Frustrated, exhausted, scared: Omicron exacerbates pandemic mental health concerns

Downtown San Antonios Deep in Our Hearts memorial has more than 3,400 red hearts to honor residents who died of COVID-19. (Chris Stokes For The Texas Tribune, Chris Stokes For The Texas Tribune)

For mental health support related to COVID-19, call the state’s 24/7 toll-free support line at 833-986-1919 or text “COVID” to 832-479-2135. You can also reach a trained crisis counselor through the National Suicide Prevention Lifeline by calling 800-273-8255 or texting 741741.

Earlier this week, someone called the state’s COVID-19 mental health support line to talk through their family’s decision to cancel Christmas celebrations amid the rapid spread of the omicron variant.

Rather than disappointment, the hotline director said, the caller felt relief: They’d lost several family members to COVID-19 over the last year and had been dreading trying to replicate family traditions without those loved ones.

“It’s very complicated to talk about those types of emotions,” said Jennifer Battle, director of access for the Harris Center for Mental Health, which operates the hotline. “Being able to provide a safe place where people can say things like that and not be judged … is really powerful.”

The support line has seen a 20% increase in calls since early December, as a new COVID-19 variant began to emerge just in time for the holiday season. Battle said a quarter of callers last week dialed in to talk about holidays, Christmas, vaccines or boosters, according to her analysis.

“Almost every call has to do with anxiety in some way, which is not surprising and has been throughout the whole pandemic,” she said. “The main key for anxiety is uncertainty, and the whole pandemic process is just a whole big bag of uncertainty.”

That uncertainty has ratcheted up in recent weeks as the highly contagious omicron variant has spread rapidly around the country. At a time when many were hoping for a holiday season more like pre-pandemic times, the country is once again dealing with quarantines, closures and canceled travel plans.

Battle said the line is currently receiving about the same number of calls as this time last year — before vaccines were widely available — with callers expressing many of the same feelings of fear, anxiety and isolation. The main difference that the support line staffers have noticed between now and the early pandemic is how many callers are seeking grief support over loved ones lost to the virus.

The line is open 24/7. She said the counselors are trained to listen, empathize and provide some coping strategies that callers can take with them into the future. They can also refer callers to a crisis line or direct them toward substance abuse resources as needed.

The state also offers a text line for people who would prefer not to call, which Battle said she hopes will help the counselors reach more teens.

Since the state opened the hotline in March 2020, counselors have answered more than 20,000 calls.

“We’re so grateful that we’ve been here for all those people,” said Battle. “But it’s also just devastating that we’re still struggling through this crisis, and still having this many people feeling scared and anxious.”

A second pandemic Christmas

Many people were looking forward to seeing family and friends in person this holiday season after a difficult year. For others, the holidays are a challenging time for their mental health, even in the best of circumstances.

“There are added pressures, there’s travel, and then the isolation that a lot of people feel especially when they are alone at the holidays,” said Greg Hansch, the executive director of the National Alliance on Mental Illness Texas.

Now, on top of all those heightened emotions, Texans are also having to navigate questions of how they can keep themselves and their loved ones safe and healthy. Many may find themselves spending Christmas in quarantine if they test positive for the virus, or awaiting news about family members.

And with so many people potentially getting infected by omicron, Hansch worries about the way shame and stigma may exacerbate the mental health impacts of a COVID-19 diagnosis.

“There’s still a perception that if you contract COVID-19, you did something wrong,” he said. “For some segment of people who get it, they did everything they were supposed to do. Perhaps they gave themselves a little bit of latitude to socialize so that they didn’t have to feel isolated. They shouldn’t have to feel stigma about that.”

The emergence of omicron is particularly devastating to many who hoped the pandemic was beginning to wind down, with vaccines widely available and many schools and offices reopening. As the state prepares for a second COVID-19 Christmas and a third year of the pandemic, Battle said, the support line has received an increased number of calls from people who report feeling frustrated, tired or exhausted.

State of mental health

Providers and experts say the mental health impacts of COVID-19 will be felt for years to come, much like in communities that experience natural disasters or wars. And this latest wave of cases and concerns will only serve to exacerbate those long-term effects.

“Chronic stress is worse than short-term stress,” said Andy Keller, the president and CEO of the Meadows Mental Health Policy Institute. “We all have a level of resilience, and we all have breaking points. And the longer that things go, the worse it’s going to be.”

Nationally, depression and anxiety rates have skyrocketed during the pandemic, though they’d begun to decrease in recent months. Deaths from drug overdoses also soared, as did youth suicide attempts.

One bright spot for mental health access has been the increased use of telehealth services. People living in rural areas that are underserved by in-person mental health providers are now able to access virtual sessions, and so are people who would otherwise need child care or to take time off work to travel to an office.

But broadly, access to mental health care remains a challenge in Texas.

“There quite simply aren’t enough mental health providers in the state to meet the need, even if a person has insurance that is willing to cover their services or the person is willing to pay out of pocket,” Hansch said. “That is a deeply troubling reality.”

Nearly 1 in 5 Texans do not have health insurance, the highest rate in the country. Hansch said it’s extremely difficult for uninsured people to access any kind of ongoing mental health care.

The state does offer immediate care to anyone facing a mental health crisis if they fear they may be a danger to themselves or others. Every county is served by a local mental or behavioral health authority that provides crisis intervention services, which can be accessed 24/7.

In addition to the COVID-19 mental health support line, the Harris Center for Mental Health operates crisis lines serving the Houston area. Battle is encouraging anyone and everyone to reach out this holiday season. She said if you call, day or night, even on Christmas, there will be someone on the other end of the phone.

“We talk to hundreds and hundreds of people on that day,” she said. “I always tell people to think about the crisis line workers, think about the support line workers on the holidays, because they’re here. They’re always here.”