Issue link: https://beckershealthcare.uberflip.com/i/1446606
24 PATIENT & CAREGIVER EXPERIENCE because of continued cautiousness about COVID transmission. On the outpatient side, the demand certainly continued, and, in fact, more people had issues related to psychosocial concerns like losing their jobs, having trouble with managing their children who couldn't go to school, and coping with racial distress. We also had high levels of distress among health system employees who faced high demands and high anxiety around treating COVID patients, and handling the professional and personal stresses induced by the pandemic. Leo Pozuelo, MD. Chair of Psychiatry and Psychology at Cleve- land Clinic: Like the rest of the country, we are seeing patients who have delayed their medical care, and thus patients are coming in medically sicker. is connotes a higher psychological burden, for both patients and caregivers alike. We have seen an uptick in psychiatric consultations on the medical and surgical floors. Our census for inpatient psychiatric hospitalizations has been very steady, only experiencing a dip in the second quarter of 2020, with a rebound and sustained full occupancy along adult and child beds. e bottleneck of access and limited supply of community health resources has been an unfortunate theme throughout the pandemic. In the outpatient sector, the demand for psychiatric and psycholog- ical services has never been higher. e silver lining of COVID has been a better acceptance of the need for mental wellness. e impact of prolonged social distancing and isolation, and its psychological footprint, will more than likely be larger than the physical footprint of this pandemic. Finally, there is the continuous strain on our caregivers. e chronic nursing and allied health shortage, coupled with still high levels of burnout among certain services lines, has been in the forefront of our leadership communications. Terry Schneekloth, MD. Professor and Chair of the Department of Psychiatry and Psychology at Mayo Clinic Arizona (Phoenix): e pandemic has caused many major social stressors, including isolation from friends and family, reduced direct social contacts at work, and disrupted employment and job loss. Common mental health consequences disrupted exercise routines with their asso- ciated sense of wellness, heightened anxiety, worsened mood, and excessive use of alcohol, cannabis and other substances of abuse. Consequently, many individuals are seeking care from mental health professionals, an estimated national average of three- to four-times normal, and access to care is very difficult. Q: What is your hospital doing in response to these trends? Dr. Weinstein: Houston Methodist is increasing access to care for our patients across the system. We have added therapists to our inpatient services and our primary care clinics. Our clinicians are seeing the most ill COVID-19 patients and reducing their medical acuity by treating anxiety. e Center for Performing Arts and Med- icine has developed a hospital-based music therapy service. Hospital leadership champions mindfulness for providers. Houston Methodist has increased access to care for our employees by eliminating copays for mental health, increasing out-of-network benefits, and opening a clinic just for our employees and their dependents. e Emotional Health and Wellbeing program is staffed by the community's best mental health clinicians and provides mental healthcare for our staff and their families free of charge. Jonathan DePierro, PhD. Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Clinical and Research Director of Mount Sinai's Center for Stress, Resilience, and Person- al Growth (New York City): e Mount Sinai Health System opened the Center for Stress, Resilience, and Personal Growth in June 2020 as a resource to support the resilience and psychological well-being of its more than 45,000 faculty, staff and trainees. CSRPG provides work- shops focused on factors that support resilience that are increasingly utilized, an app providing mental health screening and resil- ience-building resources and immediately accessible behavioral healthcare. CSRPG partners with many other stakeholders within the MSHS, including the Office of Well-Being and Resilience, the Department of Psychiatry, human resources and spiritual care to provide robust, multitiered support during and beyond the pandemic. Dr. Barg: We continue to work tirelessly to accommodate the evolving mental health needs of our community and support our workforce. Early in the pandemic, we developed and implemented protocols to ensure safe patient care delivery in all facets of mental health treatment. Operationalizing telehealth removed significant barriers for individuals needing ambulatory mental health services. We test all patients in need of inpatient mental health treatment for COVID-19 and have protocols to safely co-manage COVID-19 patients with psychiatric needs on our medical units. is allows us to continue to deliver therapeutic group interventions, which are integral for inpatient psychiatric and addiction treatment. Our collaborative care programs — Penn Integrated Care and Mental Health Engagement, Navigation and Delivery — continue to expand access to mental health treatment in primary care and hospital settings, respectively. We also developed Penn Cobalt, a digital platform for access to mental health and wellness resources for our employees, and the COVID-19 ambulatory listening and medication manage- ment clinic to support employees. Dr. Ginsberg: We took several steps to address the growing demand for mental health services. Most significantly, we have expanded our telehealth capabilities and significantly increased our number of virtual office visits. is has led to profound shis in the deliv- ery of psychiatric care — one that has had a positive impact going forward. Additionally, we transformed our Consultation-Liaison Psychiatry service to a virtual platform for a subset of our patients at our Manhattan campus site. Lastly, we developed and enhanced our network of behavioral health services to meet the growing healthcare demands of our workforce of 45,000+ employees. From an operational standpoint, the move to virtual care has al- lowed us to hire more psychologists and psychiatrists to meet these growing demands, as we are not as constrained by the availability and costs of office space since most of our providers work virtually from their homes. During COVID-19, across the NYC metro area, there was a con- traction of inpatient and outpatient behavioral healthcare services available. is has contributed to an increase in the number of people seeking psychiatric care in our emergency rooms — nearly double from a few years ago. Dr. Danovitch: Cedars-Sinai is on the leading edge of recognizing that mental health and physical health are inextricably linked. We screen every patient for mental health conditions and, when indicated, we have a hospital-based psychiatry service that sees hospitalized patients, starts them on appropriate treatments, and refers them for continued care in the community aer discharge. As an academic medical center, Cedars-Sinai is also studying the impact of delivering addiction services to hospitalized patients with substance use disorders. ough published results from these studies are still pending, emerging data shows that patients are very recep-