Mental Health and Rethinking Coping Strategies

June 2, 2020

In the midst of COVID-19, there’s a lot of talk about self- care, managing stress, and coping with quarantine. It’s great to see these messages and gentle reminders for folx to take care of themselves, as this experience has begun to be regarded as a global trauma. But what do those of us with pre- COVID mental health diagnoses do when the coping strategies we’ve come to rely on to get us through a “normal” day are harder to maintain.

Olga Trujillo is an internationally renowned speaker and author who has devoted her career to helping advocates, first responders and others in the field better understand the impact of trauma on survivors of sexual assault, domestic violence, child abuse and human trafficking. Olga speaks candidly about her diagnosis of Dissociative Identity Disorder (DID) and shares her experience as a survivor of sexual violence navigating this world with DID to educate others.

I recently had the opportunity to hear Olga speak about the impact COVID-19 has had on her existing coping strategies and ways we, as advocates, can help survivors with mental health diagnoses try to create some normalcy in this abnormal time.

First, let’s name the coping strategies often utilized by survivors, and others, with mental health issues that are being challenged at this time. Methods like finding a routine, limiting stimulation, creating predictability, and changing conditions that create challenges may not feel possible right now. If you’re working from home it’s easy for your usual workday routine to be disrupted by not having the energy (or sense of urgency) to get up and shower. When thinking about limiting stimulation, many mental health diagnoses that survivors hold are rooted in a lack of sense of safety, so feeling the need to check the news and COVID statistics regularly may feel like a necessity. Finally, I want to lift up that changing conditions that create challenges is a huge barrier at this time. This particular coping strategy can be very important for survivors who feel they are lacking control over their lives. Ordinarily if a survivor were feeling overwhelmed at home or felt like they needed to go out to become reconnected and grounded in their bodies, it may be just as simple as leaving, but that’s not the reality we’re in right now. Now to leave the house, there is certain preparation that may be necessary, feeding into feelings of lack of freedom.

So what are the consequences of these barriers to coping? Those with mental health issues may have an increase of fear, stress, and panic at this time. Folx may be feeling exhausted, unfocused, irritable. This new life that we are navigating may be creating chaos and confusion in the lives of those who have developed mental health safety plans and are not able to execute them right now. For folx with mental health related issues that have other vulnerabilities, they now not only have to try to find ways to cope with maintaining balance in their minds, but they also have to take extra precautions to protect their physical health. This is exhausting. We as advocates can help by being a supportive ally to their overall well- being and validating the difficulty that folx may be experiencing at this time.

The most important thing to do as an advocate supporting a survivor with mental health diagnoses struggling with maintaining coping strategies: remind them to be gentle with themselves and let them know you’re there to support them. Ask the survivor you’re talking with how you can be supportive to them or their caretaker/ support system. Recognize that their previous safety plan may not be doable right now and help them come up with a new one. Work with the survivor to make sure the safety plan will be helpful and not overwhelming. If you’re wanting to help the survivor find a new routine they can stick to, put something as achievable as waking up and making the bed. Or taking a shower. Make sure you are validating that this may be hard and remind the survivor to be patient with themselves as they settle into this new routine. Help survivors cope and navigate new safety precautions they may be encouraged to (or have to)  comply with. Wearing a mask may not be possible for some folx, and for others it may be really triggering. If a survivor truly cannot wear a mask because it will cause more harm, do not force this on them. Help them come up with other solutions that will be comfortable for them and mitigate risk of contracting or spreading illness. It can be helpful to plan for some things to create some predictability. This may be mapping out a plan for getting groceries or if they have to go to the doctor for a routine visit. Think through best and worst case scenarios and help them come up with a plan for both situations. Offer to talk with them before, during, or after. Due to the lack of mental health understanding in the U.S., many survivors with mental health diagnoses are in jobs where they are at an increased risk of needing to apply for unemployment at this time. If you’re working with a survivor that needs to apply for unemployment, help them with this. You don’t have to have all the answers, but just having someone to take some of the stress off their shoulders is huge. You can help get them connected to the right people and walk them through the process. I know that when we’re operating on the helplines and have other calls coming in it can be hard to focus on spending 30, 40, 60 minutes with one caller, but it is our role as advocates to provide that emotional support. This is just as important as helping someone file a 50-B or helping someone look for shelter.

Mental health diagnoses are often regarded as “invisible disabilities”; however, what we should be doing as advocates is creating visibility for the needs of those with mental health diagnoses. Survivors with mental health related issues have needs for support, but may be afraid to ask for help because they fear not being taken seriously and have internalized messages to “just get over it” or “it will pass”. For many marginalized survivors, they may not trust certain systems or feel there is not a safe place to ask for help. When you’re working with a survivor with a mental health diagnosis, this could be depression, anxiety, PTSD, DID, etc, and they’re trying to tell you what they need, listen. Thank them for trusting you to ask for support with this. We cannot assume we know what survivors need, all survivors cope differently. And just because someone does something differently, doesn’t mean they’re doing it wrong. They’re doing what they know to just keep going. Remind those you’re working with that they don’t have to be perfect, that they’re not perfect, but that they can do this. Take the strengths based approach to help them see how much they’ve already accomplished just by waking up today and choosing to reach out. Assure folx that everyday may not be good, but there’s something good in every day. And finally, do the work as an advocate to learn ways to support and center the community of survivors with mental health related issues.

This information will be helpful beyond COVID-19. A personal shift could happen in the life of a survivor at any time and they’ll have to re-work what they may have been using for years to get them though.
This information was adapted from the webinar: “Advocacy Strategies for Ensuring Access to Services and Healthcare for Survivors with Disabilities During COVID-19 and Beyond” hosted by End Abuse of People with Disabilities. Information in presentation given by Olga Trujillo, J.D.

Blog Post by Leah Poole, NCCASA's Rural Sexual Assault Services Specialist