ROANOKE RAPIDS — Since the COVID-19 pandemic took hold of the nation last year, some health care professionals have seen a spike in mental health issues.

At the beginning of 2020, Gov. Roy Cooper gave several executive orders to try to slow the spread of the virus. The orders resulted in implementing social distancing guidelines, limiting mass gatherings, mask mandates, business and school shutdowns. Eventually, a stay-at-home order was issued on March 27 and was not significantly eased on until May 8. Additionally, a three-phased plan to reopen businesses and public spaces came into effect in April, but another executive order came on Dec. 8, implementing a modified stay-at-home order.

On Jan. 14, and nearly a year into the pandemic, Dr. Nathan Harper, medical director of Behavioral Health at Vidant Medical Center and East Carolina University, said he believes there is a great deal of weariness and fear lingering in the public due to COVID-19.

“A contagious disease that can cause anything from absolutely no symptoms or a fatal process can seem very abstract for people and lead to problems taking it seriously,” Harper said.

Comparing the previous years to 2020 in mental health, Harper said there has been an initial drop off of patients seeking care, as outpatient clinics struggled to make virtual appointments happen and work well. In addition, the emergency department saw a dramatic decline in visits in the spring, but has noticed a spike in people seeking help for mental health issues, Harper said.

“But this is not over yet either,” he said. “I have noticed more issues facing patients socially, especially social isolation, boredom and children falling behind in school.”

Harper said the emergency departments in the hospitals appear to have returned to pre-COVID levels in regard to visits and inpatient numbers.

Kristin Clayton, a licensed clinical social worker and CEO at Statewide Mental Health and Disability Services PLLC in Roanoke Rapids, said she has seen a spike with people experiencing more depression, paranoia and anxiety. More people are staying at home due to fears of the virus, Clayton said.

“For example, I stay at home much more, but I’m not paranoid,” she said. “When you have, for example, somebody that’s already paranoid — not all of them, but a lot of them, their paranoia increases.”

Clayton recalled giving one of her therapy patients a later appointment to pick up her medicine to avoid large crowded areas, per the patient’s request. She said Cardinal Innovations Health Care authorized SMHDS’s therapists to conduct clinical assessments over the phones. Clinicians also make home visits, but the majority of patients do not want the clinicians to enter their homes out of fear of being exposed to COVID-19, Clayton said.

Harper said a contributor to much of the mental health issues is job loss, followed by insurance loss and access to medical care.

“Depression and anxiety have been big problems, as well as isolation,” he said. “Having people not be able to work is actually unhealthy for them. Also, they are spending more time with family with less money and activities which can cause interpersonal problems at home.”

When asked if there is an increase in suicides, Harper said it is unclear at this time.

“I’d add that substance use problems [addiction to alcohol and or other drugs] will likely turn out to be a problem associated with pandemic as well and may lead to problems much later in people’s lives long after this is hopefully behind us,” he said.

Another issue is a decrease in children’s school referrals for mental health, due to most children not having in-person learning, Clayton said.

“We see a lot of our children have stopped coming to the medication clinic because they’re not on their medication like they were supposed to,” she said. “Parents have taken them off the medication because they can pretty much handle them at home. There’s a lot of stimulation at school, whereas at home there may not be as much distractions, and the parents are not keeping them on the medication consistently or taking them off the medication.”

The Daily Herald reached out to school districts for a response on how the pandemic has impacted school staff and students.

Mark Barfield, director of student services and public affairs at Northampton County Schools, said the school district has accepted the challenges of remote learning and no athletics during the pandemic.

“As a result of remote learning, parents and staff have shared that students are missing the physical interactions with peers and staff,” Barfield said. “The faculty and staff are not able to monitor the physical and mental aspects of students daily. Our students are not able to strengthen their social-emotional skills.”

He said the school social workers are making home visits and connecting families to external agencies for students who are struggling with virtual learning. Additionally, school nurses are providing virtual support to students who have severe medical plans, including the employment of an outside agency to support identified students with social-emotional needs, Barfield said.

“The district leadership and school executives stressed the importance of building strong relationships with students and parents to work collaboratively to ensure the success of the students,” he said. “Parents need to look for drastic changes in students’ behavior. Parents can provide opportunities for students to express their feelings about remote learning during this pandemic. Parents are encouraged to stay in communication with their children’s teachers.”

Allie Evans, executive director of School Improvement and Accountability for the Roanoke Rapids Graded School District, said the district has seen a “plethora of emotions” that have affected staff and students.

“Staff and students are working hard to continue to build relationships with each other and focus on the social-emotional health and on each others’ well-being,” Evans said. “However, there is a grief that goes along with losing normal everyday routines and the expectations that were held for the year. Our staff and students have been resilient in times of uncertainty.”

Community Outreach Liaisons, counselors and administrators are working to continue to address concerns and potential dangers children may encounter, she said. Home visits, phone calls and one-on-one sessions are conducted, Evans said.

“Our wrap-around teams are continuing to address the social-emotional health of all of our students and how best to individualize and meet their needs,” she said. “We continue to work with our school-based mental health provider from Rural Health Group Inc. to provide intensive support to our students who need additional support.”

Harper said helping during this time could be as simple as asking “how your friends and family are doing,” including if someone is anxious, how their mood is and if there is anything that they want to talk about. He also said there has been a long-standing myth that discussing or asking someone about suicide may make them act on the thoughts they are having.

“This is very untrue and not valid reason to avoid those talks,” Harper said.

For those having thoughts of suicide, call the National Suicide Prevention Lifeline, available 24 hours a day, at 800-273-8255. For any other mental health issues, contact Statewide Mental Health and Disability Services at 252-308-1247 or the Cardinal Innovations Mental Health Crisis line at 800-939-5911.