Take Note: NAMI Blair County Director Aimee Burns On How The Pandemic Challenges Mental Health Care
More people have felt anxious and isolated during the pandemic. At the same time, mental health services have been harder to access.
Aimee Burns, executive director of the National Alliance on Mental Illness in Blair County, talked with WPSU's Min Xian about COVID-19’s impacts on the mental health care system and shared her personal story of living with mental illness.
Here’s their interview:
Min Xian: Welcome to Take Note on WPSU. I’m Min Xian.
With pandemic restrictions on social interaction, many mental health services were limited over the past year, while more people experienced isolation and anxiety. Aimee Burns is the executive director of the National Alliance on Mental Illness in Blair County. She has seen first-hand how the pandemic has added pressure to the already strained mental health care system in Central Pennsylvania. And she’s seen the effects on those who are providing care, including Burns herself, who lives with mental illnesses.
Aimee Burns, welcome to Take Note.
Aimee Burns: Hi, thank you, Min, for having me here today.
Min Xian: The National Alliance on Mental Illness provides mental health services in communities across the country. Can you talk about your work with NAMI in Blair County and how you came to work in the field of mental health?
Aimee Burns: Well, I have worked in mental health and people with physical disability needs for the last 30 years, I started out in non-medical homecare, and eventually, over the years, moved more into focusing on mental health. It's just something that I felt called to. There is a need that people need to know that they're not alone, that they have support, and that we really need to work towards removing that stigma that people attach to somebody with a mental health condition.
My scope of work with Nami in Blair county is - it's very broad. I work with the county itself. I work with Blair County Health Choices, Blair Family Solutions and other agencies to provide mental health programs and support groups within our community. My office is responsible for Blair County, but we also reach out to the surrounding counties as well such as Clearfield, Cambria, Clarion, Bedford, where there's a lot, even a lot less mental health workers to assist people in need.
And so I develop programs, with other community leaders, but also not Nami sanctioned or approved programs. We teach a family-to-family course, which helps family members of individuals with a mental illness, understand what their family member or loved one is going through, and how to respond in certain situations. We help them learn how to handle a crisis. And we also have a peer-to-peer course, which helps individuals with mental illness and they learn from their peers. Every trainer, facilitator and presenter has been somewhere along their life in a mental health crisis or has a mental health illness themselves.
And we have family support groups, Nami connection recovery support group, which is for people in recovery from mental illness, and sometimes a co-occurring - it might be a mental illness and an addiction. We have in our own voice, which is people who also have suffered from mental illness and they are willing to share their story to help other groups of people understand to help remove that stigma, and also to help law enforcement, paramedics, firefighters to hear their stories to help them understand should they encounter an individual who might be in crisis?
Min Xian: You live with mental illness yourself and have said it's not always easy to talk openly about it. Can you talk about what it's like living with mental illness, and how you got to a place where you feel comfortable sharing about it?
Aimee Burns: Living with mental illness, early on, because I went so many years undiagnosed, was not easy at all. Because I didn't know what was wrong with me. Why do I feel different than the people around me, than my family? Why are they excited about this? And to me - maybe a family event is coming. And everybody's excited. And I'm just the opposite, anxious, depressed, I look for excuses not to go, I look for every excuse why it's going to be a bad thing. So it becomes very difficult because people don't understand, why do you continually do that? This is a reunion, it's supposed to be a good thing. So then you start becoming more of an introvert and closing yourself off from everybody, because you don't even understand why you can't find the good in it. And then you feel like everybody's upset with you. So then you're anxious and looking over your shoulder, so to speak. Because you wonder, what are they saying about me now? So it becomes this domino effect, what may have just been a bit of anxiety, then grows into depression, then grows into seclusion, and goes down the line.
And once I was finally diagnosed with severe anxiety disorder and depression, it became easier because then I was able to seek therapy to help me work through the anxieties, and to help me understand why my brain thinks the way it does, and how to react when I feel those things starting to happen, and how to recognize when they're starting to happen. So that I can basically redirect my brain and tell my brain, well, it's not really this, it is this, which then helps you become more understanding of yourself. So that's a good thing. To me. There was another part to that question, or did I answer both?
