Dealing with mental health challenges and having an intellectual disability, going through a scary pandemic, and a stay-at-home policy are major challenges of these unprecedented times. How can we help our clients to safely deal with all of this?

In March 2020, the coronavirus pandemic resulted in an unprecedented and historic shelter in place order across the Bay Area. Our first question has been how can all of us, staff and clients, be safe? How can we help our clients to have symptoms, fears, worries, and grief under control in a time of a new “normalcy”?

The Hope Services Counseling Center is managed by Anna Fernandez, Director of Behavioral Services. It provides behavioral health services to more than 1600 clients with severe mental illness and a co-occurring intellectual disability in the counties of Santa Clara, Santa Cruz, Monterey, San Benito, San Mateo, San Francisco, and Marin. Over the course of the pandemic, the number of clients served – and the locations we were able to serve – increased.

We asked ourselves how we could help our clients, be sure clients and staff had minimal exposure, and yet continue to serve, treat, and support. We are aware of the suffering and the need to ameliorate the mental health aspect of individuals with intellectual disability and their families and caregivers.

Our Counseling Center was able to smoothly transition to a virtual clinic in the days after the shelter in place order. The main keys to this transition were the support of our staff, our strong electronic health records support team, the use of apps like Zoom and FaceTime to contact clients, and more flexibility in the application of HIPAA rules and regulations thanks to the new guidelines.

This has meant that all psychiatric services – ranging from case management linking clients to other appointments, behavioral support in the home, individual counseling, group counseling, collateral support for family members, and appointments with psychiatrists and nurses – are now offered via phone and telehealth options. A limited number of in-person, face-to-face appointments have been available for urgent situations. Since the vaccine rollout, more face-to-face sessions have been made available, and currently, all clients requiring in-person visits are being seen by clinicians, behavioral coaches, and case managers

The counseling center experienced minimal disruption in services. Case managers coordinated with families to ensure continuing access to mental health treatment, and clinicians started meeting with clients via phone (and video-conferencing) within a day of the shelter in place order. Within three weeks, nearly every client receiving services had been contacted by at least one person making sure that the client was safe, healthy, and still able to access needed treatment.

We discovered that shorter sessions more than once a week were well received by our clients and seemed more productive. We wanted to reach out to our clients using the tools that were more comfortable for them such as video calls, texting, or regular phone calls. We soon discovered their preferences and we are doing our best to accommodate them.

This continuity of services has helped clients maintain a needed structure in a challenging time. Our case managers are ensuring that clients are being supported emotionally and are linking clients with resources needed to keep them healthy and engaged in the treatment. Some case managers have worked with other non-profits to help clients access computers and the internet at home. Others are providing them with resources to connect to online support groups. Some are helping clients use technology to access medical appointments and leisure activities. Therapeutic Behavioral Services (TBS) coaches continue to provide support to family members and to clients, checking in and tracking behaviors, and providing interventions that can promote positive outcomes. Psychiatric services have continued with little interruption, and most psychiatry appointments are now occurring either through video conferencing or telephone calls. As of late April, some of the Center wellness groups re-started, with more groups focused on meditation and relaxation during the COVID-19 crisis.

We wish all to be safe. We believe that all the people suffering from any mental illness will be able to reach out for help. We believe that everybody deserves to be healthy in spirit, mind, and body.