Coronavirus has rocked the nation with a year of restrictions, lockdowns, missed gatherings and events, isolation and a staggering loss of more than half a million American lives. As the pandemic stretches into a second year, Americans struggling with increased rates of depression, anxiety, and insomnia are looking for mental health support, and providers are working hard to keep up with the demand.

When the pandemic first began, Dr. Mary Alvord, said there was an almost immediate increase in those seeking treatment for both anxiety and depression. Alvord is a psychologist and director of Alvord, Baker & Associates in Rockville, Maryland, a group of 19 clinicians focused primarily on children, teens and families.

“I think everybody was just in a state of disbelief that this was coming on so quickly and dramatically,” Alvord said. “That first rush was anxiety in terms of daily uncertainty of not know what was going to happen [regarding] the pandemic. And I think that it turned to a lot of sadness.”

Psychologists like Alvord report seeing more patients with anxiety and depression over the last year and most say they are treating patients remotely via telehealth. Last fall, a third of psychologists said they are seeing more patients since the start of the pandemic, according to the American Psychological Association (APA).

Of psychologists who treat anxiety disorders, nearly three-quarters of those surveyed by APA reported an increase in demand for treatment, while 60% of those who treat depression saw an increase. Similar rises in demand for treatment for trauma and stress-related disorders and sleep-wake disorders were also reported.

“We’ve had a waitlist of about 187 people,” Alvord said. “We seem to reduce it, and then we go back up again.”

The use of telehealth was expanded thanks to emergency orders put in place by states to increase access to services during the pandemic, the APA said. The Centers for Medicare and Medicaid also revised rules to allow expanded services via telehealth. The group is pushing to continue this access for at least six months after the federal government declares the pandemic is over.

There are still many barriers to treatment including the number of available mental health professionals, cost, stigmas and time, but telehealth expansion has increased access to care for many.

“You’re able to see a therapist in your own home, you don’t have to rely on transportation or childcare. I do think that that helps, once you’re in treatment, to be able to access it. But we still have a pretty substantial problem within the health-care system in having enough providers for the people who need them,” says Dr. Vaile Wright, senior director of Healthcare Innovation at the APA.

Wright noted, however, that the lack of health-care professionals has been a long-running, pre-pandemic problem. “Even if we do things like reduce retirement ages or increase the workforce, we’re actually never going to meet the needs of all the people,” he said.

The pandemic may have fueled growth in telehealth services, but the trajectory is expected to continue. The global telehealth market, beyond just therapy, is projected to reach $312 billion by 2026, according to data from financial data firm PitchBook, more than quadrupling 2019 levels. Overall $1.8 billion was invested into virtual health companies in 2020, including companies Doctor on Demand and MDLive, both of which offer virtual therapy, PitchBook analysis shows.

Frontline health-care workers, parents of children under the age of 18, and fathers — more than mothers — have been seeking treatment as of late, according to the APA. It’s too early to say if those who sought treatment during the pandemic will continue to access care once life gets back to normal, but expanded telehealth could help.

“I think that the convenience that consumers have come to expect will encourage them to stay in treatment as opposed to having to go back to in person. So that’s going to be a big component,” Wright said. “I also think that we are going to see long-term mental health consequences if individuals aren’t able to address their stress levels that they’re experiencing right now.”

In particular, Wright noted, essential workers — including frontline health-care workers — parents with children under the age of 18, individuals from communities of color, and younger adults with high levels of stress and distress are most vulnerable.

Alvord of Alvord, Baker & Associates is also advocating for the expansion of telehealth, having trained 10,000 mental health professionals over the last year on how to do it effectively and ethically. A silver lining of the extreme challenges faced globally over the last year, she said, is the conversation around mental health has come to the forefront.

“We’re all in this together, so the message is, ‘You’re not alone,’ ” she said. “The stigma of mental health really has lifted, because it’s okay to not be okay. There’s a normal stress level that’s a part of life, and grief and loss and sadness that goes along with that.”