The COVID-19 virus and shelter-in-place orders means a worsening of mental or behavioral health conditions. For those already suffering from depression, the outbreak has likely only compounded issues further.

Home Health companies including AccentCare and Elara Caring, two of the largest providers in the country, are working overtime on their behavioral health services.

In the past year, 47 million Americans have reported a mental illness, according to statistics from the Kaiser Family Foundation. Over 11 million have had a mental illness that caused functional impairment and restricted life activities.

Seniors are at the highest risk for COVID-19 as they are more likely to have complications and more likely to struggle with the isolation and loneliness.

“We’ve definitely seen escalated concerns — stress, fear, anxiety — caused by the COVID crisis,” Scott Powers, CEO of Elara Caring, told Home Health Care News. “We are already dealing with patients who, for the most part, are homebound oftentimes due to other functional disabilities,” Dave Davis, chief clinical innovation officer at AccentCare, said. “There was already a layer of disconnect from their usual activities of daily living and communities. And then on top of this, having further isolation definitely exacerbates depression as well as anxiety.”

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