who rely on encouragement from their peers as they develop independent identities, said Dr. Myra Fernando, a child psychiatrist at Community Hospital of Monterey Peninsula, who has seen similar trends as those reported by the Suicide Prevention Service in her own clinic.
“I’ve been hearing more stories of kids with friends that have completed suicide,” she said, as well as seeing increased depression, anxiety, self-harm and substance use among people in the community.
The fact that crisis hotlines have been receiving more youth callers is concerning, she said — but there’s a silver lining. “The message that also sends to me is that these young people are looking for help and that they are getting information on how to seek help,” she said.
There’s less stigma about talking about how kids are feeling than there used to be, she said, but child psychiatry still has a long way to go before it can catch up to the needs of children.
In addition to professional services like those offered by the county or private practices, Fernando recommends that kids and teens get enough physical activity to boost their mood, that families prioritize having open discussions about mental wellbeing and that kids still make time to safely socialize with friends, using technology if necessary.
She cautioned that passive and excessive technology use can make mental health matters worse, but using it as a tool to meaningfully connect with others (such as video-calling a friend) or to practice mindfulness (such as with a meditation app) can be useful, she said.
‘This feels awkward to ask, but I care about you…’
Talking about mental health issues can make some people uncomfortable, but knowing what to do in times of crisis can be critical. For example, locking up firearms and safely stowing pills and other dangerous objects can help prevent fatalities from suicide attempts.
Something else is learning how to spot warning signs of mental distress — and reaching out, even if it feels awkward.
A common misconception Edgull has encountered is people worrying that if they ask someone if they’re suicidal, it will introduce that thought into their head.
However, “you will not make someone suicidal by asking them if they’re having thoughts of suicide,” said Edgull.
The script can be as easy as “Hey, you know, I’ve noticed X, Y and Z and I’m concerned about you, or “This feels awkward to ask, but I care about you—I’m just really wondering, are you having thoughts of suicide?” she said.
Because there’s still so much stigma surrounding suicide, it’s difficult for people to bring up if they’ve been having suicidal thoughts, even to someone they trust. By just asking the question, said Edgull, it takes the burden off of them from having to be the one to open up about it.
There are also formal suicide intervention training programs, like the ASIST (Applied Suicide Intervention Skills Training) program, which is offered by the Family Service Agency in addition to a number of other mental health services.
Fash said the ASIST training is one of their most sought-after programs. People who go through the program learn intervention skills, she said, including recognizing the warning signs of suicide and learning how to communicate with someone they suspect may be at risk.
“In our everyday conversations with people, people reach out to us all the time. But we don’t always know what to say when someone is really struggling,” said Fash. She said ASIST training strengthens our ability to communicate better and have those difficult conversations with the people we care about.
The training is popular with professionals like first responders and school counselors, but anyone can take it, said Fash, who would love to see everyone in the community trained.
Resilience and creativity
Despite the despair, there are glimmers of hope.
Every day Heflin says she sees resilience and inner strength in her senior clients.
“These are people that have been through a lot in their 70, 80, 90 years of life. And so they know what struggle is. They know that things do change — that things pass.”
Fernando is also impressed by the strength and creativity she’s seen in young people during the pandemic.
“It’s really cool just listening to kids and how they’re figuring out ways to cope with how different life is — they’re taking up new hobbies, they’re changing up their routines, they’re working on art projects”
With no end to the frustration and uncertainty of the pandemic in sight, Fernando suggests parents practice patience and self-kindness so kids can mirror that behavior and learn, “Hey, I don’t have to know all the answers right now.”
It’s advice that seems wise for those of all ages.
“I don’t know how to fix things right now,” we can say, “and that’s OK.”
Contributed by local news sources