Mental Health & COVID: Adults & Families part 2 of 3

Health Law Talk Presented by Chehardy Sherman Williams

+ Full Transcript

Rory Bellina (00:15):
Hello everyone, and welcome to Health Law Talk presented by Chehardy Sherman Williams. Before we get started, please be sure to subscribe to our podcast and follow us on Facebook, Twitter, LinkedIn, and YouTube, – links in the description below. We hope you enjoy this episode.

Conrad Meyer (00:35):
And good morning everyone, or good afternoon, depending on when you’re listening to this. This is another health health law talk episode with Conrad Meyer and Rory Bellina. Rory, Good

Rory Bellina (00:44):

Conrad Meyer (00:45):
Everyone. And today we’re, we’re doing part two of our series under Covid and Mental Health. And Rory and I have been talking about this. We think it’s a very timely issue. And we’ve had part one with adolescents today, we’re doing part two C, mental health and adults and families. Yes. And, and so we have two special guests with us today, Felicia Kleinpeter and Christopher O’Shea. Are they on the phone? Felicia?

Felicia Kleinpeter (01:13):
Yes. Hey, good afternoon.

Conrad Meyer (01:15):
Okay, so we’re gonna go ahead. Yeah. Good morning. Good afternoon. Whenever time you’re listening to this Felicia, why don’t you go ahead and introduce yourself to the audience and give a background about what you are, what you do, and, and, and give the audience an idea about how you handle mental health.

Felicia Kleinpeter (01:32):
Thank you. my name is Felicia Kleinpeter, I am the co-founder and Chief Executive Officer at Imagine Recovery in uptown New Orleans. Imagine Recovery is an outpatient mental health and substance use treatment facility. And I am, to be transparent, I am a person in long term recovery from substances and mental health issues. So I, you know, have a good perspective on helping people get through things, having been through things and service, you know, adults and families here in our center and, you know, on the phone and things like that.

Conrad Meyer (02:07):
Fantastic. Christopher, what about you?

Christopher O’Shea (02:10):
Hey, everybody. Christopher O’Shea. I am a co-founder of Imagine Recovery in New Orleans and the co-founder of TPN Health. I have a background. I have an msw. I am a combat veteran from Afghan and Iraq, and I’m also a person who has been living his life coping with mental health.

Conrad Meyer (02:34):
Well, Christopher, thank you for your service. Yeah, thank you. And, and, and just for the, the audience purposes, give a brief background. What does Imagine Recovery do?

Felicia Kleinpeter (02:44):
Imagine Recovery? we have treatment programs, intensive, outpatient, outpatient, and soon a level of care called partial hospitalization. So people come to us for, with substance use issues, mental health issues. we have group therapy, individual therapy, psychiatry, family sessions, family education, family support those kind of things. So some people go to treatment, you know, residential and go away. We are in the city in real life. You come to us on a weekly, you know, for 10 weeks, 12 weeks, sometimes longer. And let us help you to, you know, get on a better mental health track, get skills, you know, connect, find community, and all those things.

Rory Bellina (03:27):
Very, very interesting. And thank you for that introduction. So I think we could just jump right in. today’s recording date is September 17th, and we’re, Louisiana Lease is in its fourth wave of this Covid 19 pandemic. so, you know, I, I think we’d like to start out with talking with you Felicia and Christopher as well. What, let’s talk about going back in time, you know, right before Covid hit, what were you seeing with your patient populations, And then as Covid hit, can you kinda walk us through what what transitions you saw and what, what different issues did you see pop up?

Felicia Kleinpeter (04:06):
Would you like me to start?

Conrad Meyer (04:07):
Sure, sure. Absolutely.

Felicia Kleinpeter (04:08):
Sure. Okay. So thinking about right before Covid hit, you know, I, when, whenever, you know, you say that, it’s like, I take this really deep breath. we were seeing, you know, people came in with mental health issues, certainly, and you know, alcohol issues substance, other substances, and people were living in, you know, living in the world and, and sort of, you know, as, as we would see people have issues. And so we were able to treat a real broad population with that and help them achieve, you know, a life worth living and, and all that stuff. You know, when Covid hit the sh it shifted to some degree. people immediately started experiencing more mental health issues. People that didn’t necessarily have one before didn’t identify as having anything that came to the forefront right away. you know, with the isolation, anxiety, fear, and all those things at depression being so isolated those really came out to the forefront. And then fairly quickly because of those things, we started seeing more alcohol abuse, substance abuse, you know just, just to try to sort of snap out of the way one was feeling in this isolation.

Conrad Meyer (05:23):
And, and, and I guess one of the things that we’d like to know is, so let’s talk about, you know, the immediate impact of Covid, which you sort of addressed just momentarily. So what did you see now, or what, a year, almost a year and a half right? Later. What are the differences? Are you seeing now present day from a year ago when Covid first started and you started seeing these mandates and lockdowns we’re gonna shut everything down? No more school, no more in person. Now it’s mask mandates, six feet, you know, kids can’t go here, there and now even vaccine thing mandates, you know, and some, some, some schools. Sure. and, and, and, and also for, and how, how is that affecting the adults and the families? What are you seeing a year when it first started and then present day?

