For Robin Miyamoto, urban clinical psychologist Honolulu County, HawaiiLast year was the hardest I’ve ever worked.
Telehealth, which she has taken advantage of during the COVID-19 pandemic, has allowed her to reach clients in the absence of in-person visits. But she found it difficult to draw boundaries, as she and other providers agreed to offer weekend or late-night sessions with patients in need.
On top of that, she says, she’s had more patients seeking help than ever before.
“We’re seeing higher rates of anxiety — whether it’s related to Covid, or related to funding, or to employment,” Miyamoto says. The Psychological Association of Hawaii, of which Miyamoto was former president, has seen a 60% increase in requests for free care during the pandemic due to the loss of insurance, she said.
“A lot of depression and isolation,” Miyamoto adds. “And then I have a lot of adults asking for assessments for[ADHD]because of working from home…people wondering about their ability to stay focused and pay attention.”
Honolulu, a unified city and province comprising Oahu and the Outlying Islands, located between top 500 Societies in general in order of No. 395, scoring 66 out of 100 points. in a mental health measures In the analysis, it achieved a score of 100 thanks to its performance compared to other societies on measures assessing deaths from hopelessness in recent years, meaning deaths related to alcohol, drug, or suicide; Proportion of adults who experienced recurrent mental disorders; and the proportion of Medicare beneficiaries with depression.
Much of the data in the Healthier Communities analysis predates the onset of the COVID-19 pandemic. Still, Leina Ijacic, Senior Administrative Officer at Institute of Human Services, a nonprofit organization working to reduce homelessness in Honolulu County, says the positive Medicare data makes sense. Quality of life for the elderly in Hawaii They often do well, she says, because they are highly respected and often live in multigenerational families, helping to nurture the next generation.
“In Hawaii, they are an integral part of families,” says Iacic. “So I think this piece could be more cultural.”
But the pandemic has meant major challenges for Hawaii when it comes to mental health — ones that providers are now working to address through comprehensive care.
A recent report prepared by Mental Health America Based on self-reported data from three-quarters of a million respondents in the United States 41% of Hawaii’s population Those who took an online depression screening test from January to December 2020, reported frequent thoughts of suicide — the highest of any state. The data comes after the outbreak of pandemic restrictions and severe restrictions on travel to Hawaii There is a huge rise in the unemployment rate.
The group also found that, regardless of whites, Asians or Pacific Islanders in general made up the highest proportion of respondents by racial or ethnic group screened for depression, at over 18%. Calculation of Asians, Native Hawaiians and Other Pacific Islanders only about 6% a resident of the United States; Meanwhile, there was a national concern about anti-Asianism hate crimes And Other accidents linked to the COVID-19 pandemic.
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A look at the data for the Hawaii Coordinated Access Resource Entry System, or Hawaii Cares A hotline for people who need help with mental health or substance use disorders, which aims to connect people with them Quarantine services and others Crisis needs Also – provides additional insight into the impact of the pandemic on Hawaii. The hotline received nearly 140,000 calls in 2020, according to Behavioral Health dashboard It was developed through a partnership between the University of Hawaii and the Hawaii State Department of Health.
In Miyamoto’s practice, the need for services during an epidemic has increased the number of people who may not seek care. She says many of these patients are Native Hawaiian, Pacific Islander or Asian residents of Honolulu who may have previously moved away due to the stigma surrounding mental health care. These groups make up the majority of the state’s population.
“Mental health has always been treated differently than physical health,” Miyamoto says. A lot of people think you can just change your attitude and get over mental health issues, she says — and that’s not true.
“But I think these stigmas have been overcome by what people are dealing with” during the pandemic, she says.
Miyamoto says providers like her have tried to increase access and access to mental health services by providing care directly within the patient’s primary care office, and bringing psychologists to work alongside the primary care provider.
“The primary care setting helps people feel more comfortable,” she says. “They won’t go to a separate mental health clinic. So the stigma is taken off.”
She also says that community health navigators — individuals who help connect community members with different resources — have been helpful during the pandemic. She says Navigators have gotten creative, offering Zoom sessions geared around the needs of the community to meet people wherever they are. It has included mental health programs that specifically target Native Hawaiians and Pacific Islanders.
There have also been efforts to address not only mental health needs, but social needs that may affect mental health as well.
The CARES Partnership in Hawaii, for example, seeks to meet housing needs as well, says Leucadia Conlon, its clinical director. Notably, Oahu has had significantly more people with homelessness and substance use disabilities in recent years than the other Hawaiian Islands, according to the Behavioral Health Dashboard. and January 2020 number of time points found that there are 4,448 people experiencing homelessness on Oahu; Of that number, more than 900 adults indicated that they were dealing with a mental health problem.
Conlon says the pandemic has only reinforced the need for a one-stop shop for behavioral health needs like Hawaii CARES, and to be able to connect people with more care then and there.
“When someone [with a substance use disorder] They have the drive to change and they make that phone call, it’s important to be able to act at the time,” she says.
The Institute of Human Services also aims to combine traditional health services with behavioral health. They work to connect people in need with supportive housing, meals, and mental health assistance, among other things.
“When we talk about mental health, we’re really talking in a broad sense, right?” says Ijacic, the group’s chief administrative officer.
This kind of sponsorship needs to be culturally appropriate to better serve Native Hawaiians and Pacific Islanders, says Heather Lask, executive director of the Hawaii Center for Health and Harm Reduction. Doing so, she says, means talking to people in places and in ways or languages that suit them.
“I think[when]we talk about cultural appropriateness for mental health and wellness, it ensures that we are asking the right questions,” Lusk says.
Resilience is “a very big part of Hawaiian culture. There is a lot of meaning in a family … It’s our responsibility to take care of each other. We also have a lot of gratitude,” says Lask. In March, the Hawaii Department of Health Launched The program is called flexibility perpetual wind, which is connected to the Hawaii CARES Hotline and offers virtual sessions and support groups aimed at providing “community resources, a break from life, community support, relaxation, and more,” according to its website.
“This project is specifically set up to provide crisis counseling to individuals who are working or dealing with additional stresses and burdens associated with the COVID virus,” says Conlon, adding that it also helps connect people with relevant local resources. One Kū Makani . initiative confirmed Healing through art, with virtual sessions of Hawaiian artists playing instruments or reciting poetry. The program’s website also includes resources geared toward Native Hawaiians.
But there is still work to be done. Miyamoto says that some people in Hawaii may be reluctant to seek care because the providers don’t look like them.
“We try very hard to promote the Native Hawaiians and Pacific Islanders who go to [behavioral health] So providers are like patients seeking services.”
“Obviously this isn’t something we’ve been able to ramp up quickly during COVID, but that’s been our mission for a while, and we now recognize that it has to be a stronger mission going forward after seeing such an uptick in services.”