Min Xian: Well, to follow up with what you’re saying, how was it like for you to come to a place where you feel comfortable sharing about it?
Aimee Burns: At first, it was very difficult because I was worried about people thinking, she's just making that up so that she doesn't have to be a part of - an active part of this family. So once I was diagnosed, it was very difficult for me to even tell my husband because you get worried; is he gonna think “Nah”? I honestly I prayed about it. A lot. And one day, I realized one of the things that's going to help me get better is to share my story. Because I spent so many years, literally, outside of work, in seclusion. I went to work, I went home. Because my anxieties and depressions just made me believe that no matter what I did outside of work, it was going to have a bad outcome.
So once I really prayed about it, I started with my husband, and then my parents, and when they were more understanding than I expected, I said, Okay, and I just talked to a therapist and said, How do I be able to talk to people to rebuild relationships. And she said, Be honest, this is who I am, this is what we have discovered is wrong with me. And I apologize if I offended anybody by always ignoring people. In all honesty, we're finding excuses to not participate. And over time, that just grew into me being a little more comfortable in saying, I suffer from severe anxiety disorder and depression, which makes me hide from the world. And that just helped me grow and not be so afraid to do things.
And it ultimately led me here to Nami, so that I could continue because I felt that pride in being able to say, this is who I am, this is how I was made. You know, this is what I've gone through years of therapy and medication, and learning how to talk about it. And all, all the therapy in the world was, it was great. Don't get me wrong, but I think being able to share with the people that were closest to me, in complete open honesty, that is what brought the most healing for me.
Min Xian: You talk about acting as a peer. How does your own experience affect your work as a mental health professional?
Aimee Burns: I think I'm more empathetic, more compassionate, and understanding when a peer that I might be having conversation with speaks to me about how they, what they're feeling, what they're going through, because I've been there. When you feel like nobody understands, I'm not even sure I understand, so how can I make someone else understand? That has really helped me grow as a professional, to keeping in mind that everybody is different. And we will never fully understand what that other individual is feeling. But we can be there to support them and help them through it, and walk them through finding ways to help them feel better.
Min Xian: I hear a lot about how removing stigma is an important first step in talking about mental health, but stigma is still prevalent when it comes to the topic. What have you observed in both your work and perhaps in your personal life as well in terms of where we stand with the level of stigma that exists?
Aimee Burns: We have a long way to go, when it comes to removing stigma.
There are approximately 264 million people around the world that suffer from mental illness and about 50% of that, they don't get treatment, not because of financial reasons, but for fear of simply somebody labeling them and that stigma that comes with being diagnosed with a mental health condition. And there are a lot of people that are misdiagnosed as well. They say that up to 20% of the people that are diagnosed with bipolar disorder, are misdiagnosed. So that all leads back to the stigma of them saying, “Well, nobody knows what's wrong with me. And now, all these people think I'm just lying, or making things up.” So some of it is self stigma.
Doctors and people tend to treat physical illness more openly, there's no stigma attached. They have a series of questions that they ask to get to the root of that illness, where mental illness, you can't see it. There's nothing that like jumps out and says, “Hey, I'm sick, I'm unwell.” So it takes a lot longer to diagnose. So that's where part of the stigma comes from.
Unfortunately, it's a lot more widespread than I probably even have observed. But in my role, people, they will call me, they're in crisis, or their family member is in crisis. You try to assist them, you try to get them the help they need. But then somebody in the family doesn't want, forgive me, but doesn't want the neighbors knowing. So they decide that you don't need that treatment, or I don't need that treatment if it's themselves. Because they're worried about what other people think because of this stigma and the lack of education to the general public about mental illness. And so those who suffer with it would rather suffer in silence. Unfortunately, that happens way too often.
The result on a lot of cases that I have seen is, at some point, it becomes a crisis. And 911 is dialed. Unfortunately, police officers are not trained to deal with mental illness. So they may not realize that the individual is in crisis. it may end up in an arrest, because the police don't understand what they're dealing with. Not saying that the police are doing something wrong. What I'm saying is they lack the training to understand what this person might be dealing with.
Min Xian: You have a family member in the military, who experienced stigma related to their mental health issues. Can you talk about how that affected them?
