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Emerging from the Pandemic Creates More Questions Than Answers

By Contributor June 9, 2021

An Anxious Transition

While the economic reopening is being called the ‘new normal,’ things aren’t back to normal, really — at least not by pre-pandemic standards. With COVID-19 still lingering, developments like the loosing of mask and gathering rules and a growing call for employees to return to the office have only ratcheted up the stress and anxiety among a broad swath of the population. In other words, for many, returning to the world as they knew it will be a gradual process.

By Mark Morris

In these unique times when COVID-19 is still active but in decline, we all have lots of questions about how to navigate daily life.

For example, if you have been vaccinated, should you continue to wear a mask? Why does the CDC say you can go without a mask, yet many public places still require one?
Should we still socially distance and sanitize in certain situations?

And, importantly, how much anxiety are such questions causing these days?

Answers can come from many places. Lauren Favorite, assistant program director with Behavioral Health Network, noted that, while information can be good, an overload of messages from different sources results in confusion.

“When we are bombarded with a plethora of information, it’s difficult for people to make a singular choice that will be the right one for them,” Favorite said. “Too much conflicting information can create anxiety.”

“Because so many people are not sure what to do, they will hold on to behaviors even when they no longer serve their intended purpose.”

BusinessWest spoke with several behavioral-health professionals who said much of the stress people are feeling right now is rooted in their concerns about how safe it is to go back into the world. Despite the May 29 reopening of Massachusetts, allowing everything from restaurants to sports arenas to fully welcome the public, Alane Burgess, clinic director for MHA’s BestLife program, said many people still do not feel safe going to the supermarket.

Alane Burgess says it’s always easier to learn how to be afraid than to unlearn that mindset.

“It’s always easier to learn how to be afraid than it is to be unafraid,” Burgess said. “Even when we’re told everything is OK, people still have questions.” As COVID-19 is a relatively new virus and scientists are still learning about it, continued concerns about personal safety are not surprising.

A recent research article looked at the trauma experienced by refugees after they emerged from a war-torn country. Favorite said their experience serves as a metaphor for these times.

“In the war zone, they had to develop certain habits and routines as a way to survive,” she said. “Once they escaped and reached a safe place, they held on to those behaviors because they didn’t know how else to act.”

All behaviors have a motivation, she continued, and the ones we followed to stay safe during the pandemic served us well. As we move beyond the pandemic, however, it’s time to examine if those behaviors are still serving us.

“Because so many people are not sure what to do, they will hold on to behaviors even when they no longer serve their intended purpose,” Favorite said. “I think many people will be in a sort of in-between place until we start to see a critical mass of vaccinations.”

Baby Steps

For many, entering back into the world needs to be a gradual process. Kathryn Mulcahy, clinic director for Outpatient Behavioral Health Services at the Center for Human Development, encourages her clients to start small.

“Instead of trying to do everything at once, I remind people it’s OK to take baby steps,” Mulcahy said. “You might not be ready to go out to the movies, but you can start getting back into the world by taking a walk in your neighborhood.”

As an incentive to go out again, Burgess advises her clients to make a bucket list of activities they are excited about doing again. “Making a list reminds people of what brought them joy before COVID and can help motivate them to get back to doing those things again.”

Lauren Favorite

“I think many people will be in a sort of in-between place until we start to see a critical mass of vaccinations.”

COVID also had a significant impact on the nature of work. Depending on the occupation, some people reported to work every day during the pandemic, while others followed a more hybrid approach of working at home some days and at the office other days. A third group has been working from home since last March.

Employers have begun asking Joy Brock, director of the CONCERN Employee Assistance Program, how to proceed as we move toward the end of the COVID era.

“Companies are struggling with how to translate all the different mandates,” Brock said. “They are having as much anxiety as their employees.”

According to the Massachusetts Attorney General’s Fair Labor Division, employers are allowed to ask if an employee has been vaccinated. In some cases, they can require vaccination in order to report to work. Exceptions are allowed for those protected by legal rights, such as individuals who have disabilities or those with sincerely held religious beliefs.