Felicia Kleinpeter (06:08):
That’s a great question, Christopher, why don’t you start with that?

Christopher O’Shea (06:12):
Okay. so I would say, see

Felicia Kleinpeter (06:20):
We just watched Christopher you know, when, when this began, we, we all basically thought maybe a few months at worst. and I think the, the, the exposure as long as a ton of the economics that began affecting everyone you always have to look at the economic side. but a lot of it’s fear the unknown for any human being, and especially those whose mental health starts getting triggered as well as caregiving, you know we all had to shift into these different roles within our own communities and families. So as an adult, that falls on you. I see a lot of fatigue. I see a lot of people who are just at a point where their mental health is just so worn down. and, and that’s developing into many other issues. the un instability of the political system, the economic system, all of that overall is always going to trigger underlying mental health as well as, you know, existing mental health for people.

Conrad Meyer (07:32):
And, and, and I don’t, I don’t disagree with that. I, I think, I think we’ve heard on our, on our, on the adolescent podcast a similar situation where things have progressed. So I guess the question, let me, let me tee it off to both of you. Mm-hmm. is some, some therapists that we have talked to have said that in the, in the initial lockdown, that they’ve seen not just negative effects, but there were some positive effects, like kids were focused they seem to disassociate maybe from some of some negative friendships, and we’re able to focus more. and so can we contrast the negative effects? Did y’all see positive effects initially and have those transitioned to negative effects? What have you seen in that dynamic?

Felicia Kleinpeter (08:16):
I’ll take that. you know, that’s interesting. There were some positive effects from Covid. there were, you know, people whose professions take them you know, on the road a lot, whether it’s, you know, musician friends of ours, or people that travel for work regularly or even people that just go away to work, right? from the home. Now, kids are at home, families are at home. kids are doing telehealth, pe adults are working on their computers from home. And that gave a lot of people time to really get to know their families, spend more time with their animals, spend more time outside, really bond and connect. So there were some positive, positive things. I know people that musicians, let’s say, whose careers have taken them on the road for 30 years and have never had one year to be home with their kids and their wives, You know?

So there were some positive effects. I think there were a lot of challenges. when you mentioned initially, kids no longer being able to go to school. I mean, we have friends with younger children that they’re having to homeschool and keep them focused on, you know, over Zoom. That can be difficult. I know something that we implemented here right away was to do a virtual parenting class, like some skill dialect, behavioral therapy skills, because all of a sudden, people are having to homeschool or, you know, be at home all the time. So there were definitely some positives and some negatives, and I think we’ve all navigated through this very well. And I know something that we had to implement here is move very quickly to find solutions and find support for people.

Conrad Meyer (09:49):
I understand that that’s, that’s I, I can see that, I can understand that that seems to reflect what others were seeing in the, in the adolescent world.

Rory Bellina (09:57):
Christopher, I have a question for you. So if we’re, if we go back and, and talk about the, the various mandates that we have what did you see, if any, of, let’s talk about the mask mandate first. What effects, if any, did you see on your patient population? And in addition to the mask mandate, if they were forced to work from home or be socially distant, or, you know, couldn’t go to their usual gym, or couldn’t go to a restaurant or a bar that they like to go to, What kind of effects did you see with adults when, you know, when, when Covid kind of started and we had the, the most serious lockdowns per se?

Christopher O’Shea (10:34):
Yeah, I mean it, it, it’s interesting to bringing that up because, you know, when, when the initial lockdown, one of the positives that came was some of the things Felicia had said, and as well as you had mentioned that all of a sudden you started to look at what’s important. You know, I, I think the, any crisis, especially one that is a pandemic those people who start to think, what’s, what’s the important priority? and so I do believe that like, going to the gym or being able to go to a movie theater or any of the things that immediately were taken away, I think all of a sudden people shifted and began looking at, you know, different forms of enjoyment, recreation, intimacy, interaction which, you know, I, I gotta tell you, you know, we all are always worried about technology. But without technology, I wonder where we would all have been be when the mandates were forced onto all of us.

Rory Bellina (11:33):
And, and Christopher, I’ve had a few therapist clients contact me, you know, unfortunately asking for referrals for divorce attorneys because the, the lockdown where yes, you know, they were, you know husband and wife or spouse and spouse were away from nine to five, or had one had a traveling job, one did it, and then they’re stuck at home, ver both working virtually that had a big they weren’t used to being together that much of a time. So how did you see that effect or Felicia? How did you see that affect your, your population?

Felicia Kleinpeter (12:05):
Well, we did see that to some degree. And we know just from being mental health professionals, that there was a large rise of, you know abuse in the household where, you know, that kind of thing was happening. And, and you know, if someone’s not, not going away, like you’re saying, there’s a lot more separation, which kind of made the relationship manageable. So we did have some instances where people that were forced together for so long did not fare well together, and so decided to part ways or get counseling, or get treatment or whatever to make the situation and the relationship last. One thing that I wanted to comment on, on your last question with the masks is it’s been an interesting process as far as the mask mandates. I believe there was a lot of resistance at first, or kind of like, we’ll do anything we have to do to get through this.