Aimee Burns: Right. I have several family members that have been in the military but two of my sons have been in the military. One was diagnosed with PTSD by his personal physician. It did not have anything to do with his military career, it happened, it was from an extension of a very bad accident. So he and I had a conversation about it. And I had explained to him that he needed to, you know, talk to his commanding officer, and see what kind of assistance he could get, because he was getting ready to be stationed. And he said, “No, Mom, I can't do that. If I do that, they will remove me from my post, and I will probably be discharged.” And he was very afraid. Because he said, the military they don't understand. And they don't want to acknowledge that somebody might need a little someone to talk to you. They will just discharge you instead. And this is my career, I can't risk my career. So that is like a really good example of how even our military needs to evolve and become more educated when it comes to mental illness and the stigma that the soldiers worry about. They will, at all cost, try to hide it.
And as a mom, it was difficult to not just pick up a phone and call someone.
Min Xian: This is Take Note on WPSU. If you’re just joining us, we’re talking with Aimee Burns. She is the executive director of the National Alliance on Mental Illness in Blair County. She’s talking with us about the effects of the pandemic on her work in mental health care and on the people she provides care for.
We are all familiar with the health and safety restrictions the pandemic brought - social distancing, masking, in-person interactions moving online. There’s a realization that those things have had a lot of effect on people's mental health. How did the pandemic affect the kinds of mental health issues that you have seen? And did it make certain things worse?
Aimee Burns: Yes, it definitely made a lot of things worse on the mental health community, not just the workers, but individuals as well. The isolation; a lot of people who otherwise would have considered themselves as not having a mental health condition, were beginning to suffer from depression, loneliness, separation anxiety. But then, as time went on, and we started reopening, more and more individuals also started suffering from severe anxiety about going back out into the world, about having to share office space with another individual, about sharing public bathrooms, and things that we otherwise took for granted earlier, prior to the pandemic. So now you're taking these individuals who have been isolated for 15, 18 months, and saying, go to work. And a lot of them are finding it very, very difficult.
We have experienced some that went into a crisis mode. And I know of a couple that had to be what they call 302’d, where they were committed for a 72 hour hold. Because their anxiety got so bad. They couldn't think they couldn't function. One individual that I know was shaking so violently, they thought that he was having a seizure. So it has really taken a toll.
On the other side, on the mental health workers. We don't have enough. There are not enough mental health workers, there's not very many individuals that are going into psychiatry, we have a shortage of psychiatrists in Pennsylvania, and a lot of other states within the country. And we have a shortage of even just psychiatry assistants, PAs, which makes it difficult. And then the shortage of beds when they have to be institutionalized.
Here at Nami, since March, we have probably had at least 16 calls, people asking for advocacy because there are no beds for their youth, their child and they're sending their child to Ohio, or to Bowling Green, there was a child being sent to Bowling Green Kentucky, that's what I was thinking of. So we have a lot of parents that are struggling because their children are being told they have to go back to school, being told they have to start participating in all these things again; it is causing them to suffer severe anxiety as well.
Min Xian: COVID-19 as a physical illness has taken a toll on particular groups of people. We have heard communities of color were hit particularly hard. I want to know if you have seen the mental health impacts brought on by the pandemic hitting any certain groups especially hard? It sounds like children and young students may be suffering in a particular way relating to online schooling?
Aimee Burns: Right. Well, it is affecting the youth, probably a little more than it is most adults, but lower income neighborhoods. The people in those communities, I think, are being struck a little harder, partially because they believe that they can’t afford to get help. And, you know, stigma as well. But having come from a lower income family, I can speak a little bit more educated on that. That was for years, I can't get help, because I can't afford to pay for it. And not realizing that there was so many services like Nami, which is free of charge all the time to everyone in the community. I never knew about places like Nami. And so getting the word out there that places like Nami exist, I'm not saying it's going to fix the problem, but I think lower income communities need to know they have an option.
Min Xian: I imagine mental health workers have been working even harder than usual for the last 16 months or so. How are you and others in your field doing right now?
