Six regional behavioral health administrators told providers last week that the impact of the coronavirus for people with mental illness and substance-use disorders could be devastating.
The state has faced tragic floods and tornadoes, and has met those crises head-on with hard work and by coming together, they said.
But "today we face a new foe," they said.
While the virus will have an impact on all Nebraskans, the isolation it will bring people who struggle with mental illness and substance abuse will have an enormous effect, will exacerbate their symptoms, said Beth Baxter, Region 3 administrator.
Because of that, the mental health regional administrators are committing to working with every provider to meet the needs of this vulnerable population.
With the directives given across the state to try to slow the spread of the virus, some providers have had to modify services, Baxter said, especially group services. In some instances, they may have had to close services.
"We have people who rely on day services for that social inclusion, their ability to communicate with others so that they're not isolated," Baxter said.
Or they may rely on those services for breakfast and lunch. So providers are working to reach out to them in different ways — telehealth or telephone — to communicate and support them.
There needs to be flexibility in funding, said C.J. Johnson, Region V administrator, or it will be difficult to keep mental health workers and therapists employed who are so vital to reach out to this vulnerable population.
Patty Jurjevich, Region 6 administrator in eastern Nebraska, said officials are concerned about losing people in the workforce.
"If we lose more staff out of our system, where we already have a shortage, it's going to be difficult," she said. "Once a program closes or even is suspended for a period of time, the likelihood of getting that back up and running at a level that it's at now is probably less likely."
The virus spread is compounding a lot of problems in the system, she said.
Residential service providers and hospitals are continuing to take clients and patients, but may be limiting the public from entering their buildings and cutting visitations to reduce risks to their residents and the community.
Baxter said now is when the beauty of technology and social platforms come into play for reaching out to people and keeping loved ones and friends connected.
One problem with that, said Kathy Seacrest, Region 2 administrator, is that a large part of the population they serve have limited access to technology. Families and friends could help to ensure they have technology to be able to allow some connection to others.
The Alcoholics Anonymous groups in her southwestern Nebraska region are going to be meeting by Zoom video and audio conferencing, but that assumes people can use that platform. Some clients are living on meager Social Security payments, and if they have a phone, they may not have adequate minutes to use.
"We can't adhere to the strict service definitions that we normally have to adhere to," Seacrest said. "We have to zoom right in on client need and make sure all the clients have a safety plan and a way to be OK during this time."
At the same time, providers still have all their expenses and need to be able to pay their staffs, she said. And Medicaid and the state division must continue to pay for the services being delivered.
Johnson said many of the people served by the regions also have medications they need to fill, and a lot of times they might not look 30 days ahead, or they may not have transportation to pick up their medications.
"It gets very complex," he said, "and again I want to stress the need for flexibility at this time to help support these people is critical."