GILLETTE, Wyo. (AP) — When Lana and Doug Dicus headed out for their usual walk through Mount Pisgah Cemetery the night of Aug. 3, they never expected what awaited them up the graveyard’s hill.
As they approached the gates, they could see police lights flashing through the fence in the distance. Panicked, Lana said she reflexively looked away and turned back, away from the scene. After turning on a police scanner, she confirmed what she already suspected.
Her daughter, Tristan Rosenau, 24, died of a self-inflicted gunshot wound in the cemetery that evening.
“It’s the worst thing any parent can go through,” Lana Dicus said. “I’m still walking around in a cloud thinking she’s going to come back through my door any day.”
The physical toll of the COVID-19 pandemic has been well documented. A growing list of more than 400,000 deaths nationally and even more hospitalizations show that, the Gillette News Record reports.
But with the calamitous year of 2020 bookended by the prospect of another year of pandemic-induced uncertainty, the harder-to-quantify mental health effects of the pandemic may be starting to show through in Gillette.
Although people struggling with anxiety, depression and bipolar disorder predate 2020, Dicus said the severity of her daughter’s struggles came to head last April shortly into the COVID-19 pandemic.
Many of her daughter’s struggles were exacerbated by “the isolation part of it, because she was living alone,” Dicus said. “She had a hard time being alone. She had to have somebody around. Her not being able to go out and socialize or be around people, she had a hard time with that.”
She said the isolation led to her daughter to consume more alcohol. Relationship issues with Tristan and her husband, from whom she was separated, made her emotions all the more volatile.
A distraught 4 a.m. phone call from her daughter in April led Dicus to finding her daughter without breath, felled by what she said was an intentional overdose.
After an emergency run to the hospital, Tristan pulled through, which led to months of ultimately failed attempts to treat the core of her mental health problems leading up to that August night.
Spikes in COVID, spikes in mental health concerns
Trying to measure someone’s psyche and how that impacts functionality can come with assumptions and misunderstandings that make the process of sharing one’s feelings easier said than done.
The impact to a person or community also is difficult to measure.
“I received more calls in the last year for counseling services than in the four years I’ve been doing this,” said Ashley McRae, community prevention specialist for Campbell County.
In 2020, there were 13 suicides in Campbell County and 84 attempted suicides. For reference, there were six suicides in the county in 2019 and eight in 2018, according to CCH.
“I think the pandemic definitely put people who wouldn’t have mental health issues in the position that they had mental health issues,” McRae said. “People who were normally out and about were now being isolated.”
Whether from social isolation, financial hardship, the loss of a loved one or something entirely different, the pandemic has brought about a confluence of potential stressors that may present as mental health issues, in the short or long term.
Mental Health America, a mental health nonprofit, found that between January and September 2020, the number of people seeking mental health help shot up from the year before. It found that 93% more people took its assessment for anxiety and that an extra 62% of people sought the organization’s depression assessment.
Among the people whose assessments showed risk for mental health conditions, isolation and loneliness was a major factor for 70% of participants.
Its findings also show a spike in the number of youth between ages 11 and 17 who took the assessment, as well as an increase in the severity of depression and anxiety symptoms recorded.
Locally, Kristina Leslie, a board certified behavioral health analyst and trustee on the Campbell County Health Board of Trustees, said that shaky economics have been one of the most noticeable changes.
“The biggest concern has been the financial and economic impact of everything,” she said. “Obviously, that’s going to impact people’s stress, people’s moods, people’s behaviors.”
She said the community outcomes may eventually present as secondary traumas after the fact once those under duress are able to transition from “survival mode” and begin processing the totality of the past year.
“I think that everybody is operating under more stress,” she said.
Less possible
Mikel Scott, executive director of the Council of Community Services, has seen that impact of economic and societal changes brought by COVID-19 firsthand through her local organization’s outreach programs.
“Our mission is to try to help people out of poverty and become self-sufficient,” Scott said. “Through the pandemic, that’s become not as possible. It feels like right now we’re just helping people get by.”
The Council of Community Services is what it sounds like. Within its umbrella of programs, the agency offers many services to help people in the community find housing, food and other types of assistance. When people slip through the cracks of other social services, Scott said the programs are often where they will wind up.
Since the start of the pandemic, there has been an increased demand for the agency’s services.