And, and there was a lot of resistance on our client’s part initially, let’s say, when we were able to, we are still masked, you know, in our building the whole time as a health provider, the staff is masked, the clients are masked, they’re all vaccinated. But am I gonna be able to connect with people sitting in a room with a mask on? Am I gonna be able to? And what we have found is, yes, that we absolutely have. It’s just become the new normal, you know? And and so also something to consider is there’s you know, people that are traveling this journey of recovery, whether it’s mental health or substances, it’s about being selfless kind of thing. So even if I’m vaccinated and I know I’m okay, I put on my mask because I’m thinking of others, you know, I wanna protect other people. So there’s, I think a lot more people have kind of gotten into that mindset that I don’t wanna create fear in other people if I’m walking around, not masks. Does that make sense?

Conrad Meyer (13:56):
It makes sense. I mean, I, I guess the, the flip question to that would be, well, if you’re vaccinated and you’re wearing masks, then so what? I mean, you know, you already vaccinated you. I, and, and I’m not, and I’m not, I’m not trying to politicize this, but in a sense, that’s the, that’s the flip question that, that we, what we have is, we have calls from clients and they’ll say, Well, wait a minute. I’m getting calls from my employees and say, Well, I’m already vaccinated. Why do I have to wear a masks now? So that’s the flip side. So when someone says that from, from a mental health standpoint, how would you counsel someone and say, Okay, I hear where you’re saying, What would you tell someone if you, if you heard that comment?

Christopher O’Shea (14:38):
I, I could answer that. And, and I think those, like you said, it’s not political. It’s very much what Licia indicated, which is, it’s, it’s a way to out to alleviate a community in a community response, less stress on you. You know, if, if, if you look at the question when it comes to why people are wearing mask or not wearing masks, the truth is you’re, you have to wear a mask. we’ve been doing it now off and on for a year and a half now. It, it, we spend way too much time discussing whether we should or shouldn’t. It. It’s the least important thing of what’s going on, right? and, and yet it is the flag that we all go to, to look at. So I understand that, but to me, there’s so many other more important issues that are happening and, and destroying communities and, and as different racial groups and economic groups, those are the things we should be focusing on, not whether I should have to wear a paper mask.

Conrad Meyer (15:43):
I understand. And, and then, and

Felicia Kleinpeter (15:45):
Additionally, Oh, excuse me. I just wanted to point out, Go ahead. I wanted to point out, you know, there was that short window of time where we thought we were all safe, the people that were vaccinated, So we went around without masks, and then a lot of us got the Delta variant, you know, fully vaccinated wearing masks all the time. So we’re still able to transmit this thing. It’s just in another form right now. So I feel like we’re at the same place we were at the beginning as far as the necessity and requirements to wear masks and keep ourselves safe and others safe. So, you know, that’s where we are right now.

Conrad Meyer (16:21):
So let’s, let’s, let’s pivot for a second. So, I mean, obviously we, we have a, we have a mental health crisis going on right now with Covid for various reasons, right? We can all agree to that mm-hmm. . So wh when you both, what advice would you give our listeners to say, okay, what are the signs and symptoms that a family or an adult is beginning to have, sort of a mental health problem or issue or crisis related to these covid measures? What should people look for?

Christopher O’Shea (16:51):

Felicia Kleinpeter (16:52):
Oh, I would thought maybe you’d wanna take that one. Sure.

Christopher O’Shea (16:55):
. So, so what, you know, and,

Conrad Meyer (16:59):
And I said it to both of y’all, so Chris, if you wanna take the first part, Felicia, I wanna hear your thoughts. So Chris, go ahead and take that out. Take that question.

Christopher O’Shea (17:05):
Yeah. So you know, what’s interesting is even prior to C’S outbreak, you know, the last year, few years, you know, mental health has become less and less of a, you know, in the background topic, it’s, you know, the, the nation began embracing it, the, the world’s embracing it. So there were good indications that you could talk about mental health, you could talk about stress, depression, anxiety, and, and you weren’t looked at as odd. I think what really, you know, it goes back to the other question where you talked about what, what’s happening among families when they were forced into this situation having to live together in such a intimate way that they weren’t comfortable. It’s normal for people to feel uncomfortable in a routine, in their relationship is disrupted the way Covid disrupted that. and as Felicia said, and you guys know, it definitely resulted in some people divorcing or separating or, or, or whatever may be.