Brock said even those distinctions beg more questions. “What if I’m vaccinated, but the person next to me isn’t? How is that going to work with masks, social distancing, and other considerations?”

When there is no clear-cut direction, individuals usually figure out how to keep themselves safe. Brock said even modest steps to take control over one’s health can help reduce anxiety. “If that means you are the only one in the office wearing a mask, that’s perfectly fine.”

Finding a comfort level at work and in the world ultimately depends on the individual. Burgess emphasized that everyone is on their own journey, and it’s OK to move at a different pace than others.

“I advise people to be patient with themselves and not make any self-judgments just because their comfort level is different than their friends or co-workers,” she said.

One clear demand Brock has heard from workers involves flexibility in work schedules.

“For the most part, people have enjoyed working from home because it makes child care easier to manage, they have been able to match or exceed their productivity, and many report lower stress levels,” she said.

With that in mind, many employers are looking at a hybrid model and trying to figure out the right mix between working at the office and from home.

Kathryn Mulcahy

“Instead of trying to do everything at once, I remind people it’s OK to take baby steps. You might not be ready to go out to the movies, but you can start getting back into the world by taking a walk in your neighborhood.”

A return to the office also means remembering how to be a colleague. Even if co-workers talk remotely every day, Mulcahy said people can get out of the habit of face-to-face conversations.

“As silly as it sounds, practicing an in-person conversation with someone outside your bubble is one more way to prevent that overwhelming feeling of being thrown back into the workplace,” she explained.

Beyond water-cooler discussions, Burgess said a successful transition back to the office also requires companies to be tuned in to the apprehensions their employees may have. “It will be important for people to have an open dialogue with their employers about any anxieties or concerns they may be feeling.”

Added Favorite, “as a supervisor in the workplace, I’m having conversations with my staff to assuage their fears about coming back on site.”

Talk About It

One key to putting COVID behind us is recognizing what everyone has gone through since last March.

“For the past 14 months, we’ve lived in a world full of trauma,” Burgess said. “The idea that we can suddenly go back to the way everything was is an impossible task.”

Mulcahy said she has heard from people who are embarrassed because they feel stressed and anxious about returning to a more normal life.

“They feel like they should be happy and excited that people are vaccinated, but instead they just feel worried,” she noted. “I want people to know they are not alone and they can reach out for help to navigate these feelings; that’s why we’re here.”

Burgess also pointed out that life was different during the pandemic, and we should accept that we are not the same people we were before.

“Our life has changed, and we have changed in some of the ways we think, how we feel, and what feels safe,” she said. “It’s important to respect who we are today because that, too, is part of the process in getting back into the world.”

When everyone was forced to suddenly deal with a pandemic, it created anxiety for many. Now, as the pandemic (hopefully) nears its end, that creates anxiety, too. Those who spoke with BusinessWest agree that talking about this stress, and letting people know their feelings are valid, will go a long way to easing everyone’s anxiety.

After all, Favorite said, “we’re still learning how to be in a world where we don’t have to worry all the time.”

An Aging Baby Boomer Population Will Test the Healthcare System

By George O'Brien April 28, 2021

Business of Aging

Wave Dynamics

Since they started entering the world just after World War II, the Baby Boomers have influenced society in general, and the business community in particular, in all kinds of ways. The same is true when it comes to the healthcare sector, especially as the oldest members of this huge and proud generation turn 75. The impact of such a large and aging group can be seen in everything from hearing practices to the many facets of the long-term care system. And in some ways, COVID has provided a preview of what it is to come.

As she talked about the massive Baby Boom generation, how its oldest members turn 75 this year, and about how almost all the Boomers could now be classified as senior citizens, Dr. Maura Brennan summoned a phase she attributed to her mother, but which she uses often as well: “No one gets out of life alive.”

