Spring has brought much hope to the country. More than 200 million vaccine doses have been administered, an increasing number of schools are reopening for in-person learning and families are reuniting after too many months apart. However, just as the COVID-19 pandemic seems as if it’s under control, there is another wave to be aware of, according to mental health professionals.

In 2020, Dr. Ken Duckworth, the chief medical officer of the National Alliance on Mental Illness, predicted that a “mental health epidemic was coming.” NAMI Greater Orlando’s Executive Director Eric L. Welch says, “Nine out of 10 adults are feeling at least one adverse effect on their mental health, so it really is affecting all of us.” He says NAMI Greater Orlando is experiencing an increase in phone calls to its information and resources line, and more people than ever are calling for “support.”

Marni Stahlman, president/CEO of the Mental Health Association of Central Florida (MHACF), says no one could have fully comprehended what would come, but as soon as the announcement was made that students would not return back to school in person, that’s when she knew it would be a crisis.

“I have a 13-year-old at home and I saw firsthand the deterioration of interaction and the anxiety of being on Zoom, and this is in a home with a psychologist mom. Imagine what’s happening in households without resources to deal with these feelings,” she says.

Mental health professionals in Florida are concerned about the state’s ability to respond to this crisis. “In Florida, the mental health system has been broken for a long time. We’re 48th out of 50 for access to mental health care,” Stahlman says, adding that many in need are being put on waiting lists because of the demand. “There is no hope in sight that the safety net system has the capacity to respond to the public health emergency related to mental health.”

Welch agrees, saying, “Recovery is a non-linear process and the trauma and grief we have experienced now may not manifest itself for years to come. Lawmakers need to recognize that a community with a strong commitment to mental health funding is crucial to the overall success of the community.”

No segment of the population has escaped the mental toll of the pandemic, not even mental health providers themselves.

“We are experiencing an increase in demand for all levels of care for mental health support. The compounding impact over the course of the past year is that essential staff are exhausted, and if not carefully supported, [it] can lead to burnout and staff turnover, which then causes a disruption in treatment for those services, and therefore the impact can result in a vicious cycle of increased challenges rather than solutions,” says Lindsey Phillips, director of external affairs at Devereux Advanced Behavioral Health. “Most people choose careers in mental health out of an innate desire to help people. When the demands for mental health support are increased, it is hard for mental health professionals to step back and maintain healthy boundaries to preserve their sustainability in the role they are in.”

Yet their work to protect and serve the most vulnerable continues.

“We have seen an impact on all types of people over the course of the past year. At some point, almost everyone has shared an experience of some level of increased stress and/or anxiety. For the groups of people we would consider more vulnerable, the impact of the pandemic has heightened the level of vulnerability,” says Phillips.

“For example, children who are at-risk for sexual exploitation. In the phase of the pandemic when stay-at-home orders were in place out of a measure for protection and safety, the harsh reality is that for some children, home is not the safest place for a child to be. Particularly if there were added stressors in the home, or increased time spent on social media where predators prey upon youth with these types of vulnerabilities.”

Stahlman explains that isolation has meant that the schools and communities that would normally be paying attention to mental health risks in children have not been able to observe them. “Normal signs and symptoms to watch for would be individuals withdrawing from social interactions, experiencing sleep disturbances, eating changes. But these are hard to find and depict through Zoom,” she says. “It requires more questions, digging deeper. Adolescents tend to just say, ‘I’m fine,’ but what is fine? Adults have to be behavioral detectives.”

Sherri Gonzales, MS, regional executive director of Children’s Home Society of Florida, says her organization has seen an increase in calls to the child abuse hotline. “The understanding is that much of that is due to the anxieties and stressors that caregivers are experiencing. Parents didn’t know how to manage school while working, and some of them lost their jobs or were furloughed,” she says. “The depression begins to settle in and they don’t know how they will get a meal on the table without a job, or how they can handle all of these responsibilities while looking for a new job.”

She continues, “We have to be aware of ways we can help the children and families in our community access services to alleviate situations of abuse or depression and link families to resources that will help.”

Much of the caretaking during the pandemic has fallen on women, says Michelle Rivera-Clonch, Ph.D., LMHC, NCC, of Peace Within: Counseling for Women. “Women are taking care of their kids and maybe their own parents, or people who are sick with COVID and these competing demands create anxiety on multiple levels,” she says. “Not to mention, 2020 was the confluence of the pandemic, the social justice reckoning and awakening and a tough election year. It took anxiety from a ‘me’ level to a ‘we’ level.”

Rivera-Clonch says she has also seen the aggravation of body image issues more so than ever before. “I would say this is due to not having as much access to gyms, plus the eating and cooking fads that took hold in 2020, as well as an increase in alcohol use and social media access that leads to comparisons.”

Although women are more likely to reach out for help due to their inherent problem-solving skills, they are also accustomed to putting everyone’s needs ahead of their own, she continues. Women must think of themselves as part of an ecosystem. “If you are not coping well, the rest of the system isn’t coping well either,” Rivera-Clonch says. “If you are taking care of yourself, you improve the health of the overall systems in which you live, work and play.”

The term self-care is tossed around a lot, but it doesn’t always have to manifest in the form of a manicure or haircut. “When we only think of self-care as appearance-oriented activities or salon services, we are more likely to defer regular self-care because of a lack of time, finances or coverage at home. We may also miss the point of self-care which is really about energy regulation and management,” she says.

Simple techniques include making sure to take a lunch break, not looking at email on your time off, singing, setting boundaries with others and quite literally putting your feet in the grass while enjoying your favorite coffee or tea.

However, if you find yourself more often in a depressed or anxious state, rather than in a state of calm, cool, collected and connected, Rivera-Clonch says it may be time to enlist the support of a professional.

“I would advise those who haven’t been to counseling to try it for one appointment. Allow yourself one session to assess the situation and then adjust how to proceed based on the data you received,” she says. “Chances are good that you might find it to be helpful and meaningful support that you’d like to continue.”

Gonzales encourages families to engage in discussing mental health together. “Knowledge is power and if you know what’s going on or what a family member is going through, it’s easier to provide support where you can, such as watching the kids while someone goes to a counseling session,” she says.

Stahlman says progress has been made in raising awareness of mental health issues and eliminating the stigma around them, but many people don’t know where to find resources. On May 20, in honor of Mental Health Awareness Month, the first-ever national Mental Health Action Day will be held in partnership with RespectAbility and 193 brand and nonprofit leaders.

Randee Poeppelman, LCSW, behavioral health director at Community Health Centers, says mental health should be part of primary care. “Mental health and physical health align and can either make symptoms worse or better,” she explains. “Also, most of the time, primary care providers are the first point of contact. Most people will go to their medical doctors first; this is why many doctor’s offices are screening for depression, anxiety and other mental health disorders during the visits.

Poeppelman encourages those experiencing trouble to reach out to their primary care doctors to begin the process of accessing care. “The first but hardest step is going to their primary care doctor who can screen them and then refer to a behavioral health provider,” she says. “The reason why this is the hardest step is because many people are either in denial that they are struggling with something, the stigma within their support system could look down on mental health issues or sometimes [they have] feelings of shame that they cannot help themselves.”