The coronavirus pandemic is still doing a number on mental health. In the most recent Household Pulse Survey conducted by the National Center for Health Statistics, nearly 1-in-3 North Carolina residents reported experiencing symptoms of generalized anxiety disorder or depression.
Many people seek counseling through a psychiatrist, psychologist or licensed clinical social worker in private practice. While some of these providers accept insurance, others do not. Even with insurance, the copays for mental health services can be out of reach.
For the uninsured and underinsured, local mental health nonprofits are filling the gap, but they struggle with funding.
“Unfortunately, the need for support with mental health issues has escalated in the last two years, and access to care and support has been affected,” wrote Pam Jaillet, executive director of the National Alliance on Mental Illness Western Carolina, to Xpress in an email.
‘Everything was exacerbated’
Nonprofits are accustomed to funding variations. “Oftentimes you don’t know year-to-year exactly what your funding picture is going to look like because it’s based on community economics,” says Meredith Switzer, executive director of All Souls Counseling Center in Asheville, which provides in-person and virtual counseling services on a sliding scale. It does not accept private insurance, Medicare or Medicaid.
The nonprofit, founded in 2000, is typically a resource for people struggling with depression and anxiety. “When the pandemic hit, everything was exacerbated, and so we saw our calls for support dramatically increase,” Switzer explains. “We found that people were calling in more of a crisis mode.”
The pandemic led to an increase in calls about stress in families, she continues. Couples counseling, as well as separations and divorces, have persisted as reasons clients reach out.
The center, which serves clients 18 and older, also saw an increase in calls from parents seeking support for their struggling children. Parents of teenagers — already navigating an often tumultuous period of life — have been especially in need of support helping their kids during the pandemic. “Teenagers are having a difficult time with the social isolation that has happened through the pandemic,” Switzer says, noting that social media usage among young people, especially the practice known as “doomscrolling,” has amplified some mental health problems.
All Souls Counseling Center is supported through private sources like individual donations, corporate foundations and mission-based foundations.
From March 17, 2019, to March 16, 2020, it received $340,019 in grant funding, according to the center’s business office manager, Nicole Almeida, in an email to Xpress. During the 2019-20 fiscal year, the nonprofit provided close to 3,600 therapy sessions and served 458 clients, according to data provided by Almeida.
The coronavirus pandemic shook up the local economies of many communities. Yet All Souls Counseling Center pushed through with continued financial support. “Early in the pandemic, we found that there was just this outpouring of support from the community — not just from private donors but also from private foundations and then corporate foundations,” explains Switzer. The center maintained its staff of about 20 therapists during the pandemic except for a small number of retirements, she says.
“Foundations in our community just recognized that nonprofits were going to struggle,” Switzer continues. “They were the ones who were really front-line.” She cites nonprofits The Community Foundation of Western North Carolina and Sisters of Mercy of North Carolina Foundation as two key grantees. She also notes that some corporate foundations “gave in larger amounts than they had previously.”
The center received $438,461 in grant funding from March 17, 2020, to March 16, 2021, Almeida says. That fiscal year also saw the number of therapy sessions drop slightly to 3,500, but the number of clients decreased sharply from 458 to 282.
According to Switzer, the reason for increased funding but fewer clients is that existing clients stayed with the center longer and fewer spaces were available. “We decided that we were going to continue seeing people [beyond the usual] three to six months of service,” she explains. The center has served some clients for two years; it isn’t the nonprofit’s norm, but it recognized the need.
The initial “outpouring,” as Switzer put it, has not continued. “We did see a lot of funding coming in initially to support mental health that has started to taper off,” she says.
Figures shared by Almeida show the nonprofit received $311,096 in grant funding from March 17, 2021, to March 16, 2022 — lower than its pre-pandemic funding. But Switzer explains, “We haven’t really seen the need for our services to taper off that is consistent with the funding tapering off.” In fiscal year 2021-22, the number of therapy sessions decreased to 2,815, and the number of clients to 260. When Switzer spoke with Xpress in April, the waitlist for therapy at All Souls Counseling Center was two weeks.
There are a few reasons funding has dipped. Foundations are moving onto other projects and priorities. The center receives public funding in the form of a grant from the N.C. Department of Public Safety Governor’s Crime Commission for qualified clients. Although this grant has been “pretty steady” for several years, Switzer explains, the department experienced cuts, impacting All Souls Counseling Center’s funding.
“We are still in the pandemic and [do not know] when the impact will subside,” she laments, adding “people are still struggling. ”
(RHA Health Services and Western North Carolina Community Health Services, a federally qualified health center, both provide mental health services but declined requests to comment for this article.)
All Souls Counseling Center will soon restart its support groups, like grief support programs.
Additionally, Switzer would like to have additional funding for outreach to a wider swath of the community. Ideally, she would like to hire an employee to exclusively focus on outreach. “We don’t have the resources identified to be able to do any outreach, which I know is a huge gap for us right now,” she explains.
“We realize there are a lot of people who need help and support and have barriers to accessing it,” she continues, noting the area’s Latinx and Ukrainian communities may benefit from Spanish- and Ukrainian-speaking counselors, respectively. Currently, only one therapist on staff is fluent in Spanish.
Switzer is hopeful that continued support will be forthcoming. She recalls how, early on in the pandemic, the center received an unsolicited $4,000 donation to be used to assist people who were in a mental health crisis.
“We’re not seeing as much of that right now,” she says of unsolicited donations. “Because, of course, we’re two years down the road. But the need still exists.”