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Mental Health Association expands to meet ‘exponential’ increase in demand

STORY BY LISA ZAHNER (Week of February 1, 2024)

The Mental Health Association, an important resource for local residents since the 1970s and an organization generously supported by island foundations and donors, has taken over the space vacated by the UF Behavioral Health practice to help better serve a community still reeling from the COVID-19 pandemic.

In Vero Beach, residents shared the emotional impacts of isolation, upheaval, worry, loss and Long Covid that people felt elsewhere during the pandemic.

But local residents also faced the economic pressures of a housing crunch caused by 1.5 million new Floridians and a property insurance crisis, coupled with double-digit inflation on life essentials boosting the cost of everything from rent and utilities, to food and fuel.

This perfect storm of factors has driven more Indian River County residents young and old to seek a therapist’s help, and the Mental Health Association is often the first point of contact for these patients, regardless of their insurance status or ability to pay.

“The pandemic has jump-started a sequence of events that will never be reversible. We are reeling. We are reeling in this community. I’m a psychologist and a CEO and I can tell you we are in a full-blown mental health pandemic,” said Mental Health Association CEO Philip Cromer, Ph.D., a licensed psychologist.

Cromer relayed the situation to trustees of the Indian River County Hospital District, which financially supports the Association’s operations. Cromer said the MHA’s service area saw a 40 percent increase in the need for mental health services from 2001 to 2019, but during the four ensuing years since the outbreak of COVID-19, the demand curve has been “exponential.”

In addition to the increased need in numbers of people, the MHA has seen a “rise in both the severity and acuity of problems across all age demographics.” He said these issues taken as a whole represent a “critical societal shift toward recognizing and addressing mental health as an integral component of overall well-being.”

Cromer said 2022 suicide statistics show record-high numbers, and he expects that trend to continue when the 2023 numbers are released.

In citing the 2023 State of Mental Health in America Report, Cromer said “Florida ranks No. 1 in the prevalence of mental health illness among adults. You want to be No. 1 in a lot of things. This is not one of those things unfortunately.”

“We also rank 45th in the ability for these individuals to access care. A little different in Indian River County because we’re unique,” Cromer said, recognizing the investment of both public and private dollars into bolstering mental health services locally, and filling the gaps in care.

A National Institutes of Health study published in 2022 tried to quantify some of what happened to Americans’ mental health in 2020 by looking at available data on the use of antidepressant medications. The NIH found that in every month of 2020, antidepressant use was 20 percent to 30 percent higher when compared to that same month in 2012 to 2019.

“The observed antidepressant use in 2020 was higher than predicted, particularly in men, and in the 30 to 59 years age group,” the study revealed, theorizing that demographic suffered the most economic and job stress from lockdowns, shifting roles and diminished productivity at work, or working from home – often with kids studying from home as well.

Parenting skills were pushed to the limit and marriages were tested as well.

The study also noted that people age 60 and older also relied upon antidepressant therapy more heavily in the throes of a pandemic which put them most at risk for serious illness, hospitalization and death.

Older adults are also at higher risk for social isolation, especially if they have no close family nearby or they could not visit with relatives and friends the way they used to before the pandemic.

“Individuals now more than ever are seeking support for mental health services,” Cromer said, noting that awareness campaigns to reduce the stigma of getting help seem to be bearing fruit, adding to the demand for services. “As we navigate complex societal changes, it is imperative to prioritize and invest in the expansion of mental health resources to ensure that the residents of Indian River County receive the necessary support and care to foster mental and emotional resilience,” he said.

Since the beginning of the pandemic, Cromer said, people who were struggling with their mental health but treading water, getting through the day, faced a tipping point of sorts from which they needed help with their issues. Those who were already in therapy were more likely to find themselves in a crisis or acute situation. This scenario not only affected adults but also children, whose routines were disrupted and whose social support systems evaporated overnight with lockdowns. Along with school went sports and clubs and face-to-face contact with friends, teachers and school counselors who provided a means for kids to cope with challenges.

“The mental health needs we are seeing in our schools reflect the growing recognition of the profound impact mental health has on students’ lives. Schools are not only academic institutions, but are also crucial environments for the societal and emotional development of young individuals,” Cromer said.

“The MHA can and will play an essential role in enhancing the well-being of students by offering specialized expertise, resources and advocacy by expanding our services.”

“The gap that we’re really seeing now is we need to expand. We have hit a ceiling at the MHA a long time ago. We’ve converted closets. We have people in cubicles. We need more space,” he said. “We signed a lease for the UF building and our plans for it are the MHA Parent and Child Center.”

“At the center, we’d like to focus on skill building to promote academic and life skills, increase therapeutic services of course. We’ll have teen groups, parent groups, workforce initiative and provide child and adolescent psychiatry,” Cromer said.

The group will be hiring a new psychiatric nurse practitioner, a new psychotherapist and more clinicians. The MHA will also be providing space for other nonprofits to run their programs for kids and families.

“It’s a big leap for us, but part of our mission and our goal is to meet the needs and fill the gaps,” Cromer said. Fortunately, the MHA is located right next door to the former UF Health offices, so they can expand without relocating, keeping the familiar surroundings their patients have grown accustomed to.

“We don’t have the ability to meet all of the students in the schools like we once had, so we have to come up with other ways to do that,” he said.

Hospital District Chairwoman Marybeth Cunningham asked if the residents are seeking out the MHA now that they are not providing services in the schools. “They’re desperate for help. Families and kids are desperate for help right now,” Cromer said.

“When we would go to the high school we would have 20, 30, 40 students who would say I’m in crisis and I need to be seen right now,” he said.

The MHA has a walk-in clinic and conducts thousands of free mental health screenings per year.

“Anybody can come in Monday through Friday and be seen without an appointment, without charge for the most part,” Cromer said.

After the initial visit, patients are offered group sessions, and they join a wait list of about 150 people for weekly one-on-one appointments. Cromer said roughly half the people on the waiting list are children. “They can come back and go to our groups as much as they want, they can come back to the clinic, so they will never be without services, but they are waiting for their forever therapist,” he said.

Both Cunningham and Hospital District Trustee Paul Westcott said they are interested in finding out the root causes of the worsening issues, and figuring out what the district might be able to do in terms of prevention.

“Do we want to solve the root cause?  Absolutely,” said Hospital District Executive Director Frank Isele.

“We have to solve the root cause so we can stop the secondary effects, but the secondary effects are there.”

“It doesn’t change the fact that the result has already happened, and there are tons of people out there who need help out immediately,” he said.

The MHA plans to have a soft opening of its new offices in mid-February, and to officially unveil the new facility in early March.