But, but I, I think when you come back to what should you look for, it, it, it’s the same thing. You would always be looking for isolation. Are they becoming very angry over very non-important issues? You know, are they being oversaturated by watching news and editorials? And are they becoming very polarized in something to a level where they begin arguing with people in the family? You know, sleeping obviously has always been a big indicator when someone in the house is sleeping all the time. They’re eating habits, not just not eating, but also only eating very unhealthy foods all the time. You know? So there are, there are lots of simple ways to notice it would, you know, by talking to a friend just the average of up and down that we all have. and then on the opposite side, becoming over analytical and being the helper, I think what we didn’t see, but we didn’t notice was the helpers who are way too co-dependent, way too connected to being that person in their, their relationships and their community. You know, burn themselves out, you know, caregivers, secondary caregivers. All of those groups are of the highest levels of suicide ideation, you know, substance use, increase misuse. so I think, I think indicators are, that you would look for is, you know, isolation is always a big one. The other would be outbursts of emotional, you know, deregulated emotions being too intense, all a subject that isn’t as important as it should be. Those are indicators,

Rory Bellina (19:52):
So, sure. So, Felicia, did you want to add anything onto that?

Felicia Kleinpeter (19:55):
I thought that was a great answer. I agree with Christopher. And like, you know, typically what we would tell families is any, any pretty drastic change in behavior, you know, change in communication and, and all of those things. But I agree fully with what Christopher said.

Rory Bellina (20:11):
So if you’re seeing, you know, a friend, family member, a loved one, you know, what are some good resources available for adults, or, you know, what’s kind of the, the first step if you think you’ve got someone who’s having a mental health issue going on, whether it be, whether it be your spouse, loved one, or a friend. I know that’s a very delicate topic to talk about with friends, but you know, kind of what’s that first step that, that we should take?

Felicia Kleinpeter (20:38):
Well, you know, there, our Christopher, did you wanna say, did you wanna go first on?

Christopher O’Shea (20:44):
No, you’re, and go.

Felicia Kleinpeter (20:45):
Oh, okay. I, I heard, heard you take a breath, . you know, I, we here are available. I mean, there are many resources online. There are, you know, suicide hotlines and, and mental, you know, on our website, imagine, we have several crisis line numbers and all of that. You know, I recommend reaching out to a treatment provider a medical, a mental health professional to find out sort of like what the signs and symptoms are, what, what’s available to help. I feel calls all the time for people that just are looking for something. It has nothing to do with my center. Just how can I help point them in the right direction, call a psychiatrist, make an appointment, call a mental health therapist just to get some support, because it really is difficult to navigate without any knowledge. What are the next steps to take? How do I approach that person? How, how can I, how can I appear loving and helpful, which is the intent without acute being accusatory, like, we’re worried about you or being overly dramatic. So I know Christopher earlier and I were talking about Ula School of Social Work has a website with research and resources for Covid we do on our site. And there are some other, you know, places you can go. Christopher, why don’t you chime in?

Christopher O’Shea (22:00):
Yeah, I, you know, I’m just listening to Leisha talking and, and I wanted to get to a place where, where as a human have I been able to share something that I wasn’t willing to share that was going on for me. And it, I think it really comes down to if you have someone in your family, give them the space with some empathy, some compassion, and more importantly, share what your own struggle is. I mean, Felicia’s in long term recovery, as well as I am to substance misuse and abuse. And so what, what, what makes that system work so well? Peer support systems work so well, and, and it translates really easy to families and friends, and even coworkers, is when you empathetically share your own struggle, it immediately can trigger that response with some, Hey, I’ve been dealing with that too. and, and so that’s the initial thing.

I think any normal person, whether you are a truck driver or a professor or a banker, you know, if you can look at yourself with someone you care about and think of your own struggle, cuz we all have it right now, that’s always the best way to start opening the door where they may share with you. And then once they share with you, the prestigious Felicia talked about, you know, whether it’s a, a online group to join, you know, the biggest thing that we recognize today is the lack and sense of community. and, and they’re all ways in which you can engage. They’re not as good as in person but they’re also not as uncomfortable. so there, there is some positives that have come from this using technology. And if you don’t have that ability, cuz that’s the thing we see within New Orleans, are lots of people who don’t have internet, they don’t have a laptop, computers, you know, they may have a cell phone. You know, there are other ideas. One of them is that we do is get someone to go out of the house. Let’s go for a walk, Let’s do something that moves the body. And, and, and that moving the body is another thing we realizing during the pandemic that if you can get people to do dancing or shaking, or that it’s unlocking them a little bit so that they might be able to share what’s going on.

Conrad Meyer (24:08):
So, So let me ask you this. I, I mean, I, I I, I’ve heard, and and let me ask you both these questions. Would you both agree that there is a lack of capacity in terms of mental health providers for the need?

Felicia Kleinpeter (24:22):

Christopher O’Shea (24:23):

Conrad Meyer (24:24):
Okay. So, so if we can both agree, if we can all agree to that, in other words, we know there’s a lack of, of capacity in terms of the providers, what would you tell the family, the adult, the individual who might not be able to afford a therapist, who might not be able to, to call a psychiatrist and make an appointment and get in quick enough? Right? What, where, where do they go? What, what kind, I mean, what’s available for them in terms of a community support or a resource based support for those individuals?

