Episode 2: COVID-19 Anxiety and Fordham

Listen to “Episode 2: COVID-19 Anxiety in Fordham” on Spreaker.

“I don’t see a single patient in my practice who isn’t effected by anxiety, to some extend, with COVID.”

—Dr. Kavita K. Trivedi

Host Mila Myles discusses COVID-19 anxiety, how it affects New Yorkers in the Fordham area of The Bronx, health disparities on race, class, location, and more, and the vaccine rollout throughout New York City with Dr. Kavita K. Trivedi, a leading epidemiologist and founder of Trivedi Consults, and Darlene Carrera, LCSW, The Jewish Board’s Director of the Early Childhood Treatment Center Program and the Grand Concourse Counseling Center in the Bronx.

Resources Discussed During This Episode

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Transcript

Mila Myles:
Welcome to New York State of Mindfulness, a podcast about mental health, wellness and the communities we live in throughout New York City sponsored by The Jewish Board. Today we’re talking about COVID-19 related anxiety and stress in the Fordham and in the Bronx areas. I’m joined by Dr. Kavita K. Trivedi, founder of Trivedi Consults.

Mila Myles:
Dr. Trivedi is a values-driven medical expert who consults internationally, nationally, and in her home state of California. Trivedi Consults takes great care in advising organizations to reopen amidst the spread of COVID-19. Dr. Trivedi’s leadership is rooted in anti-microbial resistance and her experience spans through the World Health Organization, Centers for Disease Control and Prevention, and is a proud member of the Society of Healthcare Epidemiology of America and California Department of Public Health. She has been consulting with The Jewish Board since March 2020. Welcome Dr. Trivedi.

Dr. Kavita K. Trivedi:
Hi Mila. It’s nice to be on.

Mila Myles:
Darlene Carrera, licensed clinical social worker, is the director of the Early Childhood Treatment Center program in the Grand Concourse Counseling Center in the Bronx. She has a bachelor’s degree in psychology from UC Irvine, a master’s degree in social work with the concentration in mental health and medical health from Columbia, a certificate in leadership through NYU and a two year certificate in psychodynamic, psychotherapy from the Institute of Contemporary Psychotherapy and Treatment of Children and Families. Darlene joined The Jewish Board in 2008 and has since been committed to increasing the capacity for mental health treatment in the Bronx communities, supporting children, young adults and families. Welcome Darlene Carrera.

Darlene Carrera, LCSW:
Hi, it’s nice to be here.

Mila Myles:
A little information about what we’re talking about today. Many of us have been dealing with anxiety and stress during this pandemic. Some of us have had a slight advantage. We’re already prepared with coping strategies, relationships, support, therapists, and some understanding of the warning signs of an impending mental illness crisis. But Coronavirus is testing all of us who have anxiety or who have never experienced anxiety, and we need to have mental health help available when the pandemic ends as well as while it’s going on. So Darlene, can you tell me a little bit about the Fordham/Bronx area that you work in, and how long you’ve been there?

Darlene Carrera, LCSW:
Sure. Our clinic, we moved in about 2017 and we actually had two different clinics. One was in the South Bronx and the other clinic was in the Woodlawn section and we moved to a area where it is very busy. Fordham Road is known for all of their stores, restaurants, it’s a lot of foot traffic and we have a lot of buses, trains that go and meet at Fordham Road. So it is a highly busy area and a lot of people know of the two streets there, well-known, Grand Concourse and Fordham Road. That’s also where the university also sits there a few blocks away.

Mila Myles:
You’re making me think I need to start going to the Bronx. Now, Dr. Trivedi and Darlene, of course today I wanted to talk about COVID-19. I mean, I know that that’s something that you two have been working with, I guess, patients and clients throughout the last year on top of other mental health issues and crises people may be experiencing.

Mila Myles:
I’m almost certain that this is something I think we all know someone even personally who this has exacerbated some things that they’ve already been dealing with on their own. And I wanted to know how COVID— and COVID-19 responses in New York, especially in Fordham and in the Bronx neighborhoods— about what have you noticed, I guess, at the onset of the pandemic when you were already working in clinics and having to switch to a virtual space to see your clients and patients.

Darlene Carrera, LCSW:
I can answer to that, this is Darlene. So, we had to completely switch into the virtual space back in March when everything around us was closing down. However, we did notice that not everybody had the capacity to do the virtual space. So we were also able to provide services via telephone and telephonic, but it did take some time and some months for us to identify families, children who needed separate laptops, telephones and things like that just so that they can have the capacity.