Aimee Burns: Personally, I'm doing well, I have been blessed that I am doing well. I have an individual, a peer that I get to speak to and we kind of support each other. So that is very helpful. I have seen some burnout within the community. When I've talked to certain offices here in Blair County. Some of their employees have recently attended our peer-to-peer course just to get that place where they feel they can speak about what they're going through.
Because a lot of them not only feel overwhelmed, because they are being so taxed. But they also feel a lot of guilt for the ones they have to say I'm sorry, I can't help you. Because they are so overbooked as it is. And it's very difficult. It's very heartbreaking when you have to tell somebody, I know you need help, but we have no room in the schedule. So you go home with that at night. And you think about that. And then that brings you another level of depression and anxiety as a mental health worker, because you know that there's people that are in need, and you can't help them, which eventually unfortunately, also leads to some leaving the profession because it becomes too stressful for them.
Min Xian: You mentioned law enforcement. Even though mental health professionals are the best suited to respond to those in need of mental health services, law enforcement are actually often involved, especially during mental health crises. But, they’re not always appropriately trained for those circumstances. How much need is there for law enforcement to better understand people in mental crisis?
Aimee Burns: There is a very large need.
I have experienced an individual in crisis. The individual suffers from bipolar disorder and was also postpartum. And was in a full blown manic crisis mode. 911 was called. The police officers responded. They don't know the individual's history, they know that they see somebody in what they are trained to see is a combative state and a state of non compliance. After a little while, the individual agreed, I will go with you. I just want to say goodbye to my baby. As they went to say goodbye to the baby, the officer grabbed the individual by the wrist. And to try and tell them, no, we'll have the baby brought to you. But being in a manic state, the individual responded by shoving the officer. So instead of being taken to a facility, it now turned into an aggravated assault against an officer charge, which had they, the officers been better trained to understand the mental health community, that may have gone much differently, and the individual may have been brought to the hospital instead of the county jail. And that happened in another county that was not here in Blair County.
So I fully believe that there needs to be some crisis intervention training or CIT teams, which are teams of mental health workers that are trained to respond to co-respond to calls like this. There is a major need for it. To me, crisis intervention training, my personal opinion is something that should be funded at every police department in the country, whether they train the individuals to understand a crisis intervention versus somebody who's truly just being combative, or they have a crisis intervention team that specifically responds to calls that sound like they're crisis calls.
Min Xian: I understand you and your colleagues are working with Blair County Police to get them Crisis Intervention Team training, but the department faces funding challenges. It seems that the need for more and better funding and resources touches many aspects of mental health. What are the most crucial changes or improvements you think should happen now?
Aimee Burns: That's a really good question. I really believe when the individuals who are tasked with creating budgets - and this comes from me working for years for the government, they need to look at the level of importance of directors’ retreats versus proper training. Or there's a lot, a lot of grants out there. How can we apply for a federal grant for this program, it has to start, honestly, with a deep compassion in your heart for people and saying, what, you know, if these are all the funds we get, and we have this many people in crisis, where can we adjust, so that we can take a little bit of these funds to create even a small team?
There are some locales that have one or two people that are CIT trained. And you don't need 30, 40, 50 people unless you might need them in places like Chicago or Philadelphia. But for most of the smaller areas, you only need one. And that funding - in one of the cities in Memphis, in Memphis, Tennessee, they'd started a CIT training program, or a CIT team. And that reduced officer injury by 80%. Because they had the individual or individuals there who knew how to respond to that person in crisis. So the funds that they saved on workers comp claims paid for that CIT team.
And I know I'm not a finance person. But I've always been taught by a very wise man, my grandfather, that where there is a will, there is a way; it just depends on how important it is to those doing the planning.
Min Xian: Aimee burns, thank you for joining us on Take Note.
Aimee Burns: Oh, my pleasure. Thank you, Min, for having me today.
Min Xian: Aimee Burns, thank you for joining us on Take Note.
Aimee Burns is the executive director of the National Alliance on Mental Illness in Blair County. She talked with us about how the pandemic has added pressure to the already strained mental health system in Central Pennsylvania, as well as impacts on those who are providing care, including Burns herself, who lives with mental illnesses.
You can listen to more Take Note interviews on wpsu.org/takenote. I’m Min Xian, WPSU.