Felicia Kleinpeter (24:56):
there are many services in New Orleans, for example, that work on either free treatment programs, sliding scale treatment programs, medicaid programs. I, we, we refer a lot to places that will take somebody for free that may make for therapy charge $18 an hour on a sliding scale. so there definitely are places and, and systems that are in place for people. There just aren’t necessarily enough of them. and Go ahead, Christopher.

Christopher O’Shea (25:31):
Yeah, I mean, no, your point’s a hundred percent. you know, so Felic is right about that, but even those places that we have, these relationships are backed up and they’re, they’re, you know that’s always been the story. But during the pandemic, even once you know, as far as psychiatry goes, even if you’re paying for one, it can take four weeks to see one right now. So, I mean, these are the real things, you know? So, so we talked to all these reasons. Someone comes you and says, I need help you get them a psychiatrist. And that psychiatrist says, I don’t have an appointment for five weeks. So, you know, we all know, you know, we, we actually dealt with that recently with someone who had all the abilities to pay and, and it still didn’t matter. So that’s really, really a huge issue.

and as far as community that the community has stepped up, whether it’s church’s synagogues and, you know community areas, the, our Buddhist center here, you know, there’s lots of different groups that are doing it. But more importantly, I, I would say right now, telehealth has, has made the economics a little easier on everyone’s side. so that’s one of the benefits I think of telehealth is, is if we can get it to a place where that, you know, people in those populations can afford, you know, $20 even an hour can get services. I, I think that’s one of the directions we need to move.

Rory Bellina (27:03):
Christopher, you read in my mind, because my next question was gonna be about telehealth. So Christopher and Felicia, Christopher, you brought it up, but both of you, I’d love for you to chime in, talk to me about how your practices pivoted to telehealth, You know, when a pandemic hit, you know, the, the, the pros and cons of trying to provide therapy through telehealth. Because in our previous episode, we definitely heard about some barriers of not being face to face. And then I’d love to hear the pros about it as well, and then, you know, how you’d like to see it continue to evolve in your practice.

Felicia Kleinpeter (27:38):
I’d love to take this one first. I have to say as the, you know, operator of Imagine Recovery, when we learned of the lockdown was coming I have to say telehealth has been an absolute, for lack of a better term, godsend, . we were faced with a situation where our whole business would shut down, our clients wouldn’t have services. And literally in one day, we were able to, you know, get a Zoom, a HIPAA compliant Zoom platform, figure out how to do breathalyzing and drug screen over telehealth, do individual therapy sessions and group therapy. And so our clients that might have just been without telehealth, they would’ve just been at home without any support, any education, any guidance, we’re very quickly able to just, okay, it’s Monday, starting on Wednesday, you’re gonna be sent a Zoom link. We help them all figure out how to log in, how to download the app, how to do all that.

And and basically seamlessly we’re able to serve them. Now, the great thing about telehealth too, at that time is you could see people’s faces because in your own home, in your own private space, you’re not having to wear a mask. So it’s been an incredible opportunity for us to be able to continue to serve people. what I would like to see moving forward is, you know, some insurance companies or law, you know, state to state laws are prohibiting let’s say I have a client that just now evacuated to another state, right? A two lane student. some, you know, doing that state to state telehealth, there’s certain times where that’s allowed and then they pull it out. But just being able to open up the services so that people can have state to state therapy, which is reimbursed and also, you know, legal. So that’s what I would like

Rory Bellina (29:30):
To see. Sure, sure. Now, Christopher, did you find that you had, when you had to pivot to telehealth, did you find that you had the same effective therapy sessions, or was there something missing there before swing

Christopher O’Shea (29:43):
The screen? You know? Yeah, I really appreciate this call. I’ve thought a lot about this. And, and I can tell you as a person who’s like the hair club for men president, that’s also a client, you know, I myself began having to engage as a person, long term recovery on recovery meetings online. And and, and so personally, I was very skeptical and I, I ended up getting a huge benefit. What we’ve determined though, is people who were just now engaging in therapies and, and mental health support, their reaction to it is not the same as someone who has maybe a few years or time in person. and, and I think also there, there is something about physical presence, no matter how much, you know, we’re, we’re big believers in education and, and having a bright therapist, smart therapist, and, and an aware therapist.

But there is something that’s not tangible that exists when you’re sharing a space in a room, as well as getting in your vehicle on the bus and going to a place and sitting with others. There’s something that to this day, we spoke, haven’t yet identified, but there’s something that, that’s healing about that, right? So that’s never going to be replaced by the actual virtual. The other thing that I found was, even though I, I like Felicia’s attitude about seeing faces, I can tell you as a person who works in therapy, that not seeing someone’s body, their physical presence, I’m lose indicators on are they plugged in? Are they involved? So in therapy, I think there’s a downside to that. on the upside, like Felicia said, I think there were lots of people during the pandemic who had a severe amount of anxiety about going out in public and being out in public.

