Editor’s note: Interviews for articles in this issue of Pinal Ways were conducted in early or mid-May, and reflect the state of the industry at that time.
If there is a positive takeaway to come out of the COVID-19 pandemic, it’s that health care workers have newfound pride in their line of work. And that includes behavioral health.
“We don’t realize that we are part of those essential services that are out there,” Pinal Hispanic Council CEO Ralph Varela said. “That’s kind of been an interesting thing for us to say, ‘That’s right. We are an essential part of services because we have that connection with our members.’ There’s a lot of need in terms of the work that we do.”
The Pinal Hispanic Council offers various behavioral health services with qualified and competent staff that accurately assess, diagnose and treat most mental health and substance abuse problems.
During the pandemic, the PHC has maintained on-site operations for clients who were in crisis and for those who needed their monthly injections. All other work was done over the phone through telehealth.
According to Varela, the agency held injection days two times a month and on those days the clients would come in at a scheduled time.
All the staff have worn protective masks and the clients are also given one to wear before entering the building. Additionally, if a member came in for something other than an injection, they would meet with a counselor or another staff member in a conference room that offered more space.
As far as having to adapt to the new normal during the pandemic, Varela said that it came in phases from being a little concerned about the virus to being completely alert and following all the guidelines of social distancing and wearing the face masks.
“Everybody started being very cognizant about having to take all these steps,” he said. “Once everyone had that cognition that this is everything we have to do, the staff really helped each other as far as the distancing and the sanitizing. There’s also been an awareness too that if you have a little cough or something, even if it has nothing to do with COVID, everyone is really cognizant and vigilant.”
After a consult, the whole area would be sanitized and even if there were no visitors, the staff would sanitize on an hourly basis. Everything from the conference room to the countertops and doorknobs.
Varela mentioned that it was a big change for the staff and the clients as both were accustomed to the face-to-face interaction.
“Our members are kind of used to coming in for their case management services and counseling services,” Varela said. “We really had to limit transportation to individuals who need the transportation either for their shots or to see one of our prescribers or our nurse practitioners.”
For the rest of the clients, everything was handled over the phone as the PHC staff contacted them on a weekly basis. That did have its perks, but it also proved to be difficult for some of the clients, as well as some of the staff.
“A lot of times individuals have reported that coming to the agency is sometimes the only place that they go to and have that human interaction because they stay home a lot due to their symptoms, whether it’s depression or anxiety,” Clinical Supervisor Laura Castorena said. “We try to contact them more than once a week because we want to make sure that their symptoms are not increasing to a point where they’re thinking about suicide or something like that.”
When a client doesn’t answer a phone call, the case manager worries about whether the client is sick or if their symptoms have worsened. Castorena mentioned that there was an increase in symptoms for some clients because of the restrictions placed by the state during the pandemic.
“I think a lot of the issue is feeling like they don’t have the support that they once had in place,” Castorena said. “Clients were more dependent on us for things and they have to be more dependent on themselves or their family members because we’re not doing face to face contact. For our case managers, because they’re mostly in the office, it’s been easier for them to do their documentation paperwork, but it’s hard not to want to run to the members and say let us help you, because that’s what we do.”
Castorena and Varela agreed that a perk of the phone calls is that it is easier to reach some of the clients. The case managers do regular check-ins and it turned out that many were more willing to talk over the phone.
“It’s been a challenging time for the members and the staff,” Varela said. “I think there’s been a lot of good lessons learned, especially about social distancing and delivery of services.”
The PHC found out that there were some techniques used during the pandemic that worked better than before the restrictions, but because of state regulations most of those techniques, which included the phone calls, were only allowed because of the pandemic.
“The case management telephonically, that’s not the preference of the state or the agency’s,” Varela said. “Given all of this, I think those are kind of the things we’re looking at in terms of will there be some ability to continue some of it because we have seen the value of doing the check-ins and having the prescribers being able to call in to the member and being able to talk to them over the phone. Things that you normally wouldn’t do as day-to-day business. I think those are very important.”