Coronavirus mental illness tips

by DJ Jaffe

Executive Director Mental Illness Policy Org

Author, Insane Consequences: How the Mental Health Industry Fails the Mentally Ill

There are things that everyone has to do to address coronavirus (ex. handwashing and avoiding crowds), and the seriously mentally ill are no different. But due to their disability, there are additional steps that need to be taken during the coronavirus pandemic.

Unfortunately, NIMH is not communicating ways to help the seriously mentally ill. Instead, they are passing out ideas on how the public can deal with stress and anxiety. Stress and anxiety are not mental illnesses. They are an appropriate and normal reaction to what is going on. What is needed are specific action steps to help the seriously mentally ill during it.

This is not medical advice. Ask your doctor for that. But following are ideas from Mental Illness Policy Org and various people in our Facebook community to help those with serious mental illnesses. Some require federal action, some state action, and some can be done by anyone. This document can be found at mentalillnesspolicy.org/coping/coronavirus and will be periodically updated (3.16.2020)

  • Federal government should waive the rule (“IMD Exclusion”) that precludes the use of Medicaid to fund hospital care for mentally ill adults so more mentally ill can get into hospitals and fewer will be kicked out.
  • Until federal government waives the IMD Exclusion states should apply for emergency relief from the IMD Exclusion by applying for a “1115 Waiver” of it.
  • Free families of seriously mentally ill who are providing housing and case management services to mentally ill loved ones from the HIPAA Handcuffs which prevent them from getting information they need to help loved ones. This can be done by including them in HIPAA’s existing “financial exemption,” and “treatment and care exemption” which allow the sharing of information with those who pay for care and or provide treatment.
  • Doctors and clinics should use telemedicine, FaceTime and other technologies in lieu of office visits.
  • Give prescribing privileges to psychiatric nurse practitioners and psychologists to help  relieve the shortage of psychiatrists.
  • Mobilize students in closed medical schools, nursing schools and social work schools to help increase the shortage of behavioral workforce. They can be used to make house calls and possibly do the blood draws for those on clozapine, check lithium levels and conduct other safety procedures. This will help them become better doctors, nurses, and social workers.
  • Arrange for way for families to safely visit  loved ones in hospitals and jails. Do not shut down visiting as it is important for patients to maintain contact with outside world. Just arrange safe way to do it, ex. by requiring temperature check and handwashing beforehand and setting up visitation tables that maintain social isolation distances. There is a fear that ending visitation in hospitals and jails will result in a lack of oversight and the return of problems.
  • Conduct pro-active review of mentally ill who are incarcerated awaiting trial to see if any can be released to families via mental health courts.
  • Fill prescriptions for 90 days rather than 60 to minimize the need to go and get refills. Change Medicare, Medicaid, FDA and insurance regulatory rules if needed to require it.
  • Fund an Uber or Taxi account to take mentally ill to clinics and pharmacies to get medications so those who rely on public transportation can get there safely.
  • Arrange for pharmacies to make deliveries perhaps by contracting with food delivery services.
  • Rather than give hotels a cash bailout with nothing in return, the government should pay for hotel rooms and put homeless in them. That will help stop homelessness, help stop  spread of coronavirus among homeless, and provide an alternative income for hotels to  overcome the decline in travel bookings. If possible, they should be staffed.
  • Distribute sanitizer, face masks and educational materials free to those in homeless camps and shelters.
  • Do not let local, state or mental health authorities divert the behavioral health workforce or other assets serving the seriously mentally ill to mental health services for members of the general public who are experiencing sadness or anxiety. Being sad or anxious is normal. Being sad or anxious is not a mental illness. The services are needed to help seriously mentally ill.
  • Make  phone calls from psychiatric units, jails and prisons available to the mentally ill in them for free so they can maintain contact with outside world.
  • Communities of faith and others should set up phone-trees to  maintain contact with housebound mentally ill. Members of the public may know a family with a mentally ill family member. Offer to call and chat with the person.
  • Mental health programs with government contracts to educate the public (ex. conduct Mental Health First Aid classes, do mental health education in public schools and colleges) should be required to reassign those publicly funded employees to helping to deliver care to seriously mentally ill.
  • Since schools and colleges are closed, the mental health workers in them should be reassigned to work with the seriously mentally ill.
  • Bring your mentally ill loved one to live at home if you can. (I realize this is not an option for many)
  • Buy  focused cable TV (or computer) subscriptions because most free broadcast is increasing anxiety through 24/7 coverage of the virus. Mentally ill with interest in sports can be given a sports subscriptions (to watch previous events) those with an interest in movies can be given Netflix. Etc.
  • Look at the supply chain for psycho-active drugs now, so any potential global supply line interruptions can be addressed while there is still time.
  • Provide at-home food-pantry services and/or ‘meals on wheels’ and/or gift certificates to chain fast-food to-go restaurants to mentally ill.

Thank you for your support of Mental Illness Policy Org. More info on coping with mental illness can be found at https://mentalillnesspolicy.org/coping