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Every day, hundreds of sick and injured patients walk into free and charitable clinics around the Tampa Bay area in need of a doctor.Many are suffering from chronic conditions, such as diabetes or high blood pressure. Some patients were referred to the clinics by staff at hospitals where they landed after years of neglecting to care for treatable conditions.The clinics allow the patients to pay what they can, or nothing at all. They are staffed by doctors and nurses who volunteer their time. They survive off donations and small grants.Many of the patients have jobs but they are living paycheck to paycheck. None have health insurance, either because they do not qualify for Medicaid or can’t afford private coverage. For these patients, the clinics are often their only option for primary care.

Florida Matters: Coronavirus, Isolation And Mental Health

Clara Reynolds, in red jacket at front, greets Hillsborough Sheriff Chad Chronister during a visit to the Crisis Center headquarters in 2018
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

We're all living in a whole new world out there - the world of COVID-19, coronavirus or social distancing. Whatever you call it, it's a world of isolation.

The changes in our daily routines and the resulting isolation can affect people's mental health in a lot of ways. Whether you're home alone, with a sick family member or with kids out of school - isolation can increase stress and anxiety.

So just what is happening out there? And is there anything we can do about our mental health? On this week's Florida Matters, we get a little insight from Clara Reynolds, president and CEO of the Crisis Center of Tampa Bay.

Clara, have your phones been ringing off the hook lately?

Our phones have been ringing beyond off the hook. I mean, let's just call it that. We started tracking COVID specific-related calls, starting the week of February 29. And since that time, when we started with 14 calls from individuals who are really concerned about how this virus was going to impact them or their family members, we are now at a place where we're getting anywhere in excess of 700 or 800 calls a week specifically related to COVID-19.

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And a variety of issues. What started off as folks being stressed and concerned for their friends and family has absolutely transitioned to financial concerns. How am I going to keep the roof over my head? How am I going to feed my family? How am I going to teach my kids and try to work a full time job?

And so all of those things have really impacted the individuals who are calling us for help and support.

Do you have enough people to handle these calls? And are you able to devote enough time to these "everyday" problems that people have, on top of what we're seeing right now with the coronavirus?

Last week, we had 1,758 calls that came in - of those, 678 were specifically related to COVID-19. So you can see we still had over 900 individuals calling us for different needs and we're still able to provide for all of them.

One of the things that we are seeing for the very first time though, is people having wait times in our queue system. Our goal is to answer 85% of the calls within 30 seconds or less. And I will tell you that the call answer rate has decreased somewhat. And the amount of time that folks are having to spend on the phone has increased to the point that we've had to implement a callback feature.

We are experiencing tremendous call volume. If you want to hold your place in the queue, then we can go in and call you. So we've had to employ that for the very first time understanding though, that suicide calls take precedence over any call.

So if there's a suicidal caller that is calling on the 800 number, those get top priority, we will meet those needs immediately. But it is definitely stressed.

I definitely don't have enough people. This is not a job though that you can just take an average person off the street to come in and do this. Vicarious trauma is something that we deal with in these calls. When you are reaching out to call to us, you are at your wits' end. So this requires a lot of training, a lot of supervision to make sure that we're taking care of the caller, as well as the person answering the calls.

You mentioned the big increase in the number of calls about financial problems. I would imagine a lot of these people are laid off of work. They're restaurant workers, people who work in small businesses, and on top of being stuck in their homes and not having a lot of contact with the world, they're cut off from their job, their work. How difficult is it to deal with people like that?

We spend a lot of time with callers talking about the need for self-care. What do you do that brings you joy? And so often the things that do that for individuals like being able to go out with friends, maybe going to a movie, we just can't do them right now. So we're having to help folks think about, okay, what are some other ways that you can take care of yourself help you to make yourself feel better in this very enclosed environment?

And so looking at (things like): do you like to read? Do you like to sew? Do you like to cook? Can you get out and just take a lap around your apartment complex or around your neighborhood? Are there ways that you can create those opportunities that are different from what you've done in the past, but maybe can bring you some joy?

We want to remind everybody that while this is a very, very serious virus, we're all in this together. And we're going to get on the other side of this. But in the meantime, we all have to take ownership for doing whatever we need to do to keep ourselves safe, to keep ourselves grounded, keep our families together. And so we're brainstorming around other ways that folks can find those places, those outlets during a very stressful time.

