Mental Health Awareness Month: Health Care Workers’ Mental Health and COVID-19

Nurse leaving his family for work during COVID-19.May is Mental Health Awareness Month–a time to spread awareness of mental health challenges and share helpful resources to promote well-being for all.

The COVID-19 pandemic could spark a mental health pandemic, too. Millions of people across the globe face uncertain economic futures, fear of getting sick, confusion about how dangerous COVID-19 really is, the possibility of having to work—or return to work—when doing so may be unsafe, and more.

Health care workers face these same challenges, but with additional layers of concern. Their exposure risk to the virus may be much greater, which in turn may increase their risk of contracting and dying from COVID-19. Some health care workers may also be facing extreme work conditions, such as having to watch people die from COVID-19 without the support of a loved one.

The people the entire world is relying on to fight an invisible enemy are facing an unprecedented crisis. Here’s what health workers can do to cope with their emotions during the pandemic—and how you can help the health workers in your life.

How COVID-19 Affects Health Workers

Because testing is limited, we don’t know the full impact of COVID-19, including how many people have been infected who have had few or no symptoms. Data on the long-term effects of COVID-19 is nonexistent. The only thing researchers know for sure is that the overwhelming majority of people who have died of COVID-19 have been over the age of 60 or had a serious chronic medical condition.

For health workers, the picture is different. Some young, otherwise healthy medical professionals are dying of COVID-19. This may be because health care workers are more likely to get the virus from patients, and therefore more likely to die of the disease. It could also be that health workers are exposed to the disease more frequently, increasing their total viral load. For now, researchers have few answers about alarming death rates for medical professionals. This risk, coupled with the uncertainty about how to mitigate it, can be emotionally exhausting.

Fearing for one’s life is enough to trigger serious mental health issues like anxiety, posttraumatic stress (PTSD), and depression. Medical professionals may also face additional stressors, including:

  • Financial uncertainty for low-paid medical workers. Home health aides, for example, may have to choose between risking their health to work and risking their family’s health due to job loss and poverty.
  • Lack of access to necessary medical equipment. Hospitals and medical facilities across the country are facing critical personal protective equipment shortages. Some medical providers must go to work knowing they do not have the best ability to protect themselves. Emerging research suggests that lack of personal protective equipment directly contributes to high death rates among medical providers.
  • Abusive employers. Some doctors report that they have been fired or sanctioned for speaking out about unfair employment practices or lack of access to protective equipment.
  • Secondary trauma. Some health workers spend their days watching people suffer and die. They may have to comfort inconsolable family members, wonder about what will happen to the children of the dead, and find ways to help dying people say goodbye to their families, which may be traumatic.
  • Survivor guilt. People who survive trauma sometimes feel guilty, wondering why they were spared as others suffered. Health workers who watch colleagues or patients die may feel guilty or despondent.

An analysis in Wuhan, China, of the COVID-19 mental health toll on health workers found that 50% had symptoms of depression; 46% reported anxiety; 34% reported insomnia, and 72% reported distress.

For some, unmanageable stress might trigger a relapse of substance abuse, or increased dependence on alcohol, sleeping medication, and other potentially addictive substances.

Poor mental health can also affect physical health. Chronic stress can also weaken the heart and the immune system.

While no research has directly tested a link between mental health and COVID-19 prognosis, research does consistently find that poor mental health undermines physical health. Health workers struggling with depression, anxiety, or addiction may be less equipped to fight the virus.

How to Support Health Workers

The following are some ideas for how you can help support health workers during this time:

  • Identify the obvious needs of the health workers in your life, then find ways to fill them. Shop for groceries. Call their kids. Make them a fresh meal.
  • Offer a sympathetic, nonjudgmental ear. Call them and listen to them talk. Don’t tell them how they should feel or ask them to ease your anxiety.
  • Donate supplies. If you have extra masks, gloves, or disinfecting wipes lying around, offer them to hospitals or individual providers.
  • Be mindful that all health workers are affected, not just doctors or emergency room workers. Anyone providing patient care is exposed to the virus, and some health workers have transitioned out of their usual specialty and into COVID-19 care. Don’t just thank doctors. You can express gratitude to nurses, midwives, janitors, nurse aides, and other health workers.
  • Ask what you can do. Some health workers have specific needs they have may not shared. Be willing to offer support on their terms.

Strategies for Managing the Mental Health Toll of COVID-19

No mental health intervention can substitute for social support, system support, and access to appropriate protective equipment. Health workers who are struggling should remind themselves that mental health issues are a natural, predictable reaction to high stress and potential danger. It is not possible to feel normal during ongoing trauma, so avoid beating yourself up if you’re struggling.

Some other strategies that may help include:

  • Asking for help. Many people are eager to support health workers, but are unsure how to do so. Ask friends or family to drop off food or chat with your kids online. Connect with a therapist or counselor.
  • Drawing clear boundaries between work and home. If at all possible, avoid taking work calls or emails when you’re at home. A break in between shifts helps preserve balance and a sense of control.
  • Going on an information diet. Health workers need to read emerging research to better understand the virus and protect themselves. That doesn’t mean they must devour every headline or spend their spare time exploring worst-case scenarios on social media. Turn off the news if you find yourself in a constant state of panic.
  • Practicing good self-care. Exercise or meditate if possible. Eat regular meals. Even if you’re working long hours and are eager for family time, prioritize getting enough sleep.
  • Talking to someone. Friends and family may be able to offer loving support. A therapist can also help you talk through your feelings, identify healthy coping strategies, and treat serious mental health symptoms. Many therapists now offer virtual telehealth services.

To find a compassionate therapist who can help you manage your reactions to this stressful time, click here.

References:

  1. Characteristics of health care personnel with COVID-19 – United States, February 12–April 9, 2020. (2020, April 16). Retrieved from https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e6.htm?s_cid=mm6915e6_x
  2. Ing, E. B., Xu, A. Q., Salimi, A., & Torun, N. (2020). Physician deaths from corona virus disease (COVID-19). Retrieved from https://www.medrxiv.org/content/10.1101/2020.04.05.20054494v1
  3. Liu, Y., Yan, L.-M., Wan, L., Xiang, T.-X., Le, A., Liu, J.-M., … Zhang, W. (2020). Viral dynamics in mild and severe cases of COVID-19. The Lancet Infectious Diseases. Retrieved from https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30232-2/fulltext
  4. Roy-Byrne, P. (2020, March 23). Mental health effects of COVID-19 on healthcare workers in China. Retrieved from https://www.jwatch.org/na51190/2020/03/27/mental-health-effects-covid-19-healthcare-workers-china

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