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THE ASTORIAN • TuESdAy, NOvEmbER 23, 2021
Teletherapy thrives amid pandemic
Patients, therapists see benefits
By ALEXANDRA SKORES
The Oregonian
Therapy starts in the morning, once a
week for Sarah Cornwell’s 15-year-old son.
He leaves his bedroom to open a Chrome-
book laptop in a nook in the corner of the
kitchen and living room. Cornwell puts ear-
buds in to give her son some privacy as he
starts his session.
Cornwell’s son is one of a growing num-
ber of Oregonians now regularly partici-
pating in therapy sessions held exclusively
online.
The COVID-19 pandemic has spurred
countless changes in how Americans com-
municate, from the workplace to personal
get-togethers, and therapists have similarly
embraced technology to stay connected to
clients from afar. Telehealth has offered
a unique and easy tool for patients to get
an appointment that is flexible with their
schedule.
Some patients are grateful they no lon-
ger must incur travel costs while others feel
more comfortable discussing personal mat-
ters from inside their own homes. Some still
prefer the value of talking in-person with
their counselor, but experts say teletherapy
has proven to give similar positive results in
patient care and expect it is here to stay.
For Cornwell, teletherapy led her son to a
happier and healthier life.
Cornwell’s son has impaired processing
and impaired working memory, so it takes
him longer to process information than oth-
ers. He’s been in traditional in-person ther-
apy since age 7, and he’s developed natural
coping strategies to remember and to combat
the stress he feels.
Online therapy has proven to be more
accessible. Now there’s no more dreaded
35-minute commute to therapy from his
home in Creswell, near Eugene. No time
spent acclimating to the therapist’s office
each visit. And his therapy dog, “Dotty,” an
18-month-old Great Pyrenees and Anatolian
shepherd mix, gets to curl up nearby while
they enjoy the comforts of home.
“Despite the world being very stressful
right now, he still has his dog with him, right
next to him at the computer and he’s very
comfortable,” Cornwell said.
There’s no definitive count of the num-
ber of Oregonians participating in telether-
apy but the need is clear for easier access
to care. People often seek therapy to over-
come personal experiences or deal with loss.
Counseling and other forms of therapy offer
a greater self-awareness and coping mecha-
nisms. Patients remain in therapy for a few
short sessions to their entire life, depending
on what they are hoping to achieve.
A national Centers for Disease Control
and Prevention report surveyed adults in
June 2020 and showed 31% of respondents
reported symptoms of anxiety or depression
and 26% reported stress-related symptoms in
the past 30 days.
In Oregon, a 2019 report from Mental
Health America showed the state had the
highest prevalence of mental illness in adults
nationwide, at 22%, or about 714,000 people.
The report tallied a wide range of diagnos-
able mental, behavior or emotional disorders,
including mild anxiety and depression up to
severe mental illness, and excluded develop-
ment and substance-use disorders.
Licensed psychologist Brad Larsen San-
Sarah Cornwell
Sarah Cornwell’s son is seen with his therapy dog.
THERE’S NO DEFINITIVE COUNT OF THE NUMBER OF
OREGONIANS PARTICIPATING IN TELETHERAPY BUT
THE NEED IS CLEAR FOR EASIER ACCESS TO CARE.
chez said the pandemic has made his prac-
tice, Portland Mental Health and Wellness,
shift how counselors work with their clients.
When the pandemic began, the practice made
the shift to 100% telehealth services.
“Demand skyrocketed throughout the
pandemic,” Larsen Sanchez said.
Larsen Sanchez said many of the provid-
ers may have lost the in-person elements of
therapy and counseling, such as watching
body language or where a person might sit in
the session, but the benefits outweighed the
costs.
In Cornwell’s case, the lack of group ses-
sions has been the only drawback she has
noticed for her son. He has been working on
remembering facial expressions, which are
often easier to do with other people, so he can
improve his ability to understand non-verbal
communication.