Clara Reynolds
Credit Crisis Center of Tampa Bay
The Florida Channel
Clara Reynolds

A lot of the tips I've been reading up online are like, all right, we've got all this free time now. So finally you've got time to do the things you've always wanted to do, right? Learn a new language, write that big novel that's been rolling around in your head, learn to play the piano, when people hear things like that, right? And maybe they just can't get up that kind of energy renew their lives, is that unrealistic? And can that lead them to feeling like they're a failure?

Oh, absolutely. I will tell you even being in the office myself, I kept thinking the same thing of, oh, I'm gonna have all this time.

I'm emotionally drained. This virus has taken its toll, I think emotionally, on everybody. And I think that's one of the other messages that we tell callers. It is perfectly normal that you are exhausted, it is perfectly normal that your sleep is disrupted. All of these things are normal.

So don't expect yourself to be the super person. Don't expect yourself to suddenly take on all of these projects, and then consider yourself a failure because you don't have the energy to do that. It takes a lot of emotional energy, to be able to be isolated every single day, to listen to the media talking about this virus every single day, it takes a toll on individuals.

So we tell folks, you know what, let's talk about some really small wins - you want to clean out a closet, you don't have to start with the 500 square foot closet, maybe you just clean out a drawer first.

Because success in the small things will then give you the energy to take on some of the bigger things. So we really encourage folks, don't think that you're going to write the big novel, as you mentioned, maybe it's just I'm going to sit down and actually type a few words today. That's going to be my goal.

Create little goals every single day, but make them small enough that you're going to be able to achieve them. Because those successes will then help give you the emotional energy to be able to take on larger ones moving forward.

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It's kind of like training for a marathon. You don't go out and lace on your shoes and run 26 miles in a day. Maybe it's you lace up your shoes and you step outside the door. Whew, that's day one. But creating those small wins, not only will help you develop the stamina to be able to do it, but it's also going to help you to feel better because you've accomplished something.

Our children haven't been in school since before spring break. And the governor just extended the closing of brick and mortar schools for the rest of this school year, which means a lot of parents not only have the social isolation, but they're basically stuck inside their homes with the kids until the fall. What advice can you give these harried parents of this too shall pass?

Yeah, I'm in that same boat. I have a high school junior. And so I completely support and commiserate all of those words with all of the parents out there that are trying to do a multitude of jobs that they never thought they were going to have to do: being a remote workforce. Now you're a part-time teacher. You're also the cheerleader. You're also the sports coach. You're the music instructor. You're the dance instructor. You're all of these roles now that you've never thought you'd have to do.

What we tell parents is you can only do what you can do. There is no expectation that you're going to replicate a six hour school day while these children are at home. There's just no way that you can dho it. Sitting down with your children and having some conversations with teachers as well as going, okay, what realistically are we going to be able to accomplish during this time, during this day, during this week?

And for those of us that do have children that enjoy video games, some of it is going to be okay, we're just going to have to let some of this go, because video games are not just an outlet for their creativity. For many of them, it is the only way that they are able to interact with their peers.

Don't expect that you're going to replicate the perfect classroom environment for your kid, oh, you're not the additional way you can do it, you're going to do the very best that you can. And everybody recognizes that families are going to do the very best that they can with the resources that they have available.

Maybe kids are more resilient than parents or their parents have these routines that they're so locked into. It's harder for us to deal with these unexpected changes that we can't control.

Yes, while on the outside, kids may be doing okay, and they may be vocalizing that they're doing okay, but I think it's really important to look at those nonverbal cues. Is your child eating more than they normally do, is their attention span longer or shorter than it normally is, are you sure that they're getting full sleep?

So it may be that while on the outside, they're like, yeah, well, things are cool, everything's great, you may want to make sure that you're looking for those additional nonverbal cues and talking with your child about it. Kids are resilient, they are very adaptive.

But if they don't think that you're in a place where you can handle hearing anything else, they will internalize a lot of things that will come out in their external, come out in eating, sleeping, socializing, those kinds of things. So I think having these dialogues are really important with your children of all ages.

And again, you think about our seniors, they are experiencing something that no senior class has ever had to experience. And such a tremendous loss of a celebration of a milestone in their life and trying to help these kids be able to cope and deal with that, I think is so important as well, and I think it's important for all of us as parents to recognize. But this is impacting our kids, even if they don't have the verbal language to talk about it.

Some estimates are 30% to 40% of the working populace out there have lost their jobs. And a lot of these people are poor, they don't have the education to just pop into another job. Basically, they're living paycheck to paycheck. What can you possibly tell these people to tell them to hang in there?