Darlene Carrera, LCSW:
There was also the wifi and the internet that they also needed to figure out. And then when you have households that have two, three, four people who are all using the internet in some kind of way, that also was a problem too. So we continue to provide services, we are open one day a week, we’re going to slowly sort of build that up and we have telephone and the Zoom access to be able to provide services. But it took some time for staff and our clients to get used to that and to be able to figure out how to utilize these different services to continue to get treatment.

Mila Myles:
Oh, yeah. I mean, I would imagine and I didn’t even think about that because I’ve had a lot of people, family members and friends who had some difficulty even already having internet adapting to virtual spaces with their children, having to switch their education in those spaces and I didn’t even realize how much more difficult that was going to be for people who had mental health and medical services.

Mila Myles:
And I see here that the poverty rate in Fordham and University Heights in 2018 was 36% compared to 17% citywide. So I could only imagine that the access to internet and the devices that allow you to have those virtual consultations would also kind of translate to not having the finances to acquire them.

Dr. Kavita K. Trivedi:
I was just going to jump in and just mention one thing here that I think one thing about having to move into the virtual space is learning how to develop relationships with your patients via a screen, which is so different and really requires different levels of expertise on how you can develop that relationship. When I see patients, I really like to reach out my hand. I don’t touch them, but just reach out so that they recognize that I’m warm and opening myself up to having a conversation.

Dr. Kavita K. Trivedi:
I think these are all techniques that we as healthcare providers have developed over the last 20, 30 years and then to have to now go to a screen and try to develop these relationships and open people up is really difficult. And then on the flip side to have the wifi issues and the issues on the other end where patients have difficulty getting on, have difficulty understanding how to interact with you over a screen, I mean, it really poses so many issues, especially in the mental health, I think, space particularly.

Mila Myles:
Yeah, I could imagine. It did take me…. Thank you for that because I forgot to mention and even question that perspective, because it did take me a minute to seek out a therapist or counselor during the pandemic because I wasn’t convinced that being in Zoom for work all day, I wasn’t convinced that I would even care or feel to be opened up again on the same screen in a completely different way and not be able to… for someone to kind of read my mannerisms while I’m speaking and what I’m feeling and also be able to receive theirs.

Mila Myles:
And that kind of, like you said, the techniques that you all developed in your expertise to get people to feel warmer and open up and that they can trust you. The worry I think with a lot of people is it feels very much like a Zocdoc online kind of consultation to get a prescription. So I’m happy that you all have found your way around that and I’m sure it’s a testament to your passion about this field and people, but also a testament to your ability to really have to adapt for the sake of your patients.

Darlene Carrera, LCSW:
So in terms of anxiety that has probably risen because families need therapy so much more now than ever before, I think that the uncertainty of this pandemic and COVID-19, and this illness really has intensified everybody’s emotions. And so being able to figure out and understand how they can access their nurse practitioner, their doctor, their therapist, that took some time also to just sort of figure out… our staff too had to realize that we had to collect email addresses.

Darlene Carrera, LCSW:
Prior to changing in this way, we didn’t use the email to go back and forth and talk with our clients, but we needed to get their email addresses for the Zoom capability, to be able to send them documents if they needed something to be signed and then also just teaching our clients how to be on the screen. So what Dr. Trivedi said too, that teaching them how to mute themselves.

Darlene Carrera, LCSW:
We see a lot of younger children and so they’re in and out and up and down and they want to… they’re bringing the camera and they’re showing us their room. And our collateral contexts with parents and guardians and anybody who’s been with the children definitely increased because we needed their help to be able to sort of sit down together in a private space, in a confidential space so that we can do our sessions in that kind of way. And I think our staff members really struggled with how to figure out ways to sort of keep the clients engaged because there are a lot of clients who they don’t like this kind of way. They want to be back in the clinic and seeing their therapist in real life.

Mila Myles:
That’s the great part of being able to go and see your therapist or your counselor, right? It’s kind of like physically having someone who wants to listen to you and wants to help you in that space. So I can only imagine what they felt like was being lost.

Mila Myles:
Back to COVID and anxiety, how have COVID and COVID responses caused people to feel anxious and stressed, especially for people who are already prone to anxiety and stress?