“He can’t really practice that if it’s just
one therapist there,” Cornwell said. “But that
doesn’t detract from the positive outcomes
that he’s had.”
Larsen Sanchez said he’s found that
patients are more likely to be vulnerable
during their sessions at home than in a tradi-
tional office setting. The idea of being inside
a safe, familiar environment was a significant
benefit for patients during the pandemic.
“Psychotherapy is so much more than just
talking and listening,” Larsen Sanchez said.
“By necessity, we attend to the experience of
the whole person.”
He believes that virtual therapy will con-
tinue — even after the pandemic fades away.
In fact, most insurance companies have
added telehealth to their policies. America’s
Health Insurance Plans, a trade group, noted
that many companies adapted to the pan-
demic, adding telehealth as a cost covered
under their plans. Telehealth encompasses
any visit with a licensed doctor, including
therapists.
Oregon House Bill 2508 was signed into
law on June 1, stating telemedicine would
be reimbursed at the same rates as in-person
visits.
Sydney Ey, professor of psychiatry at
Oregon Health & Science University, said
the pandemic brought heightened attention to
mental health. This last year proved to be a
very stressful one.
“The problem is COVID is so unique in
that it’s not a one-time thing,” Ey said. “It’s
been ongoing, and it’s not just COVID.”
Ey said the past year has brought large-
scale issues to the table for many patients,
including the loss of loved ones due to
COVID-19, but also global issues like climate
change or political instability worldwide.
“People take in multiple hits and one of
the things about stress is that you can even-
tually break anybody if we pile enough stress
on them,” Ey said.
And the research to keep it around,
according to Ey, is there. People are doing
just as well with telehealth appointments as
they would with in-person appointments.
The National Council for Mental Wellbeing
reports youth patients showing more bene-
fits, such as discussing more depth and emo-
tion in their conversations.
Noting wellness apps like Calm and Head-
space, Ey said that many of her patients have
turned to the ease of getting help from tech-
nology, rather than having to go in-person to
a licensed psychologist.
If a patient “lives in a rural community
that doesn’t have as many therapists ... they
now have access to mental health profession-
als across the state,” Ey said. “I think tele-
health could end up being incredibly help-
ful and address a huge problem that exists
worldwide — access to more mental health
treatment.”
For Cornwell and her son, teletherapy will
continue to become a part of their daily rou-
tine, and it won’t be going away anytime
soon.
Her son looks forward to therapy now, and
Cornwell has noticed less meltdowns and no
stress hives from the effect of leaving for
in-person therapy. He has more time to work
on drawing, playing games and focusing on
his schoolwork.
“Just having that consistency, and that
routine and availability of a therapist to help
him through things — the positives just really
outweigh the negatives,” Cornwell said.
US overdose deaths reach record high
By MIKE STOBBE
Associated Press
NEW YORK — An estimated
100,000 Americans died of drug over-
doses in one year, a never-before-seen
milestone that health officials say is tied
to the COVID-19 pandemic and a more
dangerous drug supply.
Overdose deaths have been rising for
more than two decades, accelerated in
the past two years and, according to new
data released last week, jumped nearly
30% in the latest year.
President Joe Biden called it “a tragic
milestone” in a statement, as administra-
tion officials pressed Congress to devote
billions of dollars more to address the
problem.
“This is unacceptable and it requires
an unprecedented response,” said Dr.
Rahul Gupta, director of National Drug
Control Policy.
Experts believe the top drivers of
overdose deaths are the growing preva-
lence of deadly fentanyl in the illicit drug
supply and the COVID-19 pandemic,
which left many drug users socially iso-
lated and unable to get treatment or other
support.
The number is “devastating,” said
Katherine Keyes, a Columbia University
expert on drug abuse issues. “It’s a mag-
nitude of overdose death that we haven’t
seen in this country.”
Drug overdoses now surpass deaths
from car crashes, guns and even flu and
pneumonia. The total is close to that for
diabetes, the nation’s No. 7 cause of
death.
