As a counselor at Whitfield Regional Hospital in Demopolis, Mentral Ledbetter cares for a different type of patient impacted by the COVID-19 pandemic.

Most of the people he works with aren't suffering from the pneumonia, shortness of breath or high fevers associated with contracting the novel coronavirus. Instead, many of them are finding themselves psychologically impacted by the anxiety, depression and other mental health issues that have surfaced or intensified for many well people in recent weeks as job losses, isolation and family members' illnesses have taken their toll.

"It's tough. You see extreme worry and different things," he said. "There's a sense of anxiety around them and not being able to see their family members and that type of thing."

Ledbetter, 32, works in three units at Whitfield dedicated to adult psychiatric patients, geriatric psychiatric patients and people with substance abuse disorders.

Patients in all three groups are experiencing issues stemming from the coronavirus pandemic, including elevated levels of anxiety, depression and increased substance use. But they also continue to live with conditions like schizophrenia and bipolar disorder, which don't go away simply because society has largely shut down to deal with a worldwide health crisis.

While the hospital side of Whitfield only has a handful of patients with confirmed or suspected cases of COVID-19, Ledbetter said the three psych units have remained busy. And now the people he counsels have the added stress of trying to imagine their lives amid the pandemic once they finish their three- to 21-day stints in one of the units.

"People are looking at, 'What will my life look like once I go beyond this point and go into the community? Will my mental health facility be available for me to go see a therapist? Or will my pharmacist be open to get my meds?'" Ledbetter said.

"We communicate with them and help them understand how things will work once they get out, that they will be able to use telemedicine or drive-up windows at pharmacies and that type of thing."

Whitfield is a 99-bed hospital that serves patients from Choctaw, Greene, Hale, Marengo, Perry and Sumter counties in the western reaches of Alabama’s Black Belt region. First opened in 1953, the facility has become a crucial health care option for area residents, particularly so in recent years as more than a dozen hospitals have closed across the state.

That means that people turn to the facility for everything from its ICU – which held two patients with confirmed coronavirus cases as of Monday, according to Ledbetter – to its mental health units.

As such, he says it's important for him to maintain a positive outlook in order to best serve patients.

"You have to put yourself in a good mindset to be able to go in and help these people. You realize that people suffer with things far worse than you yourself do," he said.

The day-to-day work undertaken by Ledbetter and other staffers in the psych units has not changed much due to the coronavirus. They host group counseling sessions, work with patients individually, conduct assessments and try to create discharge plans to help people improve and maintain their mental health.

And yet the reality of the pandemic still gets to some patients within the psych units, where they have access to TV news, contact with family members via telephone and video-chat, and other sources of information about the latest regarding the pandemic.

"We had a session last week and with all our safety precautions – we had to wear masks and [personal protective equipment] and all that type of thing and we asked the patients how they felt about that," Ledbetter said. "They felt that staff was having to protect themselves from the patients but really it was more that we had to protect us from giving it to them at the same time."

His job also now requires providing indirect support to patients with confirmed or suspected cases of COVID-19, which he and other staffers do via video-chats, literature distribution and other non-contact means.

And the virus exacts a mental toll on hospital staff and employees, particularly those who work in the ICU and directly with sick patients. Though everyone who enters the hospital is screened for symptoms of the virus and employees are provided with masks and other protective gear, there is a level of increased stress that goes along with working in health care during a pandemic.

“The anxiety just is kind of high as it relates to the coronavirus within the hospital,” Ledbetter, who lives in Demopolis, said. “All staff are taking care not to take it home to their families or get it themselves.”

At the end of the day, he says that he believes he is helping people and that he feels lucky to be able to continue doing so during this trying time. That’s what carries him through the unique difficulties of being a counselor in the midst of a global pandemic.

"We do make a lot of difference in people's lives. We're there at different stages of people's lives," Ledbetter said.

"We are helping to create change for these individuals and it does make a difference.