She used those words to convey the thought that, while this Baby Boom generation may in many ways be healthier than those that preceded it — fewer smokers and more exercisers, for example — and it has enjoyed access to better healthcare and innumerable advances in treatment, from artificial joints to improved cancer care, its members will eventually see their health decline, and they will need increasing amounts of care. And many already do.

“I don’t believe this generation, which I am part of, will readily tolerate limited access to the best care.”

While Brennan — a 70-year-old geriatrician and palliative-care physician — says people being able to live longer is in itself a success story, it has also become a challenge, for today, and especially tomorrow.

Which brings us back to those oldest Boomers, those born just after World War II, who turn 75 this year. That’s the age when, statistically, people begin to see their needs for healthcare increase, said Brennan, adding that, as one might logically assume, when a large number of people hit that threshold all at once, the system will be taxed — in all kinds of ways.

“As one might imagine, it’s going to impact virtually every sector and specialty, with the possible exceptions of OB and pediatrics,” she explained. “We’re going to see increasing numbers of older people; not all those folks are going to be frail and complicated, but there will be an increasing number of people with multiple medical problems.

Dr. Maura Brennan says the healthcare system is struggling to meet demand for direct-care workers, and the situation might get worse.

“The numbers and the complexity will rise,” she went on. “And it will impact every area of healthcare, with probably the biggest impact being in home care and nursing-home care because, personally, I don’t believe this generation, which I am part of, will readily tolerate limited access to the best care that’s going to allow them to stay in their homes and communities as long as possible.”

Mary Flahive-Dickson, chief operating officer at East Longmeadow-based Golden Years Home Care, agreed. She said the milestone age being reached by the oldest of Baby Boomers provides an opportunity to look hard at what’s in store for the healthcare system and ask the question: is it fully prepared for the challenges to come? And, if not, what needs to be done so it might be better prepared?

In many ways, Flahive-Dickson said, the COVID-19 pandemic has actually provided a preview of sorts for what’s coming as this large generation ages, with regard to everything from telehealth to the way the overall healthcare system was tested by sheer volume of cases and even vaccination efforts, to the manner in which the need for home-care services is growing.

During the pandemic, this need was fueled by growing fears of nursing homes and other senior-living facilities. Many of those fears still persist, but for Baby Boomers, by and large, the greater issue is simply wanting to remain independent — and in the home — as long as possible.

Eric Aasheim, a certified senior advisor and owner of Oasis Senior Living of Western Massachusetts, agreed. Aasheim, who assists seniors and family members through the complex process of transitioning from home to senior-living communities across this region, said the entire long-term-care sector will be tested by the aging of this generation.

“What I see, and what I worry about, is that the long-term-care system — and that includes in-home care, nursing homes, and assisted living — is just not ready for the sheer volume of patients and residents that they’re going to have,” he told BusinessWest. “And even though these individuals living longer and their resources are being depleted, there are so few places that have any kind of programs for low-income seniors. Unless something dramatically changes in terms of the number of assisted-living facilities that can serve low-income residents, there won’t be needed options for seniors.”

Meanwhile, besides sheer size and that sense of independence and not wanting to rely on others, the Baby Boom generation boasts some other characteristics as well, including what could be described as denial when it comes to getting old and admitting some aspects of their health have deteriorated.

“That’s not a disaster or a tsunami. That’s one of the greatest success stories in modern history; people are able to live longer and enjoy their lives better.”

And that’s why, even though she is generally seeing more patients than she was years ago, Dr. Susan Bankoski Chunyk, an audiologist, says she’s seeing a continuation of, and perhaps even an exacerbation of, an annoying trend whereby people will put off seeking help for their hearing years after they acknowledge they have a problem, due to lingering perceptions about hearing aids making people look old and feeble, even though modern technology has changed that landscape.

And that’s just one example of why there are still many question marks about how and to what degree this generation will present challenges and opportunities moving forward.

Age-old Challenges

Before getting into any real detail about the Baby Boom generation and its advancing age, Brennan wanted to set the proper tone for the discussion.