This helped alleviate that. So, you know we didn’t make them come in person. that was interesting. Felicia did something where we have enough space in buildings that for people, we wanted them to get out of their houses during the pandemic mm-hmm. . So she would allow them to come and, and stay one person in separate rooms at our facility and join virtually. So we saw a much healthier uptick in the people that we did that with than the people who just stayed in their homes. and you know, there, there’s all kinds of research that’s been out about you know, what are the downsides. I think what Felicia said, the out the, the other part of that is it’s allowed people cross borders and states to realize their issue is there are people from all over the world and all lots of blanks. So there, there was some of that, which I, I think was good.

Conrad Meyer (32:26):
So a couple of follow up on that, Chris. Okay. Christopher, So let me ask you this. So you mentioned earlier about not being able to see body language and body cues. When you were evaluating your patients, how much of that would, and and this is to both of you Christopher first, what do you think, how much of that is, is involved in your assessment of a patient’s condition?

Christopher O’Shea (32:50):
You know, it’s interesting. Felicia will actually be better at this question than I am. I can tell you this, that body language and, and the, and the levels in which all therapists have, have become educated in the last five years is a lot more important than we realize. Psychiatry has used it for many, many years. It’s a big part of their training. But for us, I think it’s a real indicator. it’s also difficult to see if they’re actually looking at you on a screen. You think they are, but they may not be. I, I think all of that plays a role. I think the, the biggest thing that Leisha will probably answer is we do a tremendous amount of research on your past history. and so I think a lot of the information is, is really being processed that way. And then we usually do have a psychiatrist, a, a psychologist, and a social worker analyzing the information that you’ve given us. So, I, I, it’s important that I think you just have to spend more time than you normally

Conrad Meyer (33:52):
Would understood. Felicia, you wanna follow up on that?

Felicia Kleinpeter (33:55):
Yeah, I agree with Christopher. Body language and physical presence is really important. you know, it is an important factor, but, you know, when, when we’re talking about telehealth, it it was just a, a great substitute, you know? And and, and also, let me say this, being in person also helps somebody not have distractions, because clients aren’t allowed to have phones in the group room or in their sessions. So when we’re on telehealth, as great as it is, and as valuable as it’s been, you know, you can tell people are looking down at their phones or they’re doing this or doing that. So, so you know, there’s upsides and downsides certainly, but I think people’s body language says a lot about them when they come to therapy and sort of their, their general, you know, presence. So that’s what I think.

Conrad Meyer (34:47):
So, real quick, let me ask you this spot question. Okay. What percentage of your patients did you see via telehealth pre Covid, Christopher?

Christopher O’Shea (34:58):
Oh I think less than 1%.

Conrad Meyer (35:01):

Felicia Kleinpeter (35:05):
I’m sorry, could you repeat the

Conrad Meyer (35:06):
Question? Absolutely. what percentage of your patients pre covid did you see via telehealth?

Felicia Kleinpeter (35:13):

Conrad Meyer (35:14):
Zero. Okay. So let’s, now let’s, let’s the follow up, obviously, What percentage of your patients now do you see post Covid Christopher?

Christopher O’Shea (35:23):
well, so we’re probably at about well, we do individually in person. So I would say probably about 80%,

Conrad Meyer (35:31):
80 per Wow, that’s a tremendous, that’s a big shift, right? Okay. Felicia, what, what about you?

Felicia Kleinpeter (35:37):
Okay, I’m gonna give you a timeline. And when Covid came, it was a hundred percent okay. And we were able to come back in person. We have one out of four groups that’s still virtual and some individual therapy and psychiatry. But here’s the thing, when, when people evacuated mm-hmm. , and we couldn’t be open, our center didn’t have power, 100% telehealth. So it’s like being able to kind of shift and move, but knowing that it’s always there to say, we don’t have power. It’s gonna be on Zoom. So it does shift and move, which having the opportunity to do that is incredible.

Conrad Meyer (36:12):
Great. Okay. Okay. So let me ask the follow up to this. Okay. So capacity wise for both of you. Okay. Ha what, in terms of, I don’t know if you put in percentages or in terms of the number of patients, but what has Telehealth done in terms of your ability to see numerosity, the number of patients? and can you quantify that?

Christopher O’Shea (36:37):
sure. I’ll, I’ll start. well, so, you know, our mission, what, what we believe Le and I we, it, it wouldn’t, it didn’t really matter. there obviously it was easier and you could have larger groups if you choose. We don’t, because to us, the capacity level of the therapists that are in, you know, some of our groups have two therapists in them. You know, our whole thing is there’s a number you get to, to where a person isn’t getting the value. So even though we had friends who owned other facilities, they were like, I now can I have 40 people in a meeting in a group? that to us seemed irresponsible. And so, you know for us, I think the group size didn’t shift. I think what Felicia can share on is it did allow us versatile for those people who couldn’t actually physically come to see us.

