Matt Henry leaned close to gaze at his wife on the other side of the glass. The window was pushed up a few inches, but he still needed to talk loudly for her to hear.

“Hi, hon,” he said. “You look good. I love you so much. I miss you.”

Henry stood in the sun, the brim of his ball cap shading his face. His wife Amy, diagnosed with early-onset Alzheimer’s disease five years ago at age 56, peered out looking perplexed. Because of the pandemic, Henry no longer may visit his wife inside the memory care unit. Instead he must trek behind the Juniper House Assisted Living building, find a spot in the flowerbed near her window and communicate through glass.

“It’s brutal,” he said. “She’s extremely confused.” Partway back to his car, he admitted, “This is where I usually start bawling.”

The retired Methodist minister from Pendleton has more solitude than he wants these days ever since the governor’s executive order banned visitors from elder care facilities in March. In normal times, Henry sings with the Pendleton Men’s Chorus and maintains a busy social life. These days he’s feeling a little stir crazy.

Henry isn’t the only person who feels lonely and anxious. Lines for Life, a Portland-based nonprofit which operates crisis lines, experienced a sizable uptick in calls to its Alcohol and Drug Helpline, Military Helpline, Youthline and Senior Loneliness Line. The suicide hotline received 621 calls during the first week in May compared with 536 calls a year ago. Calls to the Senior Loneliness Line, funded originally by Clackamas County, increased so much in the past couple of months that the organization went statewide with the line a couple of months ago.

“We put it out there and it blew up,” said Greg Borders, chief clinical officer of Lines for Life. “It’s just intuitive as to why that line is needed right now. It just makes sense. Seniors are feeling isolated and lonely. They’re reaching out.”

People in other demographics are feeling anxious too.

Sharon Kuehn, who manages the David Romprey Oregon Warm Line for Heppner-based Community Counseling Solutions which oversees mental health services in several Eastern Oregon counties, said demand for the peer line in the past two months increased from about 120 calls per day to an unprecedented 300, then fell back slightly in the last couple of months. With support from the Oregon Health Authority, the agency was able to temporarily add staff and increase coverage.

Loneliness, isolation and feeling shut-in account for a quarter of calls.

Borders echoes Kuehn’s observations. Common themes are health worries, isolation and financial concerns.

“We’re definitely hearing the name COVID-19 mentioned in almost all the calls,” Borders said.

Some mental health experts worry that pandemic-induced despair may trigger increased rates of suicide down the line. The link is uncertain since we’ve never experienced economic downturn woven together with a pandemic.

No one truly knows what will happen until it happens. Community Counseling Executive Director Kimberly Lindsay said a spike in the suicide rate isn’t a foregone conclusion, but she believes public health agencies like hers need to prepare for the likelihood.

“I think history is the best predictor of the future,” Lindsay said. “You only have to look back to history to get a flavor of what’s to come. There is a strong correlation between suicide and the economy. There’s a strong correlation between suicide and unemployment.”

So far, 36.5 million Americans have filed for unemployment since March. She pointed to research showing increasing suicide after significant economic contractions such as the Great Recession of the late 2000s and the stock market crash in 1929 that led to the Great Depression. Neither of those economic crashes were paired with a global pandemic.

“I am super concerned,” Lindsay said. “You are going to have deaths attributable to coronavirus. You are going to have people with health conditions that went untreated due to fear and anxiety of accessing health care. You’ll have homelessness and hunger.”

Lindsay said her organization embraced a strategy called Zero Suicide about two years ago and has since been working through all the steps.

“It is an evidence-based approach to getting serious about suicide,” she said. “Zero Suicide infiltrates every layer of an organization from maintenance to the board of directors. You are going to train every employee on how to have a meaningful conversation with someone who is feeling down. Eventually we will broaden out to include the entire community and encourage them to be on the same page.”

The arrival of coronavirus added more urgency and the need for creativity.

“We have already been working on Zero Suicide but COVID is another layer in the onion,” she said. “To identify suicide risk, you have to be nimble and responsive. How do you do screening without people coming through your front door? You have to adapt.”

The organization planned to give community partners QPR (question, persuade, refer) training in two-hour in-person sessions. Now they may go online. Lindsay believes everyone should learn how to talk with people in their lives who seem depressed.

“People resist getting involved with someone who is depressed,” she said. “They say, ‘What if I say the wrong thing? What if I upset them?’ You don’t have to be Einstein to do this. You ask a few questions. You persuade and you refer.”

Lindsay hopes for the best, but doesn’t pretend she isn’t worried.

“I’m really concerned,” she said. “We are going to see a fallout from a mental health perspective.”

Borders offered ideas for staying mentally healthy during COVID-19.

“Reach out to others,” he said. “Keep some structure to your day. Things that worked before COVID-19, keep those in place. If you’re somebody that got up at the same time and went to bed at the same time every day, try to do that. Get some fresh air. If you’re used to exercising, do that. It’s so important to move. Try to keep your hygiene up. Change your clothes. Eat healthy.”

Henry beats back pandemic-induced loneliness by taking physically distanced walks with friends. He regularly heads out to the yard where he has transformed a weedy strip of dirt into a viable garden and filled pots on his deck with basil, chili peppers, chard and cherry tomatoes. He knows he isn’t the only one who finds solace in the soil.

“I think most people are getting through this by getting outside and getting into the garden,” he said. “If my wife were at home and in her right mind, this would be an entirely different thing.”

In many ways, Amy has already left him, but not being able to visit normally still takes its toll.

“I miss her, COVID or no, there’s nothing that could change that,” he said. “COVID just accentuates that tremendously.”