Indeed, she told BusinessWest that years, if not decades, of talk about a ‘silver tsunami’ have succeeded in casting discussion about the aging Boomers — and, again, she’s a proud, card-carrying member of that generation — in often-negative tones.

Mary Flahive-Dixon says most Baby Boomers want to age in place, in their own homes.

“This notion of the silver tsunami makes the aging of the population sound like an impending natural disaster over which we have no control that’s going to sweep everything away,” she said. “It feels to me, and most geriatrics leaders, like we’re framing things wrong; we’re setting this up as ‘us versus them’ — us young healthy, productive people against those old people who are going to overrun the system. These people are … us. They’re our neighbors, our teachers, our relatives.”

That said, a lot of ‘us’ are getting on in years. Indeed, maybe half or more of all Boomers can now get a senior discount at the movies, the golf course, and the pharmacy. And large numbers of them are now over 70, which means many aspects of the healthcare system — from eye care to urology; orthopedics to hearing care — are certainly already seeing an impact, and it will only grow as more Boomers reach 70, 80, 90, and beyond.

Restating the matter (again, she doesn’t want to classify it as a problem), Brennan said the Baby Boom generation is indeed large (it’s estimated that, by 2035, 10% of the population will be 85 or older; it’s closer to 6% now), and its members are living longer than the generations that preceded them, again, because of better health and better healthcare.

“That’s not a disaster or a tsunami,” she said. “That’s one of the greatest success stories in modern history; people are able to live longer and enjoy their lives better.”

That’s true, but so is what her mother said so often: that no one gets out of life alive.

“Some period of decline is going to occur for virtually all of us — unless we die in our sleep from a funny heart rhythm or get hit by a truck crossing Main Street,” she told BusinessWest. “And the causes of death in recent years have shifted; if you look back 50 or 80 years, the causes of death were frequently things like trauma, infection, death in childbirth — things that take you rather quickly when you were reasonably functional prior to that. That is no longer true. And with the successes we’ve had, and with people living longer, they are increasingly likely to die of multiple progressing chronic diseases.”

What does all this mean? Increasingly, Brennan said, people will need more care from more people as they age and approach end of life — a team-based approach, if you will.

“We’re going to have to think about care a different way because it’s not all about the doctors and the nurses,” she explained. “People will need hands-on home care, they’ll need symptom management, they’ll need direct-care workers who are grossly underpaid and overworked, and who churn through the system, with tremendous turnover.

“We’re struggling to meet those needs now, and it’s perceived to be, and is, a major problem,” she went on. “And if we do not alter the way we are paying, recruiting, supporting, and respecting those people, it will be infinitely worse. We’re going to need to restructure things, pay people differently, and offer them different kinds of professional development and career ladders that will make those positions more attractive; otherwise, we have a self-perpetuating situation. It’s the classic axiom — the system produces exactly the kinds of results it was designed to produce. If we don’t change the system, you get what you’ve got.”

Another issue that will have to addressed regards the number of specialists that will be needed to care for this larger generation of older residents, said Brennan, referring to geriatrics doctors, general nurse practitioners, social workers, pharmacists, and more.

Dr. Susan Bankoski Chunyk says people still put off seeking treatment for hearing loss due to outdated perceptions about hearing aids.

“As the number of older folks is increasing, the number of experts is not increasing, not one iota,” she told BusinessWest. “And, in fact, in some fields, such as geriatric medicine, the number of certified geriatricians has actually probably declined somewhat because we’re not replacing people who are retiring with equal numbers of new grads.”

The Shape of Things to Come

Flahive-Dickson agreed, noting that among the Boomers now in or approaching retirement are large numbers of healthcare workers. Replacing them and making the kinds of systemic changes Brennan mentioned will be just some of the many challenges facing the healthcare system moving forward.

Several of the others involve the growing trend of people wanting to age in place — and especially in their own home.

