This story is part of a collaboration between Central Connecticut State University and University of Central Lancashire.
Teletherapy, the new normal during the pandemic lockdown, is the only option for some in the United Kingdom and United States. People can get help for anxiety and other mental health problems without leaving their homes.
But for some people dealing with circumstances never seen or dealt with before, not having in-person therapy is a loss teletherapy cannot replace. The result could be long-term consequences for college students no longer getting therapy, as well as others who are finding teletherapy, which can take place over the telephone or computer.
“It’s really, really important that when all of this is over and life seemingly goes back to normal, that we consider the fact that people’s mental health might not have gone back to normal yet and we don’t know what normal will look like or if the normal we knew will ever come back,” said Marwah El-Murad, project manager at the Higher Education Mental Health Foundation in London.
Mental health services that have been impacted by coronavirus include group sessions, support groups and online counseling. El-Murad also said that fewer college students have been seeking services.
“What that means is if they [students] are experiencing any mental health problems, they are actually far less likely to talk about it to their peers or to seek support for that mental health problem, so there is still a long way to go.”
Emily Thomas, who attends college in Leeds, England, said her school only allows four counseling sessions maximum each year. After trying to get help from a private practice and being unsuccessful, Thomas thinks seeking help during Covid-19 “would be a lot more difficult” due to lack of resources. Though college-age people are considered “digital natives,’ they do not necessarily gravitate toward teletherapy.
In the US, Michael Russo, director of Counseling and Student Development at Central Connecticut State University, also reported a decrease in students seeking help.
Since the start of the fall semester, counselors at Central Connecticut saw a dramatic increase in the number of students seeking mental health services, and that growth continued into the spring, in line with national trends, Russo said. After campus closed, the counselors got teletherapy up and running using WebEx in just 10 days and expected to see a spike in students needing services.
However, after reaching out to all current or recent students who were utilizing services, about only 55 to 60 percent of students agreed to continue with teletherapy, meaning around 40 percent did not want virtual help.
“[COVID-19] has caused a mental health crisis and its impact will be seen long after the virus has passed.”
Dr. Michael Russo
Russo believes the drop-in appointments may be due to students having less time due to the change in academics, family commitments, or the lack of privacy of having to speak openly in a home rather than a private session.
“[COVID-19] has caused a mental health crisis and its impact will be seen long after the virus has passed,” Russo said.
Russo said that he as well as the other CCSU counselors are expecting to see the number of students utilizing services rise again once people are allowed back on campus.
See Also: Cultural Differences Shape US and UK Mental Health Response
Some young people with their own private therapists have found teletherapy lacking as well.
“I kind of felt stuck almost. Instead of taking steps forward I was taking steps back because I wasn’t expressing how I felt or things I was going through or am going through so it [teletherapy] wasn’t that great,” 18-year-old Marina Dauti said about losing privacy during sessions in her home.
Dauti, who seeks services in Litchfield, Connecticut recently resumed in- person therapy after four weeks of teletherapy. Her therapist was still doing limited in-person sessions; however, Dauti had to switch to teletherapy due to her father’s medical condition. Switching back to regular sessions for Dauti was a “relief.”
The rejection of teletherapy seems to cross gender, ages, and social position.
Gregory Stackhouse, 34, a factory worker in Agawam, Massachusetts was trying to seek in-person therapy but was frustrated when he found out that would not be an option.
Before the pandemic, the factory where Stackhouse works, which makes plastic display cases and other items, was not designated an “essential” business, but it has transformed into one, now making plastic sneeze guards for stores. Stackhouse said the work environment was becoming “more relaxed due to social distancing.”
Despite a more relaxed environment, Stackhouse said in an interview that he was seeking mental health services for the first time since childhood, and just wanted someone to talk to about his anxiety and panic attacks that he has been struggling with for some time. He also feels that he may have PTSD due to family issues over the last 10 years.
Privacy for Stackhouse isn’t a problem because he lives alone but losing closeness by talking to someone through a screen is. However, after being told he could not get in-person sessions, Stackhouse said teletherapy is his only option.
After filling out an online application and doing an interview-like process over the phone, Stackhouse said he felt discouraged because of some of the questions he was asked such if he lived with anyone and if he would be able to pay for the service.
Stackhouse said although the people over the phone never expressed rudeness, more in-depth questions made him feel that his situation may not be as serious as others in their [counselors] eyes.
Stackhouse said he had his first virtual appointment with his regular doctor because of constant migraines and felt a level of discomfort by not having him in the room while addressing certain questions.
After answering ‘no’ to questions– do you have numbness in the hands, tingling in the feet and coronavirus symptoms like lack of taste and smell, heavy breathing and tightness in the chest?– he says his doctor said, ‘Okay good, that means you aren’t having a stroke.’
“I don’t know if the emotion was conveyed by the look on my face when he asked that because he was looking at his computer from the side while I was talking to him so we were never face to face.”
Stackhouse said he may also experience discomfort if he used his for teletherapy.
Despite this view about teletherapy, clinical social worker Briggitte P. Brown, of Spirit Soul and Body Clinical Services, thought she would see a decrease in appointments, but her caseload stayed consistent. She found that a lot of teenagers liked teletherapy, while older adults said they would wait to resume sessions when quarantine was over.
Brown works with a lot of clients who have experienced or are currently experiencing trauma and does a form of psychotherapy, eye movement desensitization and reprocessing (EMDR).
“I find that it’s been very, very difficult for those clients because of the lack of physical connection. We’re not seeing each other face-to-face and that’s been a really big struggle but those clients are becoming more independent because they don’t have a choice otherwise.”
Faster appointments than before are available at Central Connecticut State University; however, losing an in-person connection can be problematic for some high-risk patients.
“My biggest concern is student’s safety because as wonderful as our counseling staff is, I do get very concerned about students who may be thinking about suicide and making sure we are on top of that and focused on that and how we are meeting their needs,” Russo said.
Whether high risk or not, teletherapy may not be the solution for everyone needing help.
“It [teletherapy] doesn’t give me much confidence in resolving or addressing my issues,” Stackhouse said.
Angela Fortuna from Central Connecticut State University also contributed interviews.