Dr. Kavita K. Trivedi:
I’ll just comment that we are definitely seeing more diagnoses of generalized anxiety disorder than we certainly did before. And I don’t see a single patient in my practice that isn’t effected by anxiety to some extent with COVID. We all have been learning about this disease as scientists have been learning about this disease. So we have been engaged kind of in the scientific method. So at the beginning it was like, “Surfaces, wash all your groceries.” And now it’s like, “Don’t wash all your groceries.”

Dr. Kavita K. Trivedi:
I think having all of the science continue to change, which we should expect, I think for the general population is really hard to then continue on in their kind of regular ways of living life. So, anxiety is definitely extremely prevalent right now. And hats off to the people that reach out for professional guidance, because I think all of us could use some ways to cope with the pandemic given that so many things have changed.

Dr. Kavita K. Trivedi:
And then on top of it, what I see also in a lot of patients is people that are used to being kind of “the strong ones” in their family, or used to being the ones that people lean on, they are having trouble coping with what’s happening and therefore the rest of their families are having trouble coping because they are not able to be those strong individuals like they usually are; and take a step back and understand we’re in the middle of a pandemic, this is an emergency.

Dr. Kavita K. Trivedi:
My son always reminds me like, “Mom, you don’t know what it’s like to grow up in a pandemic.” And I was like, “You’re right. I don’t because I didn’t have to, but you also haven’t been a parent in the pandemic and it’s hard on all ends.” And I think starting with empathy is the first place to start; to understand we have to empathize with every single person right now. Our stories are also different and our stressors are also different, but many of them stem from what’s happening around us.

Darlene Carrera, LCSW:
I think also too, I mean, one of the coping strategies that I talk about with the staff and what they say to the patients/clients is gratitude: appreciating all the good that is around us and sort of taking a spin on a positive attitude towards life. We’ve talked a lot with patients about creating—and this doesn’t have to be something elaborate—but a gratitude jar, gratitude box or writing down in a journal just what they are grateful for, what makes them happy, who makes them happy, dating when that was and just as positive reframing.

Darlene Carrera, LCSW:
Because as Dr. Trivedi said, right now we don’t have all the answers, we’re not in control. It can feel defeating and scary and all of those things really take a toll on us mentally. We all are going through sort of this collective trauma. And so we have to take care of ourselves. So I would say that gratitude is just something that I push and I try to remind everybody to do, being thankful for the small things that we do have. It goes along with just the empathy and knowing that everybody’s kind of… we’re all going through it at the same time.

Mila Myles:
That spoke to my heart, it really did. What are some ways of coping that you saw change during the lockdown and today with people that you have coming to see you?

Darlene Carrera, LCSW:
I think that one of the topics I wanted to speak about was trying to curb what we see and being mindful of what we hear from in terms of the news. So I think that it’s so important to be informed and to know what’s going on, and so understanding and having the capacity to have sources that are trusted. But at the same time, we hear that families have the news on 24/7. So everybody in the household is hearing, seeing, reading news that can be alarming and anxiety provoking and sometimes sensationalized.

Darlene Carrera, LCSW:
So, I would say that although it is very important to be informed so we know what to do when we are going out there, I think we have to look at how often we are and track that and be specific maybe to the timeframes of when we are going to watch the news, hear the news, read the news.

Darlene Carrera, LCSW:
Our clients tell us all the time, “Oh, I heard this, or I saw this.” And so we’re trying to sort of figure out, “Is that true?” Like, “We’ll get back to you.” But I think being mindful and really being specific about when you’re watching it so that it’s not going on all day long and producing that much more anxiety. We can go through so many emotional roller coasters just watching 10 minutes of the news.

Mila Myles:
I definitely made other people feel anxious, watching it and reporting throughout the house what was happening next on the news. And I have a partner—and I’m not allowed to now listen to the news out loud in the morning. I have to watch the 10 minute top-line segment that I watch on my headphones because she doesn’t even want to hear it in the other room.

Dr. Kavita K. Trivedi:
I think I’ve seen the outdoors be something that’s really been helpful for both providers and patients and clients just getting outdoors for a walk, breathing some fresh air. I think that has done wonders for lots of people. So I think that has been just one thing that I would really recommend for people just to… I myself can be stuck in my house all day and realize, “Oh my gosh, did I even get outside even for a minute?” That can be really healing and can help you begin again, if you will, to start fresh when you come back in the house from having an outdoor experience.

