PHILADELPHIA – Since 2016, Mark Trainer has worked as a counselor for Crisis Text Line, a national nonprofit organization that provides a free mental health texting service for people in crisis. On any given day, he talks with texters about a “very wide swath of challenges,” including struggles with school and relationships with their family or peers.

But in March, the tone of those conversations shifted as the pandemic took hold across the country. Trainer, who is based in Bethlehem, Pennsylvania, found himself talking to people who couldn’t see their therapist due to social distancing measures. They texted him about their struggles getting psychiatric medications renewed. Teens sent messages about how their parents were now unemployed, leading to more conflict at home, while parents talked about much of a strain virtual school was.

“The pandemic has exacerbated things for people who were already struggling with mental health issues, but it’s also brought a whole new group who are struggling to cope that previously may have been healthy to the text line,” said Trainer, 59.

While many public health experts and advocates have raised the alarm about COVID-19′s negative impact on mental health, those effects likely won’t be quantifiable for another year or so. But the steady increase in people reaching out to crisis hotlines and text lines across the country sends a sobering message about the overall emotional impact of the pandemic.

Crisis Text Line reported its highest volume ever in November, recording over 180,000 conversations — an increase of 30,000 from October and 78,000 from September. Nearly four in 10 conversations discussed depression or sadness, and over nine in 10 texters were age 34 or younger. The Trevor Project, which focuses on suicide prevention among LGBTQ youth, also saw a significant increase in texters and callers — at times, even doubling pre-COVID volume, said Rob Todaro, communications manager for the organization. YouthLine, a teen crisis helpline based in Oregon that emphasizes peer-to-peer support, also saw an increase that has continued from the beginning of the pandemic.

“We had a big increase at the beginning of March and April that didn’t really go away,” said Emily Moser, YouthLine’s programs director, noting a 35 percent increase in call volume this year. “It spiked and hasn’t stopped.”

Moser said many callers are experiencing grief around not being able to do things they would usually get to do. “And while adults have had multiple years to practice stress management and build skills around that, young people haven’t had that,” she said.

Moser stressed that YouthLine has not seen an increase in teens talking about suicide or suicide ideation, despite the increase in calls.

“We don’t know what’s going to happen,” Moser said. “And it’s important not to make super scary inferences without more information.”

Local crisis intervention centers that take calls rerouted from national hotlines are seeing the same increase. Valley Creek Crisis Center in Chester County experienced a “very extreme increase” in calls starting in May, said Sonja Kenny, supervisor of the center. The increase peaked in October, and while the number of calls has since dipped, it remains high, she said.

“The nature of the calls continue to be associated with losses, like job loss, and loneliness and isolation,” Kenny said. “And there are a lot of barriers to accessing services in the community at every level, which means a lot of things fall on us. For example, when someone can’t get to a shelter or a food bank, they’re more likely to go into crisis when that’s happening.”

That’s what DaeZone Jenkins wanted to address when she set up New Jersey COVID Relief, Inc., a nonprofit that provides struggling families in the Philadelphia region with essential items, like food and clothing, as well as monetary assistance for rent and groceries. Jenkins, who is based in Voorhees, set up a 24/7 support line to help people who are experiencing emotional difficulties after interacting on Reddit with people in crisis.

“I couldn’t sleep because I was constantly responding to comments and emails from people just pouring their hearts out,” said Jenkins, 29. “I realized that there needed to be a place where people can reach out at three in the morning, four in the morning. Everyone’s needs aren’t always financial, sometimes people just need a listening ear.”

Isolation is another factor that has affected mental health, Trainer said. The number one thing he encourages people he talks to is to figure out a way to abate their isolation.

“Isolation is the worst because it forces us to figure everything out on our own,” he said. “When we try to do that, we get into our own heads and sit there and suffer. When we reach out to other people, it takes us outside of ourselves, so we can learn from other people and feel understood.”

Moser said that many teens who reach out to YouthLine talk about how lonely and isolated they feel, as well as the uncertainty surrounding the pandemic.

“The biggest thing we can do for them right now is to model what it means to be mentally healthy and have tough conversations around how they’re feeling, how hard this is for them, and how you, as an adult, can help,” she said.

Although Trainer recognizes that mental health has worsened for many this year, he said that the way teens are willing to talk openly about their struggles is encouraging.

“The stigma has been reduced,” Trainer said. “People are more open and proactive in reaching out for help. The things we can do to keep ourselves healthy have gained a tremendous amount of visibility. Life isn’t always easy and we’re realizing that we all struggle, and we can help each other.”

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