And this brings her back to COVID and what has been learned during the pandemic.

“More care was moving toward the home, basically as a result of general anxiety about facility care — about being in hospital, about being in a skilled nursing facility,” she explained. “Because of this crisis, we’ve seen more people want to get their care in the home.”

And this is a trend she expects will continue into the future as more people from this huge generation confront questions about the care they need and how and where they want it provided.

But questions arise from this supposition — many of them, in fact, including whether there will be enough providers to care for all those people who will want to stay in their homes, and also whether the payers are willing and able to adjust to a changing landscape of need and pay for services they currently don’t cover.

Again, Flahive-Dickson said the pandemic has provided an intriguing lens for looking at the problem — and the future as well.

“If COVID has done anything for us, it has previewed what is to come,” she told BusinessWest. “The pandemic has shown us that this surge in home care is a glimpse of the future. And it has provided this glimpse not only to healthcare professionals and the general population, but also to regulatory bodies, such as Medicare and Medicare Advantage.

“They have had to relax a lot of rules,” she went on. “As the Medicare population is continuing to grow, Medicare benefits haven’t caught up to that, and this is a huge problem. There are fewer than a dozen states that even offer non-medical home-care services to be paid for by a plan, and that plan is a singular plan, and that’s Medicare Advantage. In Western Mass., no one has a Medicare Advantage plan that offers the benefits of non-medical support, so it’s either out of pocket, or you have to qualify for one of the few programs that cover this.”

As for home-care workers, she said a number of demographic trends (Boomers generally had smaller families than the generations that preceded them) and other issues point toward individuals needing someone outside the family to care for them — and real challenges when it comes to having a steady supply of workers to provide that care.

That’s another lesson from COVID, she said, referring to the law of supply and demand, which was certainly exacerbated by a pandemic during which many had apprehensions about working in others’ homes.

“Fewer and fewer family members are capable of being a caregiver, either because there are fewer families, period, or … because family members might be on a different coast,” she explained. “Just because you grew up in Springfield doesn’t mean you stay in Springfield.”

Aasheim agreed, noting that these demographic trends are just some of the challenges facing the Baby Boom generation. Another is their own lack of preparedness for what is to come — financially and otherwise.

He said that only one individual in 10 has long-term-care insurance, and this is a matter to be addressed — just not when someone is 75 or even 65; those products have to be bought much sooner. Meanwhile, not enough members of this generation (and it’s not exactly unique in this regard) have their ducks in a row when it comes to needed documents — and needed preparation for poor health that often comes on suddenly and without much warning.

SEE: List of Senior Living Facilities

“What I try to focus on with the Boomers are the things they can do now, before that eventuality,” he explained. “This includes having discussions with your family about what your preferences are in terms of long-term care, gathering the documents together, getting power of attorney and a healthcare proxy, all those things. That’s what I hammer away with them — get that stuff done now, while you’re still healthy and you have the energy and the mental capacity to deal with it, so your family doesn’t have to handle it in crisis mode a few years down the line.”

Unfortunately, he said, many don’t heed this advice.

“They all nod when I talk to them in these presentations, but are they going home and getting that stuff together? My thought would be, probably not,” he went on. “Because most of the calls I get are from people who are in crisis mode.”

Bankowski Chunyk is another who wishes that more Boomers would heed some advice. Or at least listen to family members telling them they can’t hear as well as they used to, and should do something about it.

She told BusinessWest that the hearing industry talked a lot about the Baby Boom generation years (make that decades) ago, and how its size and advancing age would comprise a great opportunity for audiologists, one they should be prepared to seize.

Bankowski Chunyk did prepare, but she said the wave hasn’t been nearly as big as all those experts predicted it would be, largely because of … well, human nature, as well as lingering perceptions about hearing aids and what they say about those who wear them.

She said data shows that, between 1989 and 2019, the average age of an individual being fitted for a hearing aid for the first time fell from 66 to 65.

