Caring for Caregivers

Research shows importance of mental health care for COVID-19 medical providers.

Posted May 21, 2020

Photo by Isaac Quesada on Unsplash
Source: Photo by Isaac Quesada on Unsplash

This post was written by Abigail Crowder.

When facing new challenges, people usually prepare to the best of their abilities for all possible outcomes. Students study the given topic before an exam, employees complete job-specific training to prepare for new roles, and first-time parents read books or talk to family and friends with experience to have a better-formed view of parenthood. These types of preparation give them a starting point when they face the challenge in front of them and can help them feel more in control of the problem at hand.

With regard to a traumatic event, resilience is the ability to respond, recover, and grow from the given situation. Different coping strategies allow people to adapt to the situation and limit their risk for different mental health disorders. In a study published in the European Journal of Psychotraumatology, Brian Iacoviello and Dennis Charney conclude that positive coping mechanisms, including optimism, a supportive social network, and active coping skills, all seem to contribute to greater measures of resilience.

As the global community faces the COVID-19 crisis, many resources are being produced with the goal of helping people cope with isolation, anxiety, fear, and other disorders.

In December of 2019, the first cases of COVID-19 were reported in Wuhan, Hubei Province, China. Four months later, the virus has spread globally, with over 3.4 million confirmed cases and 239,000 deaths, according to the May 4th, 2020 Situation Report from the WHO. These numbers continue to rise and have left many people at an increased risk of mental health disorders.

This crisis has put a particular strain on medical professionals, specifically those dealing with COVID-19 patients, as they work in stressful, isolated, and high-risk situations that can contribute to trauma and psychological distress. To learn more about the mental health impact of the virus on medical professionals, Lijun Kang from the Psychiatry Department at Renmin Hospital of Wuhan University and Simeng Ma from the Computer Science and Technology Department at Huazhong University of Science and Technology in Wuhan led a team of researchers to examine the psychological state and needs of medical professionals working in Wuhan. Their results are compiled in an article in the journal Brain, Behavior, and Immunity.

The Study

The team distributed six-part questionnaires to doctors and nurses working in Wuhan, China, for participation between January 29, 2020, and February 4, 2020. The survey included basic demographic data, a mental health assessment, risks of exposure to COVID-19, mental health care services accessed, psychological needs, and self-perceived health status compared to that before the COVID-19 outbreak.

The mental health assessment consisted of four questionnaires that evaluated an individual’s likelihood of depression, anxiety, insomnia, and distress. Participants were also asked if they had access to mental health care, and of all participants, 36.3 percent had accessed psychological materials, 50.4 percent psychological resources through media, and 17.5 percent individual or group counseling. Finally, the risk of exposure was evaluated by asking participants whether or not family members, friends, neighbors, or patients had contracted the virus.

In all, 994 people, 18.4 percent doctors and 81.6 percent nurses, completed the survey. Using statistical methods, the responses were divided into four categories based on the average scores of their mental health assessment: sub-threshold mental health disturbances (36 percent), mild disturbances (34.4 percent), moderate disturbances (22.4 percent), and severe disturbances (6.2 percent).

The study found that individuals with higher levels of disturbance and psychological distress had both increased risk for COVID-19 exposure and had accessed fewer mental health care resources. All participants expressed interest in obtaining skills for psychological care, but those in the sub-threshold and mild categories were looking for skills to support others, while participants in the moderate and severe disturbance categories wanted self-supportive skills.

Some solutions

During this pandemic, people rely on medical care providers for their work in keeping the population safe and healthy. Unfortunately, as Kang and Ma et al. write:

“The number of people suffering from mental health impacts after a major event is often greater than the number of people who are physically injured, and mental health effects may last longer.”

Including mental health care protocols and resources, both before and during a crisis, can be very beneficial for the health of medical providers and allow them to serve for a longer time. Adding these pieces ensures that medical staffers are equipped with all tools necessary to serve their patients. The authors continue:

“A large rapid response team in crisis situations should include mental health care workers. Local medical and nursing staff at the epicenter of a crisis are pivotal to the overall response, and care for these caregivers… is essential in efforts to extend their immediate efficiency and to better protect their mental health in the long term.”

Depending on the severity, mental health disorders can impair an individual’s ability to function. In order to protect the medical professionals that are integral to society today, psychological resources need to be more accessible. These resources should continue to be available, and mental health education should be provided that can help medical providers increase their resilience and better protect themselves during future traumatic events.

While the duration of the COVID-19 pandemic is unknown, smaller outbreaks are likely to occur until a vaccine is developed. Just as one would continue training to advance in their careers, hospitals and medical providers should prioritize mental health care to equip themselves for the uncertain years to come. 

Abigail Crowder is an M.A. student in the Humanitarian and Disaster Leadership program at the Humanitarian and Disaster Institute at Wheaton College in Illinois. She currently serves as the Operations Director at Re:new Project in Glen Ellyn, IL.

References

Iacoviello, B. M., & Charney, D. S. (2014). Psychosocial facets of resilience: Implications for preventing post-trauma psychopathology, treating trauma survivors, and enhancing community resilience. European Journal of Psychotraumatology, 5(1), 1-10. https://doi.org/10.3402/ejpt.v5.23970

Kang, L., Ma, S., et al. (2020, March). Impact on mental health and perceptions of psychological care among medical and nursing staff in Wuhan during the 2019 novel coronavirus disease outbreak: A cross-sectional study. Brain, Behavior, and Immunity. https://doi.org/10.1016/j.bbi.2020.03.028

The Mayo Clinic. (2017, May 18). Resilience: Build skills to endure hardship. Retrieved from https://www.mayoclinic.org/tests-procedures/resilience-training/in-depth/resilience/art-20046311

The Mayo Clinic. (2020, April 2). COVID-19 and your mental health. Retrieved from https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/mental-health-covid-19/art-20482731

The World Health Organization. (2020, May 4). Coronavirus disease (COVID-19): Situation report 105. Retrieved from https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200504-covid-19-sitrep-105.pdf?sfvrsn=4cdda8af_2