Lessons Beyond the "Sandbox"
School of Humanities and Social Sciences, we all get to meet - virtually - Kevin Holder.
Kevin has been an adjunct faculty member at Reynolds since 2011. He was recently featured in an NBC article on May 11 about the challenges faced by black mental health clinicians during the COVID-19 crisis.
While the NBC article focused on a more specific topic - black clinicians and the impact of COVID 19 - it was clear there was more to learn from Kevin about his experiences in the Richmond area. As if the stresses of mental health clinicians aren't enough, the pandemic has stretched our local services in ways we may never have considered.
Kevin's thoughtful, robust, and informative insights give us a better understanding of what is happening all around us right now, even if we aren't out and about to see it in person.
Kevin: I work as a Senior Emergency Services Clinician for Chesterfield County. Most people refer to us as Crisis Clinicians. Crisis work is 24/7 – 365 days a year just like police, fire, and EMS. At work I answer crisis phone calls as they come into the call center. I pre-screen individuals for psychiatric hospitalizations when they are having a mental health emergency, whether they are voluntary or involuntary. I provide crisis counseling to individuals and families. Chesterfield Jail is a partner with us so I conduct risk assessments for the people there. I participate in court hearings for “commitments” and “re-commitments” that determine if a patient needs to stay involuntarily at the hospital for additional psychiatric treatment, stay voluntarily, or can be discharged. The job comes with a fair amount of documentation and clinical charting that needs to be completed on a daily basis. In my profession of social work, especially in the Human Services and Mental Health courses I teach, students learn Surveyor’s Rule #1 – “If it hasn’t been documented, it hasn’t been done.”
Before COVID-19, my typical day would start with going into the office and logging in so the phones would ring in the office and no longer to the on-call clinician. Then I would post the schedule on the walls and door of the roles that clinicians would have throughout the day. I would make sure the fax machine and printers all were filled with paper since we do a lot of faxing and printing throughout the day/night. Then I would check work emails and just wait for the crises to start coming in. If a jail or hospital evaluation was needed, I would drive to the jail or the hospital. If the magistrate issued an order or the police picked somebody up that needed an evaluation, I would meet them at the police station (during late nights, weekends, and holidays). If this occurred during the day, police would bring them to the center to be evaluated. COVID 19 changed all that.
Q: How has your job changed now? What is your daily experience in this pandemic?
Kevin: My job has vastly changed now because I’m only in the office one or two days a week so the rest of the time I’m working from home providing tele-behavioral health services. The crisis calls come in via software that is installed on my work laptop. The face-to-face evaluations are conducted using video conferencing. The person being evaluated might be at the hospitals, jail, police stations, or juvenile detention. The time it takes to complete the work is still about the same, but there is no travel time involved now since I’m using this technology. Although travel time has decreased, I believe the volume of calls and evaluations has increased, unfortunately.
Q: What is the situation in the areas you are serving now? What do you see?
Kevin: A lot of people are hurting emotionally and feel isolated. Sometimes people feel isolated even if they are not the only ones living in their house. This has lead to an increase in suicidality, emotional disturbances in children and adolescents, as well as depression and anxiety in all populations. Psychiatric hospital beds are filled to capacity so people are spending hours and sometimes days in emergency rooms, waiting for a psych bed to become available. This is bad for the patients because being in an ER for that long can be over-stimulating and increase their anxiety. This is bad for the police that often times have to stay with the patients because that’s two police officers that are no longer on the road keeping the public safe.
Q: What does the community need the most?
Kevin: The community needs more inpatient psychiatric beds for children, adolescents, and the geriatric populations. There is a severe shortage of psych beds. We need more therapists providing individual and group telehealth services in the community, in private practice and in public mental health. The community needs equal access to adequate technology to allow for the provision of these services. That includes hardware (devices and laptops), software, and high-speed reliable internet connections. This pandemic has exposed the digital divide that our community has been experiencing for many years.
Q: Will your experience impact what you share with your students? How?
Kevin: Absolutely! I share as many of my experiences with students as time permits because they need to know what they are getting themselves into and prepare for these situations in the “sandbox” known as my classroom so they can competently navigate these experiences while out in the real world. Students tell me they appreciate the case scenarios and are often shocked to find out that the scenario was something I actually experienced in the field. I plan to share my telehealth and overall work experiences in this pandemic because part of my experiences will become their new normal once they graduate and are in the workplace.