“I’m not sure a lot of progress was made getting people to address their hearing,” she said with some sarcasm in her voice, adding that, while there are certainly more people of that age than there were several years ago, sheer volume is not creating the immense opportunity that was predicted back in the ’80s and ’90s.

Whether it will materialize eventually or not, she doesn’t know — but she does know the Boomers are perhaps more vain when it comes to hearing aids than the generations that preceded them, so her industry has some work to do to change those perceptions.

Bottom Line

Perceptions are not the only thing that will have to change if the Baby Boomers, and those in the healthcare system who will care for them, will adequately manage this sizable demographic shift.

Brennan is right when she warns about this challenge becoming an ‘us versus them’ scenario, but she’s also right (and her mother was right) when she said that no gets through life alive.

As this generation ages, it will present enormous challenges to a healthcare sector that in many ways seems unprepared for what’s coming. That’s evidenced by the number of comments that began with the words ‘if things don’t change’ — comments referring to everything from workforce to accommodations for low-income seniors.

Only time will tell if things will, indeed, change. What is known is that the Boomers, as they have at every other phase of their life, will alter the landscape as they reach 75 — and beyond. And in all kinds of ways.

Pandemic Ratchets Up the Stress on Kids, Teenagers

By Joseph Bednar April 14, 2021

Health Care Special Coverage

Youth in Crisis

Let’s face it — the past year of COVID-19 has probably been tough on you, in any number of ways that weigh on your peace of mind. But what about your kids? How are they doing? And … do you even know? That might seem like a flip or aggressive question, but a group of local teenagers who have been talking to public-health leaders about the issue say their parents aren’t fully hearing them when it comes to the impact of the pandemic. And that impact, in many cases, has been worrisome.

Alane Burgess began by stating the obvious.

“It’s not normal for kids to be home all the time.”

As clinic director of the BestLife Emotional Health & Wellness Center, a program of MHA Inc., Burgess is one of many healthcare professionals keenly invested in how the COVID-19 pandemic has impacted young people. And the picture is worrisome.

“They like to be out. They like to socialize. Most kids like to be with friends,” she said. “COVID forced isolation on a lot of people; they haven’t been able to go to school, to socialize, to be involved with activities they once loved, like sports. Community spaces haven’t been open.”

It’s not surprising, she added, that this isolation has contributed to an uptick in anxiety, depression, frustration, and a tendency to act out in negative ways.

Indeed, according to the Centers for Disease Control and Prevention, between April and October 2020, hospital emergency departments saw a rise in the share of total visits from childen for mental-health needs. Nationwide numbers on suicide deaths in 2020 are still unclear, but anecdotal evidence suggests an uptick.

“Kids are excited to go back and see their friends and have some sense of structure, to be in society again. But there are definitely a lot of adjustments to be made.”

But here’s the less obvious reality, Burgess noted: while the pandemic may be (and that’s may be) on its last legs and schools and other gathering places are slowly opening back up, that doesn’t mean the stresses of the past year will just fade away.

“Kids are excited to go back and see their friends and have some sense of structure, to be in society again,” she told BusinessWest. “But there are definitely a lot of adjustments to be made.”

When COVID struck, she noted, the shifts were quick and unplanned — kids were suddenly learning at home, and many of their parents were suddenly working there. It has been a challenging time, particularly for working parents with young children who need help with school.

But transitioning back to whatever will pass for the new normal poses its own challenges, she said. “It was originally going to be two weeks, and weeks turned into months, and months became a year. Now, they’re going back out into a world that’s changed; it’s not going to be the same — there will be masks and social distancing and limitations on clubs and activities.”

Tamera Crenshaw says barriers to accessing mental healthcare are myriad.

Socially, certain young people — those with a more introverted personality — found they thrived in the remote setting, and are anxious about returning to campus, Burgess added. Others found the home setting to be an escape from bullying, and are palpably fearful about going back.

