Arkansas started receiving federal crisis counseling funding in March, but state program leaders have tailored the standard federal emergency funds to a different type of emergency.
The Federal Emergency Management Agency funding allows mental health providers and others to jump into action and provide community-based outreach and psychoeducational services to individual survivors and communities affected by events like tornadoes, hurricanes and terrorist attacks — any major natural and human-caused disaster declared as such by the governor of a state — according to FEMA.
But the major disaster declaration made by Gov. Asa Hutchinson and other leaders across the U.S. last spring was not in response to a single devastating incident but rather the ongoing threat of covid-19.
The Crisis Counseling Assistance and Training Program funds are meant provide short-term interventions that involve assisting disaster survivors understand their situation and reactions, mitigate stress, develop coping strategies, provide emotional support and connect with other individuals and agencies that help survivors in their recovery process, according to FEMA.
It’s there to help people process and pick up the pieces in the aftermath.
FEMA has authorized money for programs in nearly every state with the funding ending June 2, an agency spokesman said.
Even if the pandemic is deemed over by June, services like these will still be needed after the storm, said Tammy Alexander, Arkansas Department of Human Services behavioral health assistant director and Stay Positive Arkansas program director.
“Everyone’s not going to be perfect the day after the pandemic ends,” Alexander said. “Like, if you had a tornado or an earthquake, these are designed to go past the one-year anniversary of the disaster event. Obviously with this, it’s different.”
Alexander and Project Manager Kathy Pillow oversee the Promoting Positive Emotions program — more commonly referred to as Stay Positive Arkansas — which distributes the federal funds to providers throughout the state. Fourteen certified behavioral health agencies jumped on board to help Arkansans directly impacted by covid-19 receive the emotional and behavioral health services they need at no cost.
Basically, that includes everyone, Alexander and Pillow said, though the program focuses on a few populations in particular: youth, seniors and health care workers.
STAY POSITIVE ARKANSAS
In several schools around the state, children designed masks while discussing their fears and concerns about the pandemic and new, often-changing rules, said several partner agency spokespeople.
Some children made kindness cards that agency workers later delivered to nursing homes residents and hospital workers as part of one of the program’s initiatives.
“Mental health begins when we’re tiny and goes into every age. I love this program partly because it doesn’t focus on a specific age,” said Stacy Humphrey, clinical director of Southwest Arkansas Counseling and Mental Health Center. “The pandemic has impacted every age range.”
The state Department of Human Services estimates Stay Positive Arkansas crisis counselors have directly reached 24,000 Arkansans. The direct contacts ranged from individual crisis counseling (500) to material distribution (18,000). Additional services include brief educational or supportive contacts, telephone contacts, support-line calls, public education and community events.
The program’s social media platforms — where it host live events and post daily — have reached over 300,000.
Pillow hosted a live Facebook event on Friday with Arkansas medical professionals who also responded to the early coronavirus surge in New York. Emily McGee from St. Bernards Medical Center said it would help medical staff if the public wears masks and gets vaccinated when available, “but also to just show support — a thank you for what they’re facing every day.”
Agency partners said they, too, have used more virtual platforms to reach people than before the pandemic — a national trend, said Erik Hierholzer, lead public health advisor for the Emergency Mental Health and Traumatic Stress Services Branch of the U.S. Substance Abuse and Mental Health Services Administration.
“That’s one good thing. Everyone in general has become more comfortable in a virtual environment and incorporating it into their programs,” Hierholzer said. “That genie is not going back in the bottle.”
While partner agencies do have guidelines they must follow as part of the Stay Positive Arkansas program, they have plenty of room for creativity with how they use their portions of the current $4.5 million given to Arkansas. The program received an initial emergency services program amount of $961,000, Alexander said.
Humphrey and her team serve six mostly rural counties and knew not everyone could be reached by traditional outreach methods or even digitally. They’ve been visiting schools, food pantries, community events, covid testing sites and local businesses. It still didn’t seem like they were reaching everyone they could about the free crisis counseling and mental health educational resources they had to offer.
“In so many of our counties, it’s hard to find a common location to provide this information. We thought, ‘What does everyone use? Utilities,'” Humprhey said.
Utility companies were happy to help, offering to put information on their statements free of charge. In one round, the group reached 26,000 people, she said. Her team works to keep everyone they can up to date on the latest food pantry and financial assistance programs, for example.
“It’s continuing to evolve. We listen and meet the needs, first physical needs and then psychological,” she said. “It’s just a good feeling to know that we were able to get groceries delivered to an elderly individual … and so much of it is that feeling of isolation. The impacts are hard to measure. Anxiety and depression is definitely higher.”
There is some overlap of coverage areas among the participating agency partners.
“There is enough going on — there is some overlap, there is some collaboration. We also have separate projects as well,” said Katie Neal, Promoting Positive Emotions team lead for Ozark Guidance, an affiliate of Arisa Health.
Alexander and Pillow said the crisis counselors who are a part of Stay Positive Arkansas and its partners are trained paraprofessionals not licensed counselors. It’s not therapy over the phone; they’re more akin to an operator.
Many times, people are experiencing a level of stress normal for a crisis situation, and others may need to talk with a therapist or need direction to a specific resource. The counselor will assess someone’s situation and connect them to the appropriate resources.
A DIFFERENT EMERGENCY
Most people are fairly resilient, Hierholzer said. He works with states’ crisis counseling program leaders.
Hierholzer said many who experience a disaster already have the built-in support — family, friends, church and community groups — without the need further crisis services.
Others may not understand the emotional reactions they’re having and need a little help.
And a few, 10% of so of those affected, may have more severe reactions, which could fall under the criteria for a diagnosed mental health issue requiring further support.
This disaster is no different. The difference is the number and groups of people affected, he said. It’s created a new risk model with larger groups like front-line workers.
Alexander, Pillow and partner agency spokespeople said they think the funding needs to be extended beyond June 2.
“I think it would be phenomenal, and I would say it’s absolutely a need. This has been an ongoing stressor for a lot of people,” said Jean Devenny, Stay Positive Arkansas team lead at Burrell Behavioral Health.
Hierholzer said the current regulations are pretty firm but do allow for the consideration of a 90-day extension. The possible need for federal funding to be extended will not be evaluated until a month or two from the end date, he said.
“Things continue to change,” he said. “I don’t know where we’ll be.”
Burrell Behavioral Health — previously known as Youth Bridge — serves Northwest Arkansas and Missouri, which offers its own crisis program funding. It hired a diverse group of crisis counselors and provided material in Spanish, Marshallese and English. It also connected with interpretation services, she said.
“We are doing everything we can to reach out to communities disproportionately affected,” Devenny said. “We want to make sure everyone can access these resources.”
The grant allows Burrell Behavioral Health and other agencies to reach individuals who may otherwise not have access to needed services because it’s free and anonymous with no eligibility requirements, Devenny and others said.
Humphrey said she’s hoping coronavirus case numbers will go down, but it will still have a prolonged effect on education, personal finances and more. Whether the federal crisis funding is extended, she said she hopes Stay Positive Arkansas and other similar programs will leave a lasting impact on public perception of mental health.
“It will continue to affect our daily lives,” she said. “We will continue to experience the effect of covid-19 way into the years, and because of that I hope it will create more of an acceptance of mental health and will lead to more services and funding for treatment.”