Lisa Elia: So I actually did a presentation on this in the middle of COVID last year where we're really seeing a lot of teens and young adults have similar signs and symptoms to grief and loss. Narrator: This is Lisa Elia, a behavioral health therapist at Catholic Charities. She specializes in behavioral management, children and trauma, of which in the last year and a half, there's been a lot. Lisa Elia: So there are stages of grief and loss that people go through denial, anger. They go through, you know, a bargaining stage. Maybe they go through a depression stage, and then acceptance. And we're seeing a lot of the ways that teens and even adults are feeling those specific stages in reference to their feelings about COVID. So, it is kind of mimicking what we feel when we lose someone or go through something like grief and loss. Narrator: Lisa is talking here about the Kubler Ross model, which outlines five stages of grief. It's a tool that has always been a guideline for her work, but now at the height of the greatest mental health crisis in decades has been particularly paramount in helping clients understand their feelings through the pandemic. Lisa's field has become particularly critical as the wait list of people seeking counseling are expansive and ever-growing, and the stakes are alarmingly high. The world is grieving. And for the last year and a half, Lisa and the team at Catholic Charities, Behavioral Health Counseling Center have been helping to heal the wounds. Welcome to Detroit Stories, a podcast on a mission to boldly share the stories of the people in communities in southeast Michigan. These are the stories that fascinate and inspire us. This episode is sponsored by Alliance Catholic Credit Union. Learn how you belong here at alliancecatholic.com. Stage one: denial, a defense mechanism that buffers the immediate shock of loss. Lisa Elia: So, I feel like at first, everyone kind of felt that this was going to be a very temporary situation. So we actually saw when we transitioned to tele-health, meaning therapy online, I actually saw a decrease in clients because everyone was like, well, this is kind of a nice little getaway. And we think we can manage you know, without therapy for right now. Narrator: Lisa is one of the 26 therapists and 42 peer supporters who work with Catholic Charities Behavioral Health Center in southeast Michigan. The center is the largest provider of behavioral health services in the state of Michigan, serving six counties, with six locations in three languages. Catholic Charities offers help for a variety of needs through individual, group or marriage and family therapy where the preferential treatment to poor and low-income families. It's a godsend for people in need as many mental health treatments and providers don't service those with Medicaid. In a typical year, the center might see 6,500 patients, but the last year and a half was far from typical. Lisa Elia: A month or two into it, we saw a spike in clients wanting to come back and do tele-health. Narrator: The state of mental health in the nation was not great before COVID-19. Rates of depression and anxiety were at alarmingly high rates, particularly for younger people, but the pandemic fueled the situation into what mental health researchers and experts have called the worst mental health crisis in decades. The demand for mental health care was and is at an all time high. Mental health professionals are struggling to meet the high demand and avoid burnout from working on the emotional frontlines of the virus, and all this against a backdrop of a stubbornly increasing number of mental illness cases. Speaker 3: During this time, when there's so much focus on our physical health, it's important not to forget about our mental health. With all the changes happening as we overcome this pandemic, it's easy to feel overwhelmed, anxious, and stressed. So joining us now is board certified... Narrator: Stage two: anger. As the numbing effects of the denial stage began to wear off the pain of loss starts to firmly take hold. As we search for blame, feel intense guilt and lash out. Lisa Elia: We've absolutely seen a spike in anxiety and depression and that's across the board and across ages. This hadn't been very traumatic, you know, across the board, on our teachers, on our nurses, doctors the homeless, everybody. And so we really need to look at society as a whole moving forward from a trauma response. Everybody's reaction is going to be different in how they kind of work through, you know, all the losses of COVID and to have some compassion, and to slow down, and to have some patience is really important. Because trauma can be really, really tricky to deal with. At times it looks like aggression, it looks like anger. And so, you know, my hope is that people can start looking at it from a trauma response. Narrator: The American medical association found that numbers of youth grappling with clinically elevated symptoms of depression and anxiety have doubled in the pandemic. Four in 10 adults have reported symptoms of depression and anxiety up from one in 10 before COVID. There's been a 12% increase in alcohol and substance abuse, and the American Family Survey found that 34% of couples reported that the pandemic has increased stress in their marriage. Lisa Elia: You know, we--there's a lot of focus on the way we are thinking, and almost the internal dialogue we have with ourselves. And at times when we're fearful, or when we're feeling pressured or stressed, it can be really critical. So we, we use a lot of what we call re-cognitive reframing. We're reframing the thoughts in our mind, to be a little less critical, a little more loving, a little more grace for ourselves, for others around us and for the situations that are coming up. And we're also really learning to stay in the present moment. So, typically people have anxiety or sadness when they think back to the past or when they think about the future. So we're really having them utilize some grounding techniques and stay in the present moment. Narrator: For a clinic that has been no stranger to the stigma some people have around mental health