Drawing from the latest available Administration.
This year, the DEA has seized 12,000
death certificate data, the Centers for
Disease Control and Prevention esti- pounds of fentanyl, a record amount,
mated that 100,300 Americans died of Milgram said. But public health experts
drug overdoses from May 2020 to April and even police officials say that law
2021. It’s not an official count. It can take enforcement measures will not stop the
many months for death investigations epidemic, and more needs to be done to
involving drug fatalities to become final, dampen demand and prevent deaths.
so the agency made the estimate based on
The CDC has not yet calculated racial
98,000 reports it has received so far.
and ethnic breakdowns of the overdose
The CDC previously reported there victims.
were about 93,000 overdose deaths in
It found the estimated death toll rose
2020, the highest number recorded in in all but four states — Delaware, New
a calendar year. Rob-
Hampshire, New Jer-
ert Anderson, the CDC’s
sey and South Dakota
chief of mortality statis-
‘I HONESTLy — compared with the
tics, said the 2021 tally is
same period a year earlier.
dON’T SEE
likely to surpass 100,000.
The states with largest
“2021 is going to be
increases were Vermont
IT GETTING
terrible,” agreed Dr. Dan-
(70%), West Virginia
iel Ciccarone, a drug pol-
bETTER, NOT (62%) and Kentucky
icy expert at the Univer-
(55%).
SOON.’
sity of California, San
Minnesota saw an
Francisco.
increase of about 39%,
Jeff Wersal | a police
The new data shows
with estimated overdose
lieutenant who leads a
many of the deaths
deaths rising to 1,188 in
regional drug task force in
involve illicit fentanyl, a
May 2020 through April
Minnesota
highly lethal opioid that
2021 from 858 in the pre-
vious 12-month period.
five years ago surpassed
The area around
heroin as the type of drug
involved in the most overdose deaths. Mankato has seen its count of overdose
Dealers have mixed fentanyl with other deaths rise from two in 2019, to six last
drugs — one reason that deaths from year to 16 so far this year, said police Lt.
methamphetamines and cocaine also are Jeff Wersal, who leads a regional drug
task force.
rising.
“I honestly don’t see it getting better,
Drug cartels in Mexico are using
chemicals from China to mass pro- not soon,” he said.
duce and distribute fentanyl and meth
Among the year’s victims was Tra-
across America, said Anne Milgram, vis Gustavson, who died in February at
administrator of the Drug Enforcement the age of 21 in Mankato. His blood was
found to show signs of fentanyl, heroin,
marijuana and the sedative Xanax, Wer-
sal said.
Gustavson was close to his mother,
two brothers and the rest of his family,
said his grandmother, Nancy Sack.
He was known for his easy smile,
she said. “He could be crying when he
was a little guy, but if someone smiled at
him, he immediately stopped crying and
smiled back,” she recalled.
Gustavson first tried drugs as kid and
had been to drug treatment as a teenager,
Sack said. He struggled with anxiety and
depression, but mainly used marijuana
and different kinds of pills, she said.
The morning of the day he died, Gus-
tavson had a tooth pulled, but he wasn’t
prescribed strong painkillers because of
his drug history, Sack said. He told his
mother he would just stay home and
ride out the pain with ibuprofen. He was
expecting a visit from his girlfriend that
night to watch a movie, she said.
But Gustavson contacted Max Leo
Miller, also 21, who provided him a bag
containing heroin and fentanyl, accord-
ing to police.
Some details of what happened are
in dispute, but all accounts suggest Gus-
tavson was new to heroin and fentanyl.
Police say Gustavson and Miller
exchanged messages on social media.
At one point, Gustavson sent a photo of
a line of a white substance on a brown
table and asked if he was taking the right
amount and then wrote “Or bigger?”
According to a police report, Miller
responded: “Smaller bro” and “Be care-
ful plz!”