We met Baxter, a house-bound gentleman who was referred by his PCP.

There were concerns of depression and anxiety, in addition to suffering from psoriasis. COVID-19 reasoned this gentleman to be self-confined to his house. Our sessions would be offered by telephone.

Our first session soon revealed Baxter in pain from psoriasis. He stated that it was spreading and affecting sleep, appetite, and other various daily functions. Watching TV he stated is a prime activity.

He lives alone.

Baxter’s wife died three years ago. Three adult children live independently with their own families respective. Each lives at a distance that Covid placed a damper upon visit. He also has three sisters who all live out west. He has not seen them for two years. Family reunions hadn’t occurred for two years. A couple of active lap-sitting tomcats are his companions. He has quarantined during COVID. The cold months have made wearing heavy clothing uncomfortable for him. Fewer clothes are easier on his psoriasis. He reports ordering food on-line; however, he isn’t hungry. He’s lost weight.

Not having gone out for months, taking different medications without any success, and not feeling good has taken a toll on him. His concentration has been impacted by the painful psoriasis. Searching for supports, even neighbors who once were active with Baxter when his wife was alive stopped visiting. After his wife’s passing, neighborhood women dropped offerings of food for Baxter. Over time, the husbands joined their wives for visits. They eventually all stopped their visits, save for two women.

Baxter was rendered emotional when relating the following. The last woman who continued to visit, his wife’s best friend, could no longer visit. Her husband’s jealousy got the best of her. He was heartbroken.

“It’s like I have a communicable disease and everyone’s afraid to catch it.”

I felt sadness for Baxter. I asked him how all these recent experiences affected him.

He believes his psoriasis adversely affects him socially. He’s embarrassed by how he looks. That unto itself proved to be a “source of grief.” We began to process for the second session an idea for support. I also asked him for a verbal consent to consult with his PCP who had referred Baxter for counseling services.

Baxter called 10 minutes before our scheduled telephone appointment. Hello, Baxter. I’m glad to hear your voice. How are you? Did you get much sleep last night?

“I’m not doing too well. My next PCP appointment isn’t for another month. I thought about you talking to her. She’s a nice person and all but maybe you can explain how you can help.”

Good idea, Baxter.

My experience has taught me that medical providers who refer to me are open to a fresh perspective. Remember, she reached out to get you help. Working together can offer many possibilities for you. For one thing, emphasizing the depth of discomfort from your psoriasis may be of value to her. Perhaps she might try seeing you sooner than your scheduled appointment. You also mentioned a desire for a vaccine shot. Perhaps she can advocate for you by scheduling where it’s offered.

She needs to hear that basic functioning of sleep and appetite are being impacted. These past few years have been challenging Baxter. Your wife passed, friends have come and gone, and your siblings and children haven’t seen you in person. Your cats have been supports; sounds like they have turned into your life. That’s just for a start.

“I get what you are saying. I need to experience some good stuff. Heck, I need to go out even just for a walk. Maybe I could walk after dark when most folks are indoors. Like I said, I don’t feel good about my body. I do need to see my PCP.”

Have you given further thought to a referral, me to a community-based agency that can supplement my services?

“Say more.”

All right. There’s a group called the Mental Health Association. They can do outreach if you consent to it. They can join me and offer services that may prove valuable. With your consent, I can meet with them to offer some early mental health insight. Thereafter, they can arrange to meet you at home.

They can then independently offer you an assessment to determine what you need. They advocate for people who have problems impacted by mental health events. The idea of ‘It takes a village’ may be a worthy venture. Working together can be a healthy outpouring of varied experiences. What do you say?

“Am I obligated if this outfit comes in? What you’re saying is they can get info from you about me, then do an assessment for stuff I might need?”

Right, Baxter. You and I for now are counseling by telephone. Allowing a reputable agency to offer complementary services hopefully will enhance your well-being.

“O.k. I get it. They need to see first-hand how I live day-to-day.”

Exactly. That will provide a more clear and concise assessment. We all get to work with you. You are your own best advocate. By phone or in person, the group might offer greater opportunities for greater success. I want to offer up to you, Baxter, an open-ended consideration for your mental health treatment. You’ve spoken about many areas of loss in your life. Given time to consider grieving, the losses may over time get you healthier. Soon, you and I might plan for a home visit or a session at my office. Think it over, please. We made another appointment for the following week. As is habit, clients may call me if a problem arises necessitating some immediate help or intervention.

Let there be peace on earth and let it begin with me.