Three months into the quarantine prompted by COVID-19, Behavioral Health Administrator Karen Haughey asked her team to think about how a sudden pivot to providing counseling and other behavioral health services online and over the phone had affected their work.

The responses that Haughey received demonstrated the staff’s creativity and commitment. They will help shape how the agency approaches the eventual re-opening of clinics closed by the pandemic, and the services it offers in the months ahead.

What they learned

Some clients began psychiatry during the COVID emergency because transportation – which might include an hour-long bus trip with multiple transfers – had previously been a barrier. One therapist had planned to end services with two clients who moved across town before the quarantine began, but telehealth allowed them to stay connected, promoting consistency and continuity of care at a challenging time.

Calls to check in on patients or schedule appointments turned quickly into phone-therapy sessions when clients were eager to talk in that moment. Staff members gleaned new insights about clients’ home lives as they met through video-conference platforms. Some parents were able to attend more sessions when they were offered remotely because they didn’t have to find or pay for child care.

One clinician planned to meet with a depressed client over the phone while they each went for a walk, supporting the client’s goal of being more active. In fact, staff were able to plan their lives around client appointments, using gaps in their schedules in ways that offered greater balance to their lives.

Clinicians learned to adapt their approach with young clients, for example, offering shorter but more frequent sessions to 6-year-olds with limited attention spans. One client expressed relief that teletherapy could continue after she starts college in the fall, as she does not want to build a new a therapeutic relationship while adjusting to college.

Want to see more of what we learned from clients? Read the results of the survey through the Maryland Community Behavioral Health Association.

An unexpected opportunity

“The silver lining to me was that we had the opportunity to offer services to people who might not otherwise show up or might not have the capacity to come see us,” Haughey said. “People are really struggling and their symptoms are going to escalate.”

Catholic Charities shifted to telehealth on March 16, with half of its 10 outpatient mental health clinics maintaining some in-person services with strict safety protocols. In the weeks since then, they’ve offered a similar number of behavioral health sessions offered as in the same period last year.

It has been harder to connect with children who had been involved through one of the 150 schools Catholic Charities serves across the state, Haughey said, but other clients are attending sessions at a rate that is “through the roof.”

What’s ahead?

In coming months, as pandemic-related restrictions lift across Maryland, Haughey said she envisioned resuming clinic operations through “a marriage between telehealth and in-person” that thoughtfully addresses any anxieties clients and staff may feel about meeting in small spaces. Recent extensions will allow the organization to keep operating via telehealth longer than initially funded, but at some point, those extensions will end, and the organization will have to find a way to fund those services.

“We are incredibly flexible to do what works best for our clients, and also for our staff,” Haughey said. “I don’t know what it’s going to look like, but we need to be very trauma informed and methodical in how we roll it out.”