Conrad Meyer (37:30):
Got it. Okay. Yeah,

Felicia Kleinpeter (37:31):
It increased our ability because as a a, a facility licensed by the state of Louisiana were able to treat anyone in Louisiana. So it did increase our clients from Baton Rouge or Chibeau, that, that maybe once may have driven here, but they were able to join every day from, from their home. So being able to service people from other cities besides New Orleans increased.

Rory Bellina (37:57):
Gotcha. Gotcha. That’s a, that’s a really good point. And I think that, like, like Connor had mentioned, Telehealth is only expanding, and so it’ll continue to allow you to, to reach more patients. And like Christopher said, that the newer patients are just so accustomed to doing things virtual. So,

Conrad Meyer (38:12):
Well, I think once you open the box, I mean, I mean, remember the red tape we had with telehealth before this? And so we remember, I mean, literally within days, you know cms came out and just cut all the red tape. It was gone. Yep. Like gone. I was like, Well, for years we’ve been looking at this and saying, Well, when, how long before the, So the, I guess now the, the, the cat’s out the bag and you

Rory Bellina (38:34):
Can’t put, put the toothpaste back in the tube and the, and the issues before where you had to have, you know, a certain software and it had, it was very expensive. It was, it had to be run on a, then you had the licensure and reimbursement.

Christopher O’Shea (38:44):
You, you, you had to have servers that were HIPAA compliant. Right,

Rory Bellina (38:48):
Right. And overnight was astronomical. Yeah. And overnight, you were able to go to, you know, consumer products. So I think that’s, that’s great. And I’d love to hear, I’d love to hear from both of you, you know, going forward where, where, like I mentioned the beginning of the call, we’re kind of in our fourth wave, and it looks like we’re coming down from that. But going forward, where do you see your, your patients going? And I guess my question means, you know, what issues do you see that are gonna continue? Or what issues do you see will, will go away for your patients? And kind of how can you predict, you know, what’s coming next, I guess, for your patient from a covid standpoint? From a covid standpoint? Yeah. Do you see that, you know, people, more people are getting vaccinated and more people are getting kind of accustomed to this new world, per se, where things are more spread out and you have to show a vaccination card in certain places, You know, What do you, where do you see your patients and or new issues going from here?

Christopher O’Shea (39:46):

Felicia Kleinpeter (39:48):
you know, I’m thinking, actually, do you wanna take it first? I’m just

Christopher O’Shea (39:51):
Wondering. I’ll, I’ll answer . So, so I, I really, I’m glad we’re, we’re bringing this up. The first thing that’s really starting to happen is when I talked about people’s fatigue it’s also trauma. This is a traumatic thing that we’re in, that you don’t begin to really process until it starts winding down or stepping away. I, I think the other aspect is we all had this dream that there would be an end date for this thing and the world would return, right? And and that we all know now that’s not gonna happen. I think in regards to when we talked about people who maybe sought out mental health during this period of time for the first time, and really engaged in it, I think what’s gonna be interesting is when it is beginning to be back in person, the anxieties of that, you know, you, you’ve gotten used to conveying whatever you’re doing, whatever form of therapy you’re doing, or, or community group through a, through a lens of a screen in your own home.

Now you physically are in the presence of others. So there’s gonna be some interesting positives and negatives that are gonna come from that. I also, Felicia and I both have been talking a lot about this. We would like to be able to con, you know, continue using the option of telehealth, but also maybe hybrid versions where there are some people in a group and some people are on the screen. and so I think, I think there’s options that have come out of this traumatic experience, and I’m gonna stay positive on that. I, I think also in rural areas they can now have access to better therapy. because if they can do it over virtual, it allows them, as Felicia said, within a state to maybe go and be a part of some place. You know, obviously we think our place is amazing, right? And so you know, that’s the, there, there are positives out of this.

Conrad Meyer (41:46):
Excellent. Felicia.

Felicia Kleinpeter (41:47):
Yeah, I would like to say just just you know, addressing the telehealth and being able to continue to do it. It’s really important that insurance companies support it and, and on from here, moving forward forever, continue to reimburse for it. I, I can’t imagine what would happen if they just decide one day to say, Sorry, we’re not doing that anymore. So just, just putting that out there. When I see changes in people, you know, people have different issues now. you know, I think I, when Christopher brought up economics before, you know, I, I look at, you know people that are in different careers now than they were when they, before the lockdown started, they, they had to, you know, their business was shut down. Their, their livelihood was shut down. It’s, which is why we have a lot of restaurants and, and stuff like that looking for staff.

People that once worked somewhere now had to move on to something else. So, and I think in those people’s lives with new careers and different economics create different stressors. And so the things that people are facing, you know, will always have a certain degree of anxiety, depression, adhd, substance use. But, but the, but sort of the causes and conditions maybe have shifted a little bit. And I believe as people, as this, you know, ends quote unquote ends, and people are back in person, there is that level of anxiety that Christopher talked about. And, and trying to get back into a comfort level, you know, reattaching to other people and reconnection. There’s been such a long stretch of kind of not doing that. It’s like, you know, with the first time you went to hug somebody, it was like, Wow, this feels odd. I don’t remember how to do that. You know what I mean? Of course you’re wearing a mask and all that. But, so I think there’s some reintegration and a lot of the skills that Christopher mentioned, the mind body medicine skills, you know, the mindfulness, the the dancing, the walking, you know, just connecting with other people is really, really important to get back into a comfort how to, how to engage back in the world, you know, post covid.

