CrystaLynn Valkyrie's usual routine to keep her depression and ADHD at bay has gone by the wayside amid the coronavirus.

With no martial arts classes or band practice, she's taking more walks in the park near her northwest Minneapolis home, painting watercolors and playing indoors with her two kids.

"People have been looking for ways to socialize and support each other online, but it's been tough, especially since we don't know what will happen in the future or how bad this will get," Valkyrie said. "A lot of people's anxiety is through the roof."

Weeks of social distancing and isolation to slow the spread of the coronavirus could cause particular harm to the one in five Minnesotans living with mental illness, providers and advocates say. The pandemic has upended the availability of treatment, activities, routines and access to people that Minnesota's mental health community relies on.

It's an unprecedented situation that experts say could intensify or roll back progress on how people deal with their anxiety, depression, suicide ideation and other mental illnesses. It may also trigger new mental health diagnoses for people.

Sue Abderholden, executive director of the National Alliance on Mental Illness Minnesota, said the organization has been telling people calling them for help to "take it one day at a time." She said most of the calls have been asking about what will happen to services and how to get help.

"For those of us who don't have a mental illness, think of the angst we are experiencing, we don't know what's happening day to day, we can't predict most days what's going to happen," Abderholden said. "It's scary and then you just think about somebody who is living with a mental illness, their symptoms are going to be exacerbated by this."

As one way to adjust, Valkyrie started the Minnesota Mutual Support group on Facebook earlier this week to help people stay connected to resources and to each other. More than 600 have already joined.

"I don't have access to my normal support," Valkyrie said. "It's been reaching out a lot online, to be honest, and helping others. And creating that group actually helps my mental health quite a bit."

People coping with mental health concerns often "lack capacity to deal with new stressors" such as the corona­virus, said Cheryl Smetana McHugh, executive director for the Therapeutic Services Agency, which provides mental health services for children and adults. She pointed out that people coping with mental health issues are often working on learning how to trust others, mending strained or broken relationships or grappling with past abuse.

Now they're being asked to practice social distancing and isolation when interactions with family, friends and the community are often crucial parts of their coping. She also pointed out that seeing news about closures and supplies running out can make things worse.

"It's off-putting and distressing [when] you think you're going to go to the store to buy eggs and there's no eggs in the store," Smetana McHugh said. "It's a discombobulating experience for people who suffered early childhood deprivation … It can be a retraumatizing or triggering experience for them like, 'I remember when I didn't have food to eat,' 'I remember when I wasn't bathed,' 'I remember when I was alone.' "

Mental health providers are also scrambling statewide to triage care and treatment for patients as the pandemic continues. They are directing patients to telehealth counseling and fielding calls from patients unsure if they should still go to therapy in person. Providers are working to keep their employees safe and reassured, but some have considered laying off staff they cannot afford to pay.

The coronavirus crisis has also put Minnesota's shortage of mental health services on display. Even as providers urge clients to move to telehealth services, they acknowledge that not every household has internet, a computer or a smartphone. And a remote counseling session won't necessarily have the same benefit as an in-person session for a patient.

Behavioral health directors at the Native American Community Clinic in Minneapolis and Open Cities Health Center and United Family Medicine centers in St. Paul said this week that they're seeing an increase in demand for services and are unsure how they'll manage with the limited staff they already have.

One clinic has given laptops to clients for telehealth services. Another is working on YouTube videos to share with clients and staff on breathing and self-soothing resources. But all three said they continue to tell Minnesotans who need help the same thing: Keep calling.

Vanessa Ng, behavioral health director with Open Cities Health Center, said the clinic is continuing some in-person treatments because some of their low-income patients were socially distanced or isolated before the pandemic. Ng said the center has already suspended group sessions and may eventually have to do the same for outpatient services.

"Some of our patients are so vulnerable, I'm more fearful of them being suicidal than getting coronavirus," Ng said. "So we have to continue with a lot of our services despite fear of exposure."

For now, Valkyrie said she's looking forward to watching the Facebook group grow. Members are trying to make sure others have food and other supplies they need, to the point where it's more people offering support than those who need anything, Valkyrie said.

Participants have helped families with special-needs children find food, helped locate child care and offered to drive people to appointments or to the grocery store.

"In the media, you see a lot of people hoarding things and being real jerks about it, but there's this flip side of people who, if someone needs baby wipes or soap or something, then other people are pointing them to resources," Valkyrie said. "It's really helpful to know people are able to get their basic needs met."

Marissa Evans • 612-673-4280