By Lillian Reese, Sara Chernikoff and Laura Franklin
Phone lines are busier for Baltimore mental health hotlines as demands for their services are on the rise. And across Baltimore, neighborhoods and communities are sticking together as they search for ways to cope with pandemic-induced stress and anxiety.
In Southeast Baltimore’s Violetville, the tight-knit community’s neighbors are even more committed to looking out for each other. In Canton, church members reconnect from across the country through online meditation sessions. And a community organizer who had been offering yoga in Patterson Park is now looking toward spring and planning outdoor movie nights for her neighbors in Waverly.
“Everything else in your life could be stressful, but community is supposed to be a place where it’s warm and welcoming,” said Ashley Esposito, co-founder of the Village of Violetville community association.
The Centers for Disease Control and Prevention has warned that cases of COVID-19 will rise throughout the colder months, and mental health professionals say that will increase stress.
Baltimore Behavioral Health System’s 24/7 Here2Help hotline received 3,000 calls in March. In October, the number was more than 5,000. The hotline provides confidential advice and emotional support to Baltimore residents, said Adrienne Breidenstine, vice president of policy and communications.
Hotline operators say Baltimoreans are distressed and anxious about the pandemic. Some are mourning loved ones lost to the virus. People are longing for normalcy, Breidenstine said.
“There is a rise of anxiety and depression and isolation is really growing and compounding those issues,” said Kerry Graves, executive director of the National Alliance on Mental Illness (NAMI) Metropolitan Baltimore.
NAMI is the nation’s largest grass-roots nonprofit organization dedicated to mental health advocacy. NAMI Metropolitan Baltimore provides services to residents of Baltimore City and Baltimore County. Graves said that although virtual classes and their Monday through Friday helpline saw a 20% increase in volume between March and October, she fears some participants have drifted away from virtual care.
“We’re seeing new faces in our support groups, but we also aren’t seeing some of the old faces though, so I do think there are individuals that just prefer to be in-person and aren’t going to use an online system,” Graves said.
“Even individuals… who have been living well for many months or years before the pandemic are experiencing a resurgence of their mental health condition due to not having that social interaction,” she added.
“Routine and interaction are a big part of someone staying mentally well,” Graves said. “Without that it’s very easy to regress.”
And as unemployment rises, researchers have found an increase in addiction and suicide rates, Breidenstine said. Social isolation and stress increase susceptibility to substance misuse.
A 2012 study published in Health Economics found that long-term unemployment increases suicide risk for both males and females.
Johns Hopkins University researchers found that across Maryland, suicide deaths among Black residents in March and April doubled recent averages until early May, when shutdowns eased and some institutions reopened. During that same time, researchers found that suicide rates among whites appeared to drop by half.
Breidenstine said health care providers are reaching a greater number of Baltimoreans through telehealth appointments, but providers know that many more people are not receiving help.
According to the U.S. Census Bureau’s Household Pulse Survey, a 20-minute online survey that has been monitoring self-reported mental health changes since late April, 41% of people who responded between Nov. 25 and Dec. 7 said they had symptoms of anxiety or depression during the previous week.
Some neighborhood leaders are finding creative ways to bring their communities together and fight off pandemic fatigue while residents await a vaccine.
Here’s how people who live in three city neighborhoods are coping:
Naadiya Hutchinson, a recent graduate of the master’s program at the Johns Hopkins University Bloomberg School of Public Health, is working to provide a sense of normalcy for her community. She spends most of her time at home now that the coronavirus shut down many of her in-person meetings.
With the help of other community organizers and support from the Better Waverly Mutual Aid group, she planned a socially distanced Halloween costume party at the Waverly children’s sculpture garden. Now, she’s planning a series of free outdoor movie nights for the spring.
“I like working with youth and with children,” she said. “You get to influence how people see the world and hopefully shape it in a positive way. And I think with COVID-19 it’s like trying to shape a sense of normalcy into people’s lives.”
