A ‘slow-motion disaster’: SC calls to mental health hotline surge during coronavirus

This story was produced in partnership with Columbia Journalism Investigations, the Center for Public Integrity, The Island Packet and Beaufort Gazette.

In September 2018, Hurricane Florence dumped record rainfall on coastal South Carolina. Nearly half a million people evacuated. Over 11,000 homes sustained at least moderate damage, and losses totaled $2 billion, according to the National Hurricane Center.

That month calls to the federal Disaster Distress Helpline originating from phones with South Carolina area codes reached their highest level in the past four years.

In April, as the COVID-19 pandemic prompted a statewide lockdown, they spiked even higher, part of a national surge in outreach to the crisis mental health hotline, according to data obtained by the Center for Public Integrity and Columbia Journalism Investigations and shared with the newspapers.

Combined monthly calls and texts from S.C. phones surged over 1,300% between February and April of this year, the data show, breaking records set during eight years of hurricanes, flooding and other natural disasters in the Palmetto State. (The data don’t track the geographic location of callers, only their area codes, meaning these numbers represent an approximation of outreach from South Carolina residents.)

The helpline, 800-985-5990, run by the Substance Abuse and Mental Health Services Administration and the nonprofit Vibrant Emotional Health, answered almost 10,000 calls and received roughly 29,000 text messages from across the country in April, a more than twelve-fold increase from February, before the coronavirus was widespread in the U.S.

The national flood of outreach recorded by the helpline during the COVID-19 pandemic is unprecedented in its roughly eight-year history, the data show.

The hotline runs 24/7, 365 days a year and provides crisis counseling and referrals to those experiencing emotional distress related to a human-caused or natural disaster, according to SAMHSA.

“With the virus going in full force, that adds stress to everybody,” said Bill Lindsey, executive director of the National Alliance on Mental Illness in South Carolina.

Since mid-March, more than 450,000 people have reported losing their jobs in the state, according to the S.C. Department of Employment and Workforce. Not being able to pay rent, afford utility bills or plan for the future only worsens pre-existing mental health issues, Lindsey said.

“This feels different, and it is,” said Roxane Cohen Silver, a professor of psychological science, medicine and public health at the University of California, Irvine.

“This is an invisible threat: We don’t know who is infected, and anyone could infect us. This is an ambiguous threat: We don’t know how bad it will get … we don’t know how long it will last. And this is a global threat: No community is safe,” she said.

A ‘slow-motion disaster’

Sarah Lowe, a psychologist and assistant professor at Yale School of Public Health, calls the coronavirus a “slow-motion disaster” with potentially widespread and persistent mental-health fallout.

Lowe, who studies the effects of disasters, said she worries that some people will be disproportionately affected, particularly medical workers, the sick, those with pre-existing mental illness and anyone facing economic challenges.

“We know from previous disasters that long-term financial strain tends to be associated with depression and PTSD,” she said.

Dozens of studies link psychological burdens with isolation and crisis, including epidemics. In one study of Hong Kong’s 2003 severe acute respiratory syndrome outbreak, nearly half of surveyed residents said the experience weighed on their mental health. Sixteen percent showed signs of post-traumatic stress disorder, or PTSD, six months after the outbreak ended.

South Carolina officials have moved to maintain psychological support during coronavirus lockdowns. After psychologists and counselors voiced concerns about the lack of reimbursement for teletherapy appointments, the state expanded online counseling coverage for Medicaid beneficiaries, following similar actions from neighboring Georgia and North Carolina.

On the federal level, the U.S. Drug Enforcement Administration is now allowing doctors to prescribe medications without having to first meet a patient face to face.

In early May, SAMHSA said it had awarded $375 million in emergency mental health and substance abuse grants to states and local organizations, including almost $2 million to the S.C. Department of Mental Health. But that amount is just a fraction of the $38.5 billion major mental health organizations estimate will be needed to save existing treatment infrastructure from financial collapse.

S.C. helplines see surge in calls across the board

In addition to the federal Disaster Distress Helpline, other mental health hotlines have recorded a surge in calls from South Carolina residents, including the National Alliance on Mental Illness’ helpline, 800-950-6264.

“Our calls to the helpline have spiked,” said Lindsey, who pinpointed the beginning of the surge around March 10, days before S.C. Gov. Henry McMaster declared a state of emergency in the state. Lindsey compared the surge to the period following the Sept. 11 terrorist attacks, when NAMI’s support groups filled with new participants.

Before COVID-19, 150 calls would be a big day, said Dawn Brown, national director of the NAMI helpline. Now, it’s surpassing that number daily.

“People with mental illness require a great support system,” Brown said. “They don’t do well with uncertainty and ambiguity, which this has certainly caused. Just when you think you’ve got a handle on it, something else happens, whether it be a shelter-in-place order or more news coverage talking about death and shortages.”

Lindsey said NAMI is referring many South Carolina residents to The United Way’s 211 resource hotline. Financial strain and mental health are connected, he said.

Since the beginning of the pandemic, 211 has recorded a 500% increase in callers worried about access to food and a doubling of request for utility assistance statewide, Sara Fawcett, president and CEO of the organization’s Midlands chapter told The State on April 20.

And the number of people taking a free screening test for anxiety offered online by the advocacy organization Mental Health America is up more than 20 percent from mid-February through mid-March, compared with the early part of the year. That’s the COVID-19 effect, said Paul Gionfriddo, the group’s president and CEO.

He’s worried the country may be underreacting to the mental-health toll. “And it’s only going to get worse as we have to bring widespread grieving into the equation as more people die,” he said. “Because people will be grieving alone.”

Where to turn for help

Mental health professionals have published recommendations for people experiencing stress, anxiety or depression. NAMI’s COVID-19 guide suggests setting limits on news consumption and sticking with reliable sources. The organization also recommends trying to follow a daily routine: getting dressed, exercising and making time for sleep.

People should stay connected with social networks at a distance, the organization says. “People with mental illness tend to isolate already,” said Lindsey, with NAMI’s S.C. chapter. With enforced isolation in place, social contact is important, he said.

In addition to the helplines cited in this article, South Carolina residents can turn to the following resources:

• Support groups are run by NAMI’s local affiliates across South Carolina. Many are being held virtually during the pandemic. The organization also publishes region-specific resource guides.
• The Crisis Text Line offers immediate connection with a crisis counselor. Text HOME to 741741.
• The National Suicide Prevention Lifeline is available 24/7 at 800-273-8255 for free and confidential support.
• The S.C. Department of Mental Health Community Crisis Response and Intervention Team can be reached at all hours, statewide at 833-364-2274 for emergency psychiatric screening and assessment.
• Many individual mental health providers are doing therapy online and can work with different kinds of insurance. Some therapists also work on sliding fee scales for the uninsured.

Reporting used in this story came from Dean Russell, a reporting fellow for Columbia Journalism Investigations, and Jamie Smith Hopkins, a reporter and editor at the Center for Public Integrity, a nonprofit investigative newsroom in Washington, D.C. Read their national story on the same topic here. The Island Packet and Beaufort Gazette localized data and reporting in South Carolina.

Lucas Smolcic Larson

The Island Packet

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Lucas Smolcic Larson joined The Island Packet and Beaufort Gazette as a projects reporter in 2019, after graduating from Brown University. His work has won Rhode Island and South Carolina Press Association awards for education and investigative reporting. He previously worked as an intern at The Washington Post and the Investigative Reporting Workshop in Washington D.C. Lucas hails from central Pennsylvania and speaks Spanish and Portuguese.