Yeah, that's a big piece of what we're doing. Thinking about some of the stories that we have gotten here at the Crisis Center of Tampa Bay - we received a call from a woman who was concerned about housing, she had been living with her mom, her mom passed away. The housing was about to be foreclosed on. So she was calling us in absolute desperation. She was calling us about the housing. But as you kind of went through the story, you understood that it's much more than housing.

Yeah, this is a woman who's lost her mother, who's not going to be able to bury her in the way that she would have wanted to be able to do. Turns out her husband was a veteran. And so we were able to quilt together some veteran services that they normally wouldn't have thought that they'd be eligible for or need. But that was the key to getting into housing.

And so I think when callers call us in their hour of desperation, what we're doing is we're brainstorming with them about, okay, what are some things about yourself that you may not have thought about, like the fact that you've got a family member who's been in the military, you suddenly now are eligible for services and supports that you didn't even realize that you were. So that's a lot of the work that we're doing.

We're also seeing callers though that would never have considered themselves poor, that maybe are making $200,000 or $250,000 a year, but they've lost their job at the beginning of this. They don't have the savings, and they're not eligible for stimulus checks. They're not eligible for a lot of these other social services.

So we're having to really work with them to think about, okay, what are some transferable job skills? What i\does your network look like? Is there an opportunity for you to maybe barter or trade, working with your landlords working with your mortgage companies? Let's talk about the language that you need to use with your mortgage company or with your landlord so that you can stay in your house. Once you're in your house. Let's not worry about that. Let's worry about how we're going to now deal with TECO.


But the key, honestly, is that you're giving people hope. That's one of the most important things that we can give each of these individual callers, because folks are calling us in desperation, they don't have any hope. And if you don't have hope, you're not going to be able to get yourself out of the situation that you're in.

So we are working to build on those blocks of hope. And those blocks will build one on top of the other on top of the other, to get folks to a place where they can think beyond this crisis that they're in right now to the potential and the possibilities that do exist.

Suicide has been associated with tough economic conditions, including unemployment, are we seeing an uptick in calls about this?

So I will tell you last week we had 48 suicide calls just related to COVID-19. We will typically get here at the Crisis Center between eight and 10 calls every day from people here in Hillsborough County who are contemplating suicide, they're along that continuum. They're either thinking about it or in some cases, they've actually gone ahead and swallowed a bottle of pills, and we're actually going to do active rescue with them.

We have not seen a spike, why, we believe because people are just dealing in the crisis of the moment, the economic crisis, the food crisis, all of those things are taking precedent right now.

However, when we get on the other side of COVID-19, we are expecting as the entire behavioral health community is, and a crisis like we've never seen before, of substance use. of suicidal ideation of behavior, health problems like we've never seen, because humans were not meant for long-term isolation. Humans were not meant for a six- to eight-week complete shutdown of our communities.

And we believe that those individuals who are holding it together right now, once we get to the other side, are going to completely fall apart. So we are working with our other behavioral health partners to prepare for that onslaught that we believe is going to come post- COVID-19.

How are you doing? How are your counselors doing? I mean, after all, you're going through the same stresses that the rest of us are, plus you have to deal with everybody else's travails all day. I mean, do you have to get counseling too?

Oh, we do a lot of self-care here at the Crisis Center of Tampa Bay and that is part of our DNA. It is a pillar of our organization is a normative culture and that culture really revolves around self-care. So we spend a lot of time, even particularly now that we have remote workforce.

Those folks are so isolated in their homes, homes that used to be sanctuary for them. We have now brought in all of the communities problems, all of the communities issues into their sanctuary space. So we're actually doing more face-to-face supervision via Zoom and Microsoft Teams than we did when people were in office. We're doing a lot of check-ins. We are doing a lot of group teaming, so that if you do get a suicidal caller, you're immediately with a supervisor who is providing that backup for you.

It's kind of like the analogy of, you're on an airline and you're flying and you've got to put your oxygen mask on first before you put it on anybody else. We really believe that here that is a mantra here. And so we work very hard to try to take care of not just our frontline staff, but all the people that are supporting the frontline staff.

Everybody here is considered a central service. So we're working diligently. Our board of directors is working diligently to make sure that everybody has the physical and emotional resources they need to continue to do this job. Again, 24 hours a day, seven days a week.

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Steve Newborn is WUSF's assistant news director as well as a reporter and producer at WUSF covering environmental issues and politics in the Tampa Bay area.