Holly Rioux, LICSW – Coordinator of Deaf and Hard of Hearing Services with GNMH – provides support to clients in American Sign Language via videophone. Courtesy photo

NASHUA – Those in the community with mental health and substance use disorders still require treatment regardless of the current stay at home order, and Greater Nashua Mental Health still is servicing their clients – just in a different way.

While businesses and organizations across the state have had to make adjustments with the way they operate and do business during these unprecedented times, GNMH also has taken the safety of their staff and clients into account while continuing to provide these services. While the majority of staff are now working remotely, there still are instances where face-to-face interactions occur. If staff is out in the community, meeting with clients face-to-face, president and CEO of GNMH Craig Amoth said they require both the client and staff member to have a face mask on. If there is a need, there are gloves available, but hand sanitizer is relied on more.

“We have roughly about 240 employees here at Greater Nashua Mental Health, and I would say maybe a little over 200 are currently doing some form of remote work,” Amoth said. “Some of them are working exclusively remotely. The vast majority of people are doing some combination of remote work as well as kind of in the office work.”

The thinking behind this initiative is if somebody does come in and presents with symptoms and has to self quarantine, and GNMH has to lock down that building, they do not want the entire staff to be put on quarantine. That is why they are staggering their staffing so that at any given time, employees are still in reserve, so in a situation if something were to happen, they could shift the staffing to make sure operations continue. This transition came about sometime in mid-March, and Amoth said he believes they are in their third week of working in that fashion.

“We had a workforce challenge before this whole coronavirus thing hit,” Amoth said. “So, at any given time, even before this, we had within the 10 community mental health centers, we’d have usually around 200 clinicial openings around the state. Now, with people needing to be out because they’re quarantined, or just not as available, certainly the workforce challenge is more significant than it was before, and knock on wood, right now, we don’t have anybody that’s tested positive, but I think it’s not if, it’s when.”

GNMH is operating with their typical office hours of 8:30 a.m. to 5 p.m. Monday through Friday. However, evening hours were previously offered, but those have since gone away because the nonprofit is limiting their client contact. GNMH has four facilities, and has limited client contact at two of them. While hours of operation have not been reduced, officials are reducing the places where they see clients.

“We know that COVID-19 will be around for awhile, and we need to conserve our human resources, along with personal protective gear,” Chief Medical Officer at GNMH Dr. Marilou Patalinjug-Tyner stated in a press release. “If our staff doesn’t remain healthy, there won’t be anyone to provide services, so we have to remain mindful of that.”

While most services are now being provided by telehealth, many clients reportedly enjoy this method of interaction. However, the telehealth visits have been found to be more challenging for parents and families. With schools closed, many parents are now working from home while their children are with them full-time. While balancing their own work, some parents now also have the extra responsibility of assisting their children with remote learning. In some cases, parents may be ill or may be taking care of someone who is ill.

While balancing all of this, it may not be easy for some to find a quiet, private space at home to conduct a phone appointment. Furthermore, some families with less funds available may have limited phone plans, creating an additional obstacle when conducting a one-hour telehealth call. However, many insurance plans are assisting their members by purchasing additional minutes or even by providing a phone, if necessary.

In addition, Community Support Services staff also is continuing to provide home or community visits. Some clients also still have to come into the center to get things such as injectable medications. The nonprofit has had to invest in enhanced broadband and other IT hardware to support their staff and clients to work remotely as well.

“The one population that I think we’re still challenged to serve adequately is some of the elder population,” Amoth said.

While guidelines that allow GNMH to provide service telephonically have been issued for Medicaid, Amoth said that is not true for Medicare, which encompasses the vast majority of their elder population. Amoth said they still are reaching out to these clients and providing service, it’s just that GNMH does not know whether or not that is ever going to be a reimbursable service or not.

Amoth also said GNMH used to offer a lot more transporting for their clients, whether that be for dentist or physicians appointments, for example. That service is now minimal, and only provided under urgent circumstances.

If a client does come into a facility, the hope is that they will make an appointment first. Upon entering, staff screens for any symptoms before the client comes in to make sure they are taking care of themselves and not putting others at risk. From there, when the client does come in and is in need of face-to-face interaction with a provider, a face mask protocol is in place for both the client and provider. Amoth said he is absolutely impressed with how adaptive GNMH staff have been in terms of responding to meet the needs.

“We are extremely proud of our staff and how they have risen to this unique challenge,” Chief of Services at GNMH Dr. Cynthia Whitaker stated in a press release. “They are compassionate, dedicated and heroic professionals pulling together to support not only their clients but also each other, as we all navigate this new territory. The fallout of the pandemic is likely going to be significant, but we fully intend be here to assist our community to remain well.”

Adam Urquhart may be contacted at 594-1206, or at aurquhart@nashuatelegraph.com.

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