Dr. Kavita K. Trivedi:
Then the other two things is connection with people. We used to call it “social distancing,” and now thankfully we’ve moved over to “physical distancing” because we really want people to continue interacting socially, we’re not saying don’t interact socially. But I think continuing those connections, whether they are FaceTime videos with your family members, with your friends, we need to have connections outside of people in our households that we see every day.

Dr. Kavita K. Trivedi:
And then I’m also advocating for interacting with family members, especially elderly family members who are really isolated during the pandemic. Having grandchildren wear a mask and stay outside only with grandparents and at least talk to their grandparents is such a healing thing for both the grandchildren and for grandparents and can help them keep going for three more months through the pandemic if they have that kind of interaction. So I think trying to figure out how to keep those connections going with people that you care about in your life is extremely important and so good for our mental health.

Darlene Carrera, LCSW:
I do want to put in a plug about sort of the being outside and the physical space. The Bronx has two of the largest parks in New York city, Pelham Bay Park and Van Cortlandt Park. And together they cover about over 4,000 acres of land. And so, although it is snowy now and there’s ice and snow, we do have those large parks that are in the Bronx that are free. And then also, I looked it up because I wanted to make sure that this was still ongoing, but the Bronx Zoo and the Bronx Botanical Garden, they also have just limited access or limited capacity also, but if you plan ahead on Wednesdays, it’s free to go there as well.

Darlene Carrera, LCSW:
So families can make a day trip. The Bronx Zoo is also a lot of acres, lots of walking, the botanical garden as well. You’re right, trying to find time to spend with family physically in an outdoor space, seeing nature, walking, being physical is so important and we need to do that more in order to stay mentally healthy.

Mila Myles:
About COVID-19, while we’re all still working on different ways to cope with the world and nation as it is right now, another thing that’s happening is that there are a few vaccines that are now being distributed. And we’ve all seen that in, I believe it was in the Fordham in Bronx area, there was a facility that was giving out vaccines. And there were people who had went to the area who were not from that area, taking up all the slots to receive a vaccine.

Mila Myles:
And I’m a black non-binary woman, and of course within my family, there are a lot of people, even myself at first jump who when it comes to vaccines, I feel like pro-choice only because with my family at least I tried to push some of them to be open to taking the vaccine, but I also tried to respect their space and understanding the histories that we’ve had and been taught around medical injustice within marginalized communities.

Mila Myles:
And with Fordham, having New York’s biggest melting pot of people from different socioeconomic backgrounds and people of color, I was wondering how or why you feel the affected communities based on race and class and jobs, other reasons why you think that they might be hesitant to take the vaccine.

Dr. Kavita K. Trivedi:
Sure, yeah. I think that there are lots of reasons why communities of color are hesitating to take the vaccine. And I think I’m going to use the word empathy again. We have to understand and give out empathy when we talk to people who have very real concerns about taking a vaccine given, as you mentioned, the structural racism, especially in the healthcare system and throughout this country. There are very real reasons why a black person may not want to take this vaccine.

Dr. Kavita K. Trivedi:
And I think the first thing that I always do is to listen to what the reasons are, because many of the reasons, or most of the reasons, are very valid. Some of the reasons I think can be related to misinformation as Darlene mentioned, so we can certainly address those concerns. But I think two things that I hear often is the speed at which the vaccine was developed, that is a concern.

Dr. Kavita K. Trivedi:
Most vaccines we know are developed in 10 to 15 years. And so this one was developed in 11 months. And so I think that there is a lot of concern about the speed and the integrity, if medical integrity or scientific integrity was maintained because of the speed. And I can just speak to that, that all the phases that are usually implemented when we develop a vaccine were all completed during this development of this vaccine, these vaccines, I should say, and they were overlapped, which is why we were able to get done so quickly.

Dr. Kavita K. Trivedi:
And the other thing that I want to mention is that the genomic sequencing that occurred in the beginning where we identified the sequencing very early on, that happened because of advances in science around genomic sequencing that occurred prior to 2020. And then the second piece is the mRNA vaccines, which are the two main vaccines that are available right now in the US, those two vaccines, the mRNA technology has been developed since the 1990s.