Meanwhile, some students, depending on how rigorous their remote-learning experience was, might find themselves overwhelmed or feeling academically behind as teachers play catch-up. Many students report coasting to passing grades, even very good grades, while feeling they haven’t been learning much.

And the economic struggles affecting many families who lost income or jobs — a definite stressor on kids — certainly aren’t over.

Tamera Crenshaw, a clinical psychologist and founder of Tools for Success Counseling in Longmeadow, said she’s especially passionate about mental health in minority populations, a demographic disproportionately affected by mental-health issues — because, again, those issues tend to be exacerbated by factors like economic stress, which have also landed hard on those populations during COVID-19.

Even remote learning has been a greater problem for communities of color because of issues of technological access and family strife over financial matters, she added. “Home isn’t necessarily the most conducive learning environment — and COVID just exacerbated it.”

An uptick in suicidal ideation is especially concerning, Crenshaw said. “Someone can have a baseline of thought, but when kids are actually expressing a plan or intent, it’s scary. And we’re definitely seeing an increase.”

Some of the factors are typical stressors on teens in any given year, but despondency has certainly been driven by greater economic instability, which can raise tension and anxiety in the home, as well as two competing factors: a longing to end a year of isolation and get back to school, and health fears about the safety of doing so, especially for kids who know someone who has died of COVID.

“These kids have not been forgotten, but even with a vaccine, they’re going to be vaccinated last,” she noted. “I can’t imagine there’s not a fear of going back into the school environment when they haven’t been vaccinated.”

The issues are deep and complex, and solutions aren’t easy. But, like most others in the mental-health field, Crenshaw says the first step to helping young people take charge of mental-health issues is clear and simple.

“You’ve got to name it.”

Start the Conversation

That means breaking through societal stigma surrounding these struggles.

“My mission is to destigmatize mental health,” Crenshaw said, noting that several factors contribute to that stigma and the resulting reluctance to seek help. “I want to help debunk that stigma.”

Beyond attitudes toward mental health, another barrier is financial — the challenge of accessing insurance that will pay for treatment, or, for those who don’t have it, navigating out-of-pocket costs while already struggling economically, she added.

“It was originally going to be two weeks, and weeks turned into months, and months became a year. Now, they’re going back out into a world that’s changed; it’s not going to be the same — there will be masks and social distancing and limitations on clubs and activities.”

A third factor is religious belief, specifically a belief by some churchgoers that mental-health professionals are at odds with faith, or that faith makes such help unnecessary. “We’re trying to educate churches and knock down that barrier,” she said. “I’m a woman of faith myself.”

Another factor is the simple fact of how few therapists of color are working today. Crenshaw’s team is largely women of color, but her practice is an exception — which is unfortunate because she knows people of color will often have an easier time trusting someone right off the bat when they can relate to them or see themselves in them.

This last factor might be a long-term struggle to overcome, she added, noting that she teaches classes in her field at Westfield State University, and none of the 17 students currently in one of her classes is a woman of color.

In fact, the mental-health and social-work fields in general are in need of more talent, said Jessica Collins, executive director of the Public Health Institute of Western Massachusetts (PHIWM). She agreed about the access issue as well, noting that mental health should be a basic support, not something available only for people who can pay for it — especially when families who can’t pay are often in greater need of those supports.

Recognizing the importance of these issues among young people, before the pandemic even began, the Public Health Institute facilitated the formation of a youth mental-health coalition in Springfield — one that brings to the table direct service providers like BHN and Gándara, Springfield Public Schools, local therapists, and, critically, a group of 11 teenagers who meet regularly.

The question at the center of the initiative is simple, Collins said. “How do we best support kids? It might sound basic, but it’s fairly new; there has not been an emphasis on the mental health of kids except in extreme cases, where the kids have to go into inpatient care.”

One takeaway so far is that teens don’t feel fully heard by the distracted adults in their lives.

“What we’re hearing, loud and clear, from our young people is, when they talk to adults, adults are not skilled at supporting them,” Collins said. “Adults are stressed, adults are stretched, and that just adds to this epidemic of young people feeling hopeless and alone and unsupported.”