She felt the pandemic’s isolating effects in March. And then, Hutchinson said, the incessant coverage of this summer’s violence against Black Americans – especially the killing of George Floyd – raised her stress to a peak level.
Her in-person yoga classes were canceled. Work meetings were moved to Zoom. She felt her circle go silent.
Hutchinson began her own routine: yoga in the park.
“I connected to some other Black women in Baltimore City who were feeling very similar,” Hutchinson said. “Yoga in the park actually started from wanting to have a space for everyone to be able to practice yoga, for everyone to have the opportunity to just breathe and let go for a moment, that felt safe to as many people as possible.”
She wanted the classes, which met every other week in Patterson Park, to welcome beginners to advanced yogis, from the athletic to the out of shape, from people who could afford to donate to those who couldn’t.
The group of 15 to 20 people came together Sunday mornings through late October. Hutchinson wanted to provide wellness techniques through yoga to Baltimoreans who may not have had a source of mental health care.
“It’s been seen to help decrease depression and decrease anxiety,” Hutchinson said. “I really wanted to offer something that could help people cope through COVID-19. And I know that doing a weekend class isn’t going to heal everyone, but I do think it’s an opportunity to build community and motivate people to get outside and get moving.”
With high levels of unemployment in a city like Baltimore, there’s a gap in access to health care, including mental health support, Hutchinson said. She also sees a stigma attached to receiving mental health care in some communities.
The COVID-19 pandemic is infecting and killing people in Black and Latino communities at much higher rates, amplifying the social and economic factors that have caused poor health.
According to the COVID Tracking Project at The Atlantic, in December, Black people made up 34% of all positive COVID-19 cases and 38% of deaths while representing 29% of the population in Maryland.
Black and Latino Americans report problems with mental health and substance abuse at about the same rate as the general population. But more than 69% of Black Americans did not receive treatment, according to a 2018 report from the Substance Abuse and Mental Health Services Administration.
“In Baltimore in particular, we know there is a lot of racial trauma,” said Graves, of NAMI. “What we’re referring to now as sort of the dual pandemic of civil unrest, due to years of pervasive racism, combined with the effects of the pandemic, mean we have a lot of individuals in Baltimore who are dealing with both issues.”
In the Southwest Baltimore neighborhood of Violetville, residents already understood the importance of looking out for one another. But the pandemic has allowed them to explore different ways to help each other at a distance.
Ashley Esposito, a co-founder of the Village of Violetville community association, knew isolation could weigh heavily on her community. Neighbors would feel the weight of being kept away from each other and out of each other’s homes. Their regular community cleanups took on a new role in the pandemic — an opportunity to get residents outside and socializing in the spring and summer.
While the Violetville community association includes contacts for mental health resources on its website and in its newsletter, Esposito and her neighbors also recognize the power of being there for each other.
“We’re not connecting people with mental health professionals. It’s more of a holistic way of dealing with it,” Esposito said. “It’s just the tiny things that we do.”
She has been making self-care related “Mental Monday” posts on the association’s Facebook page regularly, long before the pandemic began, to remind her neighbors to take care of themselves.
“An empty tank will take you exactly nowhere,” read a recent Mental Monday post from November. “Take time to refuel.”
Esposito also saw the positives of offering a few community yoga sessions in the fall. In September, she organized yoga in the park to give her neighbors the opportunity to get outside together.
“It’s important to open [yoga] up to everyone so those folks who are really struggling with mental health feel welcome,” Esposito said.
Before the pandemic, Emily McGuire, an avid crafter who uses they/them pronouns, and many of their neighbors got together once a week for craft groups for sewing, quilting and knitting.
McGuire understood the impact small social interactions such as those have on well-being.
“I also suffer from depression… but I understand just breaking up your usual routine, the changes of your structure can be really difficult on your mental health,” McGuire said.
“The loss of things that you would normally do… There are a lot of little meet-ups that people would do like going over to each other’s homes and having little powwows.”
