Minnesota nonprofits are boosting mental health services, bracing for a wave created by the COVID-19 pandemic.

This is the "calm before the storm," said Shannah Mulvihill, executive director of Mental Health Minnesota, a St. Paul nonprofit. "We're concerned there's going to be a flood of people in need of help. We will continue to see an increase in anxiety, depression and PTSD-like symptoms for a long time going forward."

Rising unemployment and social isolation during the COVID-19 pandemic is exacerbating anxiety, depression, eating disorders and other mental health issues. According to the Washington Post, a federal emergency hotline for people in emotional distress registered a more than 1,000% increase in April compared with last year. And, in a Kaiser Family Foundation poll, nearly half of Americans reported the coronavirus outbreak was harming their mental health.

Mental Health Minnesota operates a warmline, which provides free help to people before they're in a crisis, that's seen a recent spike in calls; the nonprofit also helped start a new hotline for front-line workers.

In Eagle Bend, Minn., the nonprofit Wellness in the Woods, which operates a state-funded warmline, has also seen an uptick in calls, especially from people who haven't sought help before, and operators had to be added during busy times, executive director Jode Freyholtz-London said.

The National Alliance on Mental Illness (NAMI) Minnesota has had an uptick in calls to its helpline and stepped up free suicide prevention classes at least once a week. It also offers free online classes and support groups.

CommonBond Communities, a St. Paul-based nonprofit that develops affordable housing, hired its first mental health consultant earlier this year to advise staff on how to better help residents.

And at People Incorporated, many new free online resiliency classes have filled to capacity. "I was pretty surprised at the response," said Russ Turner, director of the nonprofit's Training Institute, which runs the classes. Building resiliency requires work, he said, explaining that people need to develop a routine, eat healthy foods, get enough sleep and do gratitude and breathing exercises.

"When there's so much uncertainty, it's easy for your brain to wander to things you can't control," Turner said. "What can you control?"

Recent suicides of a local paramedic and a New York doctor have spurred more awareness about mental health issues. But experts caution against linking suicides to the pandemic, noting that suicide often results from multiple factors. Most important, they say, is that suicide is preventable. To get help, call the National Suicide Prevention Lifeline at 1-800-273-8255.

"This idea that there is a direct correlation is an oversimplification," said Dan Reidenberg, executive director of the national nonprofit SAVE (Suicide Awareness Voices of Education), which is based in Bloomington. "If you're struggling, reach out. Help is available."

In fact, therapy and other mental health services are easier to access with providers shifting to telehealth, said Sue Abderholden, executive director of NAMI Minnesota.

With skyrocketing unemployment, isolation and alcohol consumption, Abderholden said, mental health issues are spreading beyond those who had been diagnosed before the pandemic. "You can only keep things together for so long," she said.

While contacts with Minnesota's Crisis Text Line (text "MN" to 741741) declined slightly in April compared with a year ago, Mental Health Minnesota's Warmline had a record number of 1,100 calls — up 10% over a typical month — and calls from Hennepin County jumped 50% compared with the first quarter of 2019.

Mental Health Minnesota also launched an initiative so people can sign up to chat with staff and volunteers over the phone if they are struggling with social isolation.

In Minneapolis, the Native American Community Clinic donated laptops and burner phones so people without the technology could access telehealth.

The nonprofit Guild Incorporated also gave phones to homeless and other low-income residents so that they can contact telehealth and services remotely, and volunteers are calling clients struggling with isolation, said Julie Bluhm, executive director.

"Everybody is anticipating this wave of need," Bluhm said. "As it dawns on us that [the pandemic is] going to be long term, people's symptoms are definitely increasing. It's normal if you're not OK. There are resources in your community that can help."