That’s why the Public Health Institute is talking about what kind of training adults — those who work in preschool and school programs, but also parents — might need to learn how to better listen to young people and work through and respond to what they’re hearing.

Jessica Collins says parents sometimes get so stressed, they don’t realize how stressed their kids are, too.

“These big direct-service providers are really competitive, so to get them in a room to talk about how can we work together to better support families, instead of just competing for them, that’s fairly new,” Collins said, adding that Daniel Warwick, Springfield’s superintendent of Schools, has also been on board with efforts like this for a long time.

For example, when he saw a 2017 report by PHIWM about the hopelessness felt by local teens who don’t identify as heterosexual, “he was so upset about that, a few years ago, he mandated some training for all Springfield public-school adults to better support kids who are LGBTQ+.”

Take It Seriously

That’s a good example of listening to young people and then taking them seriously — which is one way to normalize mental-health needs, Collins said. “If you can’t talk about it, you can’t figure out for yourself what you need.”

And one thing young people need right now is reconnection. While many kids are tired of the technology-only avenues for connecting with friends, Crenshaw said, Zoom calls, text chats, and the like have been an overall positive in staying in touch. But she also encourages kids and families to take opportunities to see friends and loved ones in person, in a safe manner, when possible.

“You can go to the park; you can go outside with a soccer ball, wear your mask, and connect. Some families have said, ‘we can’t do this alone,’ and became part of each other’s bubble, taking turns doing homeschooling. We encourage these ways of connecting with each other.”

And don’t give up on trying to talk to your kids, Burgess said, even when they don’t feel like talking back.

“The most important thing any parent can do during these times is open a dialogue with their children and allow kids to have open communication,” she said. “What are they thinking? What are they feeling? Then we can guide them and help them through their own resiliency and make adjustments.”

Families can help combat their kids’ isolation, she said, by planning quality family time, even if it’s just having dinner together, around the table, every night, or scheduling a family game night every week. Those moments, she noted, can naturally help kids let their guards down.

“You want to have that quality time, that open communication to talk and listen to your kids and ask, ‘how are you feeling? What’s going on? What can I do to help make things easier?’ Sometimes, as a parent, we’re not able to say ‘yes’ to everything, but we can look for compromises and help kids make some of the decisions.”

The problem in identifying signs of distress, Crenshaw said, is that teenagers, even on their best days, often prefer to be isolated, or present a sullen demeanor. So how can parents separate normal teen ‘attitude’ from real warning signs?

“Are they communicating as much with you, or are they isolating in their rooms moreso than normal? Are they eating normally?” she asked. “Even prior to COVID, parents would say, ‘I didn’t know there was a problem — I thought that’s how kids are.’”

It doesn’t hurt for parents to simply ask their kids, directly, how they’re feeling, what’s working or not working in their lives, how school is going, and if they’re feeling more anxiety than usual. “If a teen is isolated in their room, that could be typical teen behavior, but maybe not.”

Physical signs may be visible, too, Crenshaw said, noting that cutting — what’s referred to in her field as ‘self-injurious behavior’ — and eating disorders are more common than some parents think.

But more often, the signs are subtler. “It’s just really knowing their disposition and what they’re involved in.”

Burgess said it’s important for parents not to go it alone if their gut tells them something is truly wrong.

“If you notice your kid struggling with severe signs of depression — really isolating, really struggling — definitely seek professional help. If your kid is talking about suicide or even just having a hard time getting back into interacting or adjusting, seeking professional help is always key.”

In the end, coming out on the other side mentally healthy — and that goes for parents and children alike — will take patience and resilience, Burgess added.

“There’s no guidebook for this. There’s no ‘COVID for Dummies’ book. We’re all doing the best we can to adapt. We’re all just going through an unprecedented time.”

Joseph Bednar can be reached at [email protected]

Emerging from the Pandemic Creates More Questions Than Answers