Lessons on Resilience From LA County During COVID-19

Source: Roya Ijadi-Maghsoodi, used with permission

The extended and uncertain nature of the effects of the pandemic require us to cultivate resilience in multiple areas of our lives. Dr. Roya Ijadi-Maghsoodi describes the COVID-19 situation in LA County, and shares some tips and insights into how we can be more resilient during this time.

Dr. Roya Ijadi-Maghsoodi is a child, adolescent, and adult psychiatrist and an assistant professor-in-residence in the UCLA Department of Psychiatry and Biobehavioral Sciences, an investigator at the Center for the Study of Healthcare Innovation, Implementation & Policy within the VA Greater Los Angeles Healthcare System, and a faculty lead for the DMH-UCLA Prevention Center of Excellence. Dr. Ijadi-Maghsoodi’s research focuses on improving care for under-resourced populations, including youth and families experiencing homelessness, and youth at high risk for trauma exposure and substance use. She is funded by an AACAP NIDA Physician Scientist Program in Substance Abuse K12 Award to adapt and implement a family resilience intervention among families experiencing homelessness and parental substance use. She also conducts school-based mental health research as part of a long-standing community-academic partnership.

Jamie Aten: How would you personally describe the COVID-19 situation in LA County?

Roya Ijadi-Maghsoodi: The COVID-19 situation has been in flux in LA County. As we described in our article, LA County acted quickly, with school districts shutting down in March and Safer at Home orders instituted by the mayor and public health authorities shortly after. Over June and July we experienced a disconcerting increase in cases and hospitalizations after shelter-in-place rules were relaxed. The role of long-standing health inequities, disinvestment, and racism in the pandemic is now painfully clear. In LA County, we have a disproportionate impact on communities of color and under-resourced communities, with findings that Black and Latino residents are twice as likely to die of COVID-19 compared to white residents. This is related to structural racism and inequities: people forced to work essential jobs to make a living, a lack of protections for essential workers, housing unaffordability and crowding, fear of evictions, increased food insecurity, and longstanding inequity in access to resources and health care services. These stressors, including social isolation, are placing a significant toll on mental health. However, we have also witnessed resilience and rapid mobilization to address these inequities: including large-scale organizing, and a pivot to deliver mental health and social resources to community members. This includes a rapid shift to provide tele-mental health care across LA County, and efforts from our Public-Public partnership between a state university and the Department of Mental Health (DMH) that we describe in our article, including disseminating information, trainings, and resources to support providers working with youth and families across the county in a trauma-informed and resilient manner.

JA: What are some ways understanding LA County's COVID-19 situation can help us live more resiliently?

RIM: Resilience is not the avoidance of trauma and adversity, but rather coping and adapting in the face of adversity. There has been clear grief, loss of life, separation, and suffering in Los Angeles, and throughout the country; related to the pandemic, the economic impact, and race-based trauma and violence. Yet, as demonstrated by history and prior disasters, people are resilient, which we have seen on individual, community, and societal levels. The rapid mobilization of community organizing and efforts of agencies to address structural determinants of health—for example, working to place moratoriums on evictions, working to house individuals experiencing homelessness, and striving for employee protections—are evidence of resilience. After schools shut down, LA Unified School District quickly started providing meals to youth and families at pick-up sites throughout LA County. After George Floyd’s death, millions came together in a massive social movement to call for reforms to address police violence and racism. On an individual level, there is clear evidence of community members supporting one-another, including youth volunteering, or wearing masks to protect each other. These acts all point towards resilience during a terribly distressing time.

JA: What are some methods people could use to cultivate resilience amidst this pandemic?

RIM: There are simple acts people can do to cultivate resilience during these difficult times. Some skills that contribute to resilience include communication, problem-solving, making meaning out of situations, empathy, and self-efficacy. Communication and social support are integral to bolstering resilience; this can be as simple as checking in with one another. In families, taking the time to validate and talk about worries youth may be feeling can bolster family communication and resilience. Developing coping skills either individually or as a family can help. These coping skills can be as simple as finding what helps one feel calm and centered, such as going on walks, listening to a comforting song, taking deep breaths, and finding simple activities for families to do safely together. Similarly, attending to basic human needs, such as getting adequate rest, taking breaks if needed, and reducing expectations during this time are important. Maintaining routines and structures to the best of one’s ability can help reduce distress. Parents can model coping for children, and help children and youth problem solve coping skills that can help them feel better. Additionally, self-efficacy, or one’s belief in their ability to solve a problem or deal with a difficult situation is an important component of resilience. Individuals—from children to adults—can cultivate feelings of self-efficacy and collective efficacy by having a role and supporting others in their communities, such as volunteering, checking on neighbors’ social well-being and needs, engaging in advocacy work, making masks, and even simple acts such as wearing a mask in public and washing hands to protect others.

JA: Any advice for how we might use what you have learned to support a friend or loved one struggling with a difficult life situation?

RIM: This is an extremely difficult time. People are struggling with many challenging situations right now, loss of loved ones, grief, separation from family members and close friends, school closures, loss of jobs, and more. We have also learned how difficult this pandemic is for service providers working with youth and families, such as educators who had to implement distance learning virtually overnight, and grapple with concern about student mental health and well-being. To support a loved one struggling, we suggest reaching out and providing support, connection, and communication, and using some of the techniques for cultivating resilience described. We also recommend encouraging the use of mental health services and reaching out to available mental health supports in the community given the heightened stressors people are experiencing. In LA County, there is a 24-hour mental health hotline to connect individuals to services, and mental health delivery is fully available remotely.

JA: What are you currently working on that you might like to share about?

RIM: As we described in our article, we have partnered with the Department of Mental Health and other County agencies to ensure that providers have the support, resources, and information they need. The goal is for providers to have information and training at their fingertips that support a trauma-informed and resilience-promoting approach. As people are dealing with zoom fatigue and multiple demands, we are trying to make this information available in both webinar and asynchronous formats. We are also working to make information available to different types of providers—from mental health to health to educators—sharing basic information about trauma, child development, parenting, or family resilience with strategies that can be