care, they saw the stigma stomped out as their phone started ringing off the hook. New clients were coming in daily and the staff without growing, made sure those people had someone to see. Jackie Smith: We're up to 30% in terms of the number of sessions we provided in the month of July between last year and this year. Narrator: This is Jackie Smith, the clinical director at Catholic Charities of southeast Michigan talking about her team of therapists. Jackie Smith: The 30% increase in numbers is no small task to you know, to take on and yet, like they have such good spirits about them. You know, when we get on a meeting and, and my office manager says, you know, we had three calls, three additional calls that we weren't able to fit into an opening. And, you know, it never ceases to fail that a couple of them will speak up and say, oh, I could add that person here on my schedule or here. Narrator: Stage three: bargaining. Bargaining is a way to hold onto hope in a situation of intense pain. For many of us, this meant believing everything would go back to normal soon. For some of us, this meant trying to find the silver lining in the situation. For others, it meant trying to regain control of home life. Well, Jackie Smith: You know, one can you know, one can always strive to create new routines by all means. And I think many people have had to do that in the pandemic. New, you know, new habits, new, special things you do with your family. You know, maybe, you know--maybe before when people, kids were out at sports activities and stuff, maybe family dinners didn't always happen, maybe with everyone home now you've set a time to, you know, have a routine and steady family dinner, or engage in other activities together and create new routines, new rituals you know, rituals and routines are always very good to keep things stable. Lisa Elia: I think a lot of people have turned back to faith to really try to understand what is happening out there in the world. I think another thing that people are doing is really looking inward towards their support systems. COVID has really changed the way we look at our support system systems, just because we couldn't actually even go visit those people at, you know, parts of time in this pandemic. So I think people are really starting to rethink, you know, who are my support systems, how can I stay more connected with them in different ways than I could before? I think we're really looking at different ways to utilize coping systems. How do we, when you know, we're doing the same routine over, and over, and over every day, how do we take care of ourselves? How do we get a break? How do we, you know, time manage, you know, you know, everything with kids, and work and everything, and how are we going to use mindfulness techniques? How are we going to pray? How are we going to take deep breaths, different things like that. So we've had to get really creative and some clients I see, you know, once a week and some, I see two, just depending on how they're coping, you know, in the moment. Narrator: Stage four: depression. This type of depression is not a sign of mental illness. It is the appropriate response to great loss. You start facing the present reality and the inevitability of loss you've experienced. And this right here is the stage where counselors are maybe the most beneficial in a time when the pandemic too quickly became about maximum efficiency working from home or the greatest loaf of bread, the Catholic Charities counselors were there to draw clients back to a healthy grieving process. And the tedium of a slow recovery. Lisa Elia: We have seen almost every client and family be affected by this. I think the first thing is just recognizing that this is a time of loss, invalidating everyone's unique experience, and then making space to just sit with them in that sadness. You know, many times we know as a society say, oh, push through it toughen up and things like that, but really, you know, in order to really get through something, we have to acknowledge it and accept it and feel it, and then, you know, support as we are helping clients to really understand and come to terms with everything. Narrator: Here's Jackie: Jackie Smith: Talking about the losses is important. I think sometimes we tend to minimize how these things are impacting us and that just, you know, worsens the issue when people come to therapy, and that could be individual therapy or finding a support group for people who have lost loved ones, having that sense of community, being able to talk about the loss, realizing that you know, there are some feelings and things that are just part of the normal grieving process, but that still are important and need to be worked through. Narrator: It's safe to say, as the Delta variant's, frightening rise, upsets our hopes for turning to normal, that we're not at the acceptance stage yet. In the storm of COVID Jackie, Lisa, and the rest of the staff at Catholic Charities continue to maintain an inordinate client load, equipping people with the emotional tools. They need to anticipate the world of new normals, new routines, and hopefully mute the chaos for just long enough for their clients to hear the still small voice of God, their ultimate motivation for all the work that they do. Jackie Smith: God has shown us unconditional love and mercy. And one wants to then share that with the people who come for help. And, you know, when we talk about love and putting one's own needs aside in order to help others there's no one who is more inspiring to me than the therapists who, who work here. Obviously they have, you know, they too are living through the pandemic. They too have had their losses and things. And yet I am amazed that every day they are able to put, you know, their needs aside and help those who are coming to us in suffering. Narrator: Detroit Stories is a production of Detroit Catholic and the communications department of the Archdiocese of Detroit. Find us on apple podcasts, Spotify, Amazon music, or wherever you get your podcasts. This episode is sponsored by Alliance Catholic Credit Union. Learn how you belong here at alliancecatholic.com.