Dr. Kavita K. Trivedi:
So, the reason we were able to develop a vaccine so fast really is because of the advances of science prior to 2020. So that’s one thing. And then I think the second thing people are concerned about are the safety risks, right? Like, is it safe for me to take this when not that many people potentially have received the vaccine? And I’ll just reiterate out of the thousands and thousands of people in the US from all different communities of color, with different underlying medical conditions, we haven’t had a single person who’s received the vaccine be hospitalized or die of COVID or die of the vaccine itself.

Dr. Kavita K. Trivedi:
So we feel very strong of a safety profile is very positive. So, hopefully those messages and combating some of the misinformation can help communities, especially these communities of color where people are being impacted the most by COVID, right? They are being impacted the most, Black people are being hospitalized and are dying at much higher rates than their white counterparts. And we see young Latinx patients who are hospitalized between 20 and 29 years of age much higher than their white counterparts. So we must do better in these communities of color to get the vaccine out to these people that are particularly being impacted by the pandemic.

Mila Myles:
I mean, of course I did not know the science before that, but that makes so much more sense. I was skeptical when they started to develop different vaccines or when the United States started to invest in the development of vaccines but I never thought about the fact that since the last global pandemic, of course, science has made so many strides that we would hope that at the rate at which it would take for them to develop that vaccine, it would drop exponentially. So that puts me, and I’m sure so many other listeners at ease a lot more.

Dr. Kavita K. Trivedi:
Mila, and let me mention two other things that that reminds me of. Number one, the sequence of the virus, we had it on January 10th of last year, that was at a time where most people in the US did not even know this virus existed. So the virus was already sequenced. January 15th, the NIH here in Bethesda, Maryland already had the mRNA vaccine developed and they were already starting testing, January 15th of last year.

Dr. Kavita K. Trivedi:
So that all happened before this was even on most of our radars. And then the other thing is I do want to address what you said about the previous administration. So these vaccines were approved under an FDA that was under a different president. But I want to mention that under every single step, when these vaccines were approved, there were independent scientists that evaluated all of the safety and efficacy data.

Dr. Kavita K. Trivedi:
These are independent academicians from all over the country who I respect, who absolutely looked at all this data and helped give approval. So it wasn’t just that the vaccine got approved by the previous administration, it was approved by independent researchers who were able to look at all of the data. So that should help people also.

Mila Myles:
Oh my gosh, it really does. It really provides a lot more trust and clarity to know that information, it really does. So I really hope that everybody listening feels a lot more at ease with that information because I definitely do. Thank you.

Mila Myles:
What are some of the emotional impacts of the vaccines, positive and negative, and what are some influences in that context?

Darlene Carrera, LCSW:
I think for us at the clinic, we have talked about it with staff. We’ve talked about how we are going to encourage and inform all of our clients about the vaccination. And I think the staff that are starting to get vaccinated, they’re sharing their experience. I have to say that some of the staff that have shared their experience about getting the vaccination, there is some sense of relief.

Darlene Carrera, LCSW:
It feels that there is some hope and that there is going to be something different in terms of getting this and maybe the ability to travel and to see family and things like that that have sort of stopped us. So I think that on a positive spin, the vaccination has been a sense of hope for some of us. But I do have to say too, at the same time, we still are trying to help understand and there is a race equity and inclusion issue and this information that Dr. Trivedi shared with us isn’t something that most people know.

Darlene Carrera, LCSW:
So I think having the right information, being able to get it out to as many people as possible and to explain it in the way that you did, Dr. Trivedi is really important because I think some of us, we just have no idea how to kind of understand the science behind how a vaccination is rolled out and having this information really helps to promote actually thinking about getting it, going to an appointment, encouraging others to go in that direction.

Dr. Kavita K. Trivedi:
And it reminds me too, Darlene, what you just said: that people should remember and note that if they get vaccinated, they are protecting their families also from this virus in their homes. And I think especially for communities of color where we have a lot of emphasis on families and families living together and multi-generational homes, I think people understanding that if you get vaccinated, you’re actually keeping the rest of your family safe. And safer is really such a positive message for communities that really relish these robust family interactions, right?

Dr. Kavita K. Trivedi:
So you getting vaccinated, people have called me and said, “Oh my gosh, I might have a turn. Should I get it if the rest of my family can’t get it? Should I do this?” Yes, you should. Because the more people that get vaccinated, the more families that are protected and the less deaths and hospitalizations we’re going to see. So if your turn comes up, I advocate you getting in that line and getting your vaccine.