She said more families have joined the Food Pantry program, but on the other hand some federal assistance has helped keep people in their homes and out of the local homeless shelter.
With the assistance of federal CARES Act funding, Scott said the Council of Community Services has been able to use its resources to help people in unstable housing situations stay in their homes, putting less stress on the capacity of the homeless shelter.
“It prevents the trauma before it even happens,” Scott said. “I wish we could do that all the time.”
Whether or not it has become cliché, Scott said the idea that the pandemic has highlighted inequality rings true in Gillette.
“We’re doing our best,” Scott said. “It used to be a little more possible.”
Lost income from a lost job carries straightforward financial consequences. But finding help becomes more complicated when benefits, such as health insurance, also are lost.
“When someone loses a job, they’re also cut off from their health care, if they had it to begin with,” Scott said. “If you’re unemployed, you lose all of your benefits, which health care is the biggest one. You can’t afford to go out of pocket … you’ve lost all of that, especially now during the pandemic.”
Mental Health America also found that Wyoming has the highest percentage of adults with a mental illness who are uninsured. The 22.9% of uninsured Wyomingites with a mental illness stands more than double the national average, which the nonprofit found to be 10.8%.
The organization also found that Wyoming ranks 45th in the United States in access to mental health care. It measured access by examining each state’s access to insurance and treatment. It also factored in quality of care, cost of insurance, access to special education and workforce availability.
Those issues that existed before the pandemic also have not improved, Scott said.
“I’m trying to quit sounding so darn pessimistic all the time,” she said. “It really, as far as mental health, I haven’t seen much actually change.”
The road ahead
Bill Heineke, a psychologist who works with abused and neglected children, and Lexie Honey, a social worker at the Kid Clinic, both saw their roles as counselors change as the pandemic set in.
Telehealth became more normalized. Mask wearing became the norm. But while masks help block the spread of aerosols, they also limit how counselors can read the expressions of their clients, or even to enjoy the satisfaction of a smile.
“The biggest struggle I tend to have (with telehealth) at home is they’re not as open because, ‘Mom might hear me in the other room so I don’t want to say that,’” Honey said.
“It’s nice to see them in their environment, but at the same time, I’d rather see them in my office,” she said.
Mostly, they both said their caseloads and the conditions their clients present have stayed fairly consistent with pre-COVID-19 sessions.
“We anticipated things being a lot different than they ended up happening here,” Honey said.
While the psychological ramifications of COVID-19, such as prolonged isolation and economic downturn, have not appeared significantly in their professions yet, that may change as the long-term effects take hold.
“I’m suspecting that when the pandemic is under control, when it’s more people are vaccinated and the pandemic is going down, there’s a decrease, we’re going to see an increase in services,” Heineke said. “I think the increase for us is coming.”
Nationally, that seems to hold up. Whether the self-reported increases in certain mental health assessments will manifest in concrete diagnoses in Campbell County down the line is yet to be seen.
“The research, the self-report inventories where 1,000 to 2,000 respondents show an increase in anxiety and depression,” Heineke said. “There’s also a higher incidence of post-traumatic stress disorder. More people are apprehensive or hyper vigilant or anxious.
“I haven’t seen that in any significant clinical way yet. I believe I will.”
Before her daughter’s death in August, Dicus said Tristan spent the summer seeking help. Alcoholics Anonymous was working for a while, but COVID-19 caused those meetings to go remote as well, lessening her daughter’s outlets and limiting the access she had to help.
Besides that, there were road trips to Casper to visit one of her doctors then telehealth counseling sessions with a local provider.
“I honestly had put my life on hold for the past year just trying to keep her safe because I knew her mental health was declining,” Dicus said.
When that August night came, she said she could not have been more surprised. Despite her daughter’s struggles and previous suicide attempts, it still seems sudden.
Sure, Tristan had struggled for years, but she seemed happy that day, Dicus said. Nothing in her upbeat demeanor that afternoon gave her mother a tell as to what would happen that night.
How much impact the pandemic had on what happened to her daughter may be impossible to know. But as the effects of the pandemic carry on, and as mental health issues percolate along with it, she wants there to be more conversation and resources exposing those possibilities.
“If her story, if it can get to one person that needs it, then that’s one more life we saved,” Dicus said. “Tristan would help anybody, so I know she’d want me doing the same thing.”