When COVID-19 shutdowns meant more people would rely on social media apps such as Nextdoor to connect, McGuire tried to find a solution to look out for those who aren’t as tech-savvy.
In the first weeks after Gov. Lawrence J. Hogan Jr. (R) issued a stay-at-home order, McGuire and their partner devised a plan where people could put a green or red laminated card in their window if they needed anything. The green sign would indicate that they were doing OK. The red sign would indicate that they needed something, such as toilet paper or even just someone to talk to.
“The idea was for other houses on the block to put the signs in their windows too so the people who needed them weren’t singled out,” said Esposito, who took on distributing the signs at a food drive. The intention was to help residents feel included and taken care of — although it turned out that no neighbors asked for help.
In April, as Easter approached, a group of neighbors set up prayer stations for outdoor worship. Todd Scholtz, the lead pastor of Wilkens Avenue Mennonite Church, and his wife, Marita, the assistant pastor, put up laminated signs around Violetville and other southwest Baltimore communities that depict the Stations of the Cross. The images mark key events from the moment that Jesus was condemned to death to his crucifixion. Some Christians use the stations as devotional tools for prayer and reflection.
The signs had QR codes that could be scanned to reveal a Bible verse or a short meditation. And activities were set up to accommodate social distancing.
“We were really doing it for our church congregants, but it became a public thing,” said Scholtz, who lives in Violetville. “I think it blessed some people in Violetville,” Scholtz said.
Activities and services that community members provided in Violetville offered an outlet for those struggling with isolation during quarantine. “We don’t think about how these little things impact our overall well being,” McGuire said.
A year ago, the Rev. Jim Hamilton would have been opening his church’s doors to its 70-plus community members. But the pandemic forced the Church on the Square to move services online.
Hamilton is an Episcopal priest but describes his place of worship as an inclusive post-denominational community church. He hasn’t spent much time inside the building on O’Donnell Square since COVID-19 shut down religious gatherings.
“Novices Beginning Together,” an interfaith meditation group that met at the church, allowed congregants to check in with one another before COVID. But the first week Baltimore went into lockdown, Hamilton was quick to move the weekly sessions online, which allowed even former congregants who had moved away to join in.
The group has grown over the course of the pandemic, and Hamilton plans to start a second session to keep the meetings intimate.
“2020 has been a real crazy year. You think about the environment in which we are all coping — it’s intense.” said Stuart Merkel, a member of the church and Hamilton’s friend. “I think our nation’s mental health is under significant stress right now.”
“I think for mental health purposes, the community has been challenged and changed during this time and it [the meditation group] has given us opportunities to strengthen bonds that were existent previously but also develop new bonds online through shared interest and through shared ideology,” Hamilton said.
Hamilton also helped start the Baltimore Neighbors Network with City Councilmember Zeke Cohen (D). The organization provides a virtual community of volunteers to check up on older Baltimoreans who are isolated and may lack emotional support. Hamilton said the volunteers form friendships with older people through weekly phone calls.
“By the end of this all of us are going to know somebody that’s died,” Hamilton said.
Hamilton lost his godfather to COVID and he says many in his community have had some kind of loss since March.
“The impact on this neighborhood is the same as everywhere,” Merkel said. “People are losing their jobs. People are scared about the future. It’s impacting our neighborhood businesses.”
The friends are grateful for the city’s walkability. Even as the days get darker earlier, the two are able to meet outdoors at their place of worship and catch up on their lives while keeping a safe distance.
“I’m thankful for our walking community, that I’m able to see Stu and walk around the park,” Hamilton said.
As the weather gets colder and coronavirus cases climb, experts anticipate more isolation.
Esposito and Hutchinson are concerned about what the future holds.
Hutchinson is moving her yoga classes online and Esposito will try to keep morale high by distributing newsletters to each house in Violetville to keep the community engaged.
“A lot of people have been connected through being outdoors and that’s going to change as we move into the colder months,” Breidenstine said.
The long term-mental health effects of COVID-19, Breidenstine said, are yet to be seen.