Dr. Kavita K. Trivedi:
And you may have some side effects, Darlene and I both had some side effects and I actually take the side effects as meaning my body is producing an immune response. So we are seeing more side effects in younger populations, under the age of 55, we see more side effects. Elderly people have less side effects probably because their immune systems aren’t as robust and aren’t actually developing as much of a response as younger people are. I think that you should welcome a sore arm after vaccination because it probably means your body is making those antibodies that we want to help prevent you from getting sick from COVID in the future.

Mila Myles:
Wow, I didn’t know that. A lot of people have been acting like what they’ve heard about people taking the vaccine is likened to like, “Oh my God, it’s like they gave you chemo and it’s tearing your body down.” So I didn’t even think about the fact that that’s an indication that my body is healthily developing a response to exactly what I gave it. Wow.

Mila Myles:
So back about the anxiety around all of this, because again COVID, it’s so interesting, right? That the pandemic is causing stress and anxiety, but also the vaccine and the thing that’s coming to supposed to save us all, it’s like a compounded anxiety and stress almost no matter what, because all of this is so foreign to some generations who are experiencing this right now.

Mila Myles:
But I want to ask about the anxiety about actually trying to get an appointment. I would assume that that’s another hurdle for people. I mean, there was anxiety around trying to have virtual meetings for you, Darlene and some of your patients. So I can only imagine that you also have patients coming to you debating, be either anxiety and stress and depression and responsibility to schedule an appointment.

Darlene Carrera, LCSW:
Yeah, that actually has been sort of the topic of the last few weeks have been, are you able to get an appointment? How did you get an appointment? It’s again, navigating some of these websites where at first you are able to put all your information and then you realize that there’s no appointments left in a location that you were hoping to get or not understanding the questions that are being asked.

Darlene Carrera, LCSW:
So we’ve had both staff and clients just having a really hard time trying to find appointments. We just found out that Yankee Stadium, as of today, has opened up their doors and will be providing vaccinations to residents of the Bronx—and that was as of today. So we are hopeful and share that information on how to get an appointment. Again, you do have to go online, you do have to have access to a computer, you have to have somebody who is able to read and answer the questions; but it is available to Bronx residents, New York city employees, frontline workers, healthcare responders, seniors.

Darlene Carrera, LCSW:
And I also wanted just to go back and say that the Bronx is an area where we have a ton of people who are going out to work. There is more people who are going out and about riding the subway, riding the train. So they are exposed in that way, going to work every day and then coming back home to multi-generational homes. So they’re going to see grandma, they’re going to see their aunts or their cousins. And so I also want to say that it’s just so important to think about it, about getting the vaccination and how that will be helpful to these families that are living with so many people, small sort of dense space.

Dr. Kavita K. Trivedi:
And can I add to that and just say that for the people in your household that are elderly who do not have access or are not as savvy with a computer, this is the time to advocate for those people to get vaccinated. So help them make an appointment, help them get to their appointment, whatever we can do to get that group of people vaccinated is I think really critical and important. And as we are advocating for ourselves to get vaccinated, we should make sure that those people who can get the vaccine right now do get the vaccine right now.

Mila Myles:
Absolutely. It’s to protect yourself and everyone around you. Yeah, I’m so happy that you’re also trying to charge the rest of us with the responsibility of the people around us. If they can’t get vaccinated and we’re leaving the house the most, then it’s our responsibility to be the person to start that process and also helping other people because I don’t think a lot of people are thinking about that. They’re getting the text messages from the city telling them who it’s available to, but they’re not realizing their role in that. And that’s when it comes down to all of us needing to work together as a family and a community. Do you have any tips, emotional or medical to stay safe, otherwise and healthy while coping with COVID?

Darlene Carrera, LCSW:
I definitely don’t want to turn it into sort of like a sad thing, but I do want to address coping with loss and grief around COVID-19. A lot of the data that we’ve just shared is very parallel to what we actually are seeing. We’ve had a lot of primary and secondary losses; primary being the deaths of actual people who have lost their lives due to COVID or other reasons. There’s just been a lot of deaths kind of around us.

Darlene Carrera, LCSW:
But then also sort of the secondary losses, what you talked about Mila, having to move, the dreams that we had that we had planned for that we had to cancel, losing jobs, losing sort of our recreation, losing friends. And so part of what we have been doing, so unfortunately we have lost clients, we’ve lost staff and we really lean on each other, we share the grief, we share the feelings, we actually name it and we share the memories of the person, we try to honor them in some kind of way.