Conrad Meyer (43:51):
I agree. And, and I, I guess the, the, let me ask you this. We could do a whole show on insurance reimbursement. I mean, we could do mul, we could do multiple shows on that. And, and I’m sure we’d have a, some very, some very interesting discussions about that. Yes, yes. So, so let me ask you this. Both of you have brought up a lot of topics, a lot of good points for families, adults dealing with this mental health crisis with Covid and, and a lot of things going on. So I’d like to ask you, what, what can you give our listeners some, some tangible resources, whether it’s a website or something they can go to for more information to help them with with getting, getting the help they need?

Felicia Kleinpeter (44:32):
Well, you know, off the top of my head, I can say, you know, I wish I had a bunch of things written down. I would give Imagine Recovery a call. Me specifically, I’m going to verbally tell people my cell phone number, if you don’t mind. It is 2 2 5 9 3 7 1 1 3 2. That’s cell I am available to. You can call me, text me. I can point you in the right direction, your resources, whatever your needs are. Christopher and I are very fortunate to have national relationships and colleagues. So whether you’re calling from New Orleans or some other state, we can help you with that. Like I said on our website, there are crisis lines. There’s suicide hotline, Tulane School of Social Work. There are many, many places to go. And I know Christopher has some he wants to share.

Christopher O’Shea (45:18):
Well yeah, I mean, I, I think, you know, I was talking to Felicia when I saw that this was something that, you know, we, we wanna give to your, your listeners as well as who listens down the road you know, Felicia’s website which is imagine At the top, there are all different current updated resources for every type of human being and, and, and, and different topics. you know, dealing with, you know, race and, and c and, and economics and col in, in every other aspect. So, so that would be a good website to go to. there’s also you know, if, if you go online, most universities in every major city have, have take on the task putting out local resources for the community. So if you live in wherever you live in and you’re listening to this podcast, and you give the university near you and go to their website, and you will find very updated information. And, and the whole key here guys, is the updated. secondly, rightfully, she just did she put her cell out there? You also hopefully will find a site or people who will get on the phone with you and direct you in the right direction.

Conrad Meyer (46:38):
Well, I appreciated both of you. I mean, I think Roy and I would would both echo that very informative. Thank you so much for everything, everything. This has been a fantastic show. We wanna really appreciate you taking the time to come on and, and really tell our listeners about some of the things they can do and things that they see with Covid. And also, I mean, very importantly, about how Telehealth has changed your practice and your outreach. I think that’s and, and really the access to, to, to the services that I think people to so desperately need. So, yeah, to all our listeners we really wanna thank Felicia and Christopher for coming on the show. if you like the show, please hit that subscribe button, make sure that you subscribe to our podcast channel. we’re gonna be coming out with a part three on Covid Mental Health dealing with the elderly. And so we’ll have some special guests dealing with elderly folks and, and how they’re dealing with covid and mental health. So thank you, Christopher. Thank you, Felicia. We really appreciate y’all coming on the show. And and sit tight for, sit tight for a minute. We’re gonna wrap it up right here.

Rory Bellina (47:46):
Thank you for listening to Health Law Talk presented by Chehardy Sherman Williams. For more information or to contact us, please visit our website linked in the description below. Also, please be sure to subscribe to our podcast and follow us on Facebook, Twitter, LinkedIn, in YouTube – links in the description below. Thank you for listening.

There is no question that Covid restrictions, mandates, and directives, have impacted the mental health of adults and families all across the world. In part two of our series on Covid’s mental health crisis, Rory Bellina and Conrad Meyer sit down with experts Felicia Kleinpeter, Chief Executive Officer and cofounder of Imagine Recovery, and Christopher O’Shea, cofounder of Imagine Recovery, to discuss the impact Covid restrictions, mandates, and directives have had on adults and families. In this very timely podcast, listeners will be provided valuable resources on how to detect, address, and assist family members and adults who might be going through mental health issues during the pandemic.  These mandates and directives have put adults and families under tremendous pressure. Ms. Kleinpeter and Mr. O’Shea will provide detail information on how to best support families and adults to help their stress, anxiety, and other mental health issues regarding the ever-changing mandates during this pandemic. This podcast is an excellent episode for all who are dealing with the pandemic.

Health Law Talk, presented by Chehardy Sherman Williams, one of the largest full service law firms in the Greater New Orleans area, is a regular podcast focusing on the expansive area of healthcare law. Attorneys Rory Bellina, Conrad Meyer and George Mueller will address various legal issues and current events surrounding healthcare topics. The attorneys are here to answer your legal questions, create a discussion on various healthcare topics, as well as bring in subject matter experts and guests to join the conversation.

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