Caused by higher numbers in unemployment, reduced access to care and ongoing discrimination, the mental health and wellness of queer people is a growing casualty in the coronavirus pandemic. For many, COVID-19 is just another stressor on top of an already difficult mental health situation.
“Mentions of the pandemic have increased more than 60 times since lockdowns began and now comprise more than a quarter of crisis services conversations,” said Rod Todaro from The Trevor Project. The volume of calls to the organization has increased, at times spiking to more than double volumes earlier in 2020.
He points out the increasing themes of isolation and anxiety, along with concerns about economic insecurity and fear of having or getting COVID-19. A recent report from Harvard Medical School found that minority stress contributes to higher risk for a number of health problems in LGBTQ communities. The report adds loss of work and income, school closures, reduced access to care and reduced access to legal protections to the long list of stress-inducing factors.
Some coronavirus-led changes are showing positive results, however, and might create innovation in the field that results in greater accessibility and support systems in the long term.
Time Out Youth Center reported earlier to qnotes that it had seen a drastic increase in its attendance since shifting to virtual programming. When a young person can go online or access a Zoom call with their cell phone in the security of their bedroom, it can make a huge difference in the ability to connect with others.
Prior to the coronavirus, Medicare and many insurance companies were not covering telemedicine or telehealth services. “Most insurance companies follow suit with what CMS (Centers for Medicare & Medicaid Services) does,” says Jacob Hamm, founder of ProHealthDesk, an administrative support and billing company for behavioral health providers.
The Trump administration announced on March 17 the expansion of Medicare telehealth coverage enabling beneficiaries to receive a range of healthcare services from their doctors and temporarily softened the requirements imposed by federal HIPPA law. The virus broke through the bureaucracy that had stifled innovation in the field for years, and Hamm thinks that much of that change is here to stay. “In the future, what we’re going to see is that the patients are going to ask for it more and more,” he says. “Patients are customers to the insurance company and if they aren’t offering a product they can sell to patients, they’re not going to buy it.” That is likely to drive further innovation in technology and healthcare to make them more secure and fit the needs of the system.
That innovation can mean more accessibility for working-class people and more support when it’s needed most as well. According to ProHealthDesk, they have seen a jump in nearly all of their behavioral health claims, which means business is booming for the industry, and it is not just due to the added stressors. There’s definitely a convenience factor.
It can eliminate the need to take time off from work, for example, just to go to the doctor. “Even before COVID-19, it was difficult to schedule time to make an appointment and go sit in a doctor’s office and schedule the time to drive there and drive back,” says Hamm. “Now, a patient can go sit in their car on FaceTime. They literally can walk away from their desk at 3:55 p.m., have a 4 o’clock session wherever they choose to be and then go back to their desk. It’s much more convenient from a patient perspective.”
“When people are in their own environment, sometimes that is itself a new positive,” says Dr. Daniel Stilwell from Thriveworks in Charlotte. “When it comes to the queer community (in particular) a generic therapy office in many ways can’t be too queer. Having clients have their own stuff around them increases some of the comfort level.”
Thriveworks was doing some telehealth work before the pandemic, but perception and discomfort of the technology had limited the request from patients. “It’s really opened up a lot of possibilities that are going to help make sure we have a greater diversity of care options,” says Stilwell. He points out that for some clients, health-related issues or access to transportation had limited their ability to get help. “This has opened up the possibility for them to be more included and honestly anytime we’re better at inclusion, we’re better at queering our spaces.”
Pride Support Services of Charlotte, a new non-profit in the area, is offering online support groups to stay connected. Started by Ray Castillo and Xavier Laporte-Sanchez, the group launched just a few months before the shelter-in-place with a goal of creating a resource to connect wrap-around health and wellness services for the LGBTQ community. “We reinvented ourselves early on and moved into doing our live sessions,” says Laporte-Sanchez. “We bring all of these other people into the conversation who are either experts in the topic or just have lived experiences, and we always like to close our ‘lives’ by asking our panelists to give some words of encouragement to people who are going through a tough situation.”
From community groups on Facebook to new telehealth counseling options, behavioral health is advancing from the benefits of creativity but most importantly from a passion within those in the industry that value taking care of each other during difficult times.
“If someone does feel alone or isolated, they’re not alone and there are people along for the ride and they can support each other,” says Stilwell. “Whether that’s a spiritual version of that or just a Facebook group where we talk about our favorite cats. It doesn’t matter — anything that can help remind us that we’re part of a larger collective is healthy.”