Darlene Carrera, LCSW:
We pause and we were there to support one another. And I think that as people have been losing people, that it’s pretty much our communities and who we have as our support systems that is who helps us to kind of get through. But being able to talk about it, being able to laugh about somebody, and think about them in special kinds of ways has really gotten us through the coping with some of the grief and the loss that’s touched us in profound ways that has been very different from any other year that we’ve ever experienced.

Darlene Carrera, LCSW:
I also want to give a shout out to my clinic because they’ve been through it, Grand Concourse Clinic and the early childhood program. They’ve really been a strong team who show a lot of resilience and they’ve done their best to honor the staff and the clients that we have lost.

Mila Myles:
Wow, wow.

Dr. Kavita K. Trivedi:
And I would just add to that that what I talk about a lot with both patients and other providers is the concept of the oxygen mask: that before you can help other people, you have to help yourself. So, you got to put the oxygen mask on yourself before you can help others. And so this is the time to figure out what you need to function as a successful provider, as a successful parent, as a successful community member.

Dr. Kavita K. Trivedi:
So, if that means taking walks, if that means yoga, if that means meditating, this is the time to carve that time out for yourself so that you can more successfully get through your day and deal with the continued hardship that we will probably face this year. But I just advocate for that oxygen mask.

Dr. Kavita K. Trivedi:
And a lot of people, especially in communities of color, do have a hard time with this. They have a hard time with putting that mask on themselves first, where they put it on other people. The only way we can do this day in and day out is if we make sure that we are well sustained ourselves. So I just really want to advocate for all the staff listening to figure out what helps you get through your day and make sure you do that every single day for yourself.

Mila Myles:
Looking at the year ahead, what kinds of support do you hope people will find? Do you have resources, especially in the New York or Fordham areas to recommend?

Darlene Carrera, LCSW:
So I think that when the weather gets better too, because right now we’ve got that snow on the ground, we do have around the Fordham area farmer’s markets, places of greenspace that people can go to to get sort of fresh fruits and vegetables and sort of nurse themselves in that kind of way. But there are a ton of websites that are super helpful in trying to find resources that are very specific sometimes to what’s happened with COVID-19.

Darlene Carrera, LCSW:
There is one website that I go to that has also an emotional support helpline. It also has resources that are COVID related assistance and that’s the New York Project Hope. It’s available in 10 different languages and it has links to a bunch of other resources, so childcare resources, I think they also lead you to CDC, so the Center for Disease and Prevention.

Darlene Carrera, LCSW:
And then I would also say that NAMI, which is the National Alliance on Mental Illness, and then also the National Institute of Mental Health. They also have a bunch of brochures, education, resources that I think are important for clients to remember that there are local things that are happening that they could be a part of. I think that helping one another, which we’ve talked about a lot throughout this talk, volunteering and being there for one another, I think is just really important.

Mila Myles:
Thank you so much, Darlene and Dr. Trivedi. I mean, this has been more than enlightening. I feel like I should pay you after this. I feel like I had a therapy session just now. You just made me feel so assured by so many things. And I’m certain that most people who are listening to this are also getting that from this interview. I really appreciate you two giving us your time today and all of your knowledge and expertise and sharing, because I know that this year we’re talking about other people and the patients and the population, but I know this year has not been easy for you as well to continue to press on and do the work that you do to make sure we are all good.

Mila Myles:
I’ll speak on behalf of everybody else, I’m truly grateful. You’ve helped and saved so many people and you’re continuing to do that, so thank you so much. Today we talked about empathy, gratitude, reaching out and doing some community work as well as a few other resources that’ll help us all get through this separately and together. Thank you to our guests, Darlene and Dr. Trivedi for joining us today.

Mila Myles:
To learn more about their work in the Bronx and the Fordham area, check out jewishboard.org. Lastly, remember that you are not alone. If you or loved ones in NYC needs mental health services and support, call our non-emergency intake line at 1-844-ONE-CALL, again, that’s 1-844-663-2255. And we’ll also be providing a landing page with all of the resources that we talked about in this interview.

Mila Myles:
Thank you so much for your time today.

Dr. Kavita K. Trivedi:
Thank you.

Darlene Carrera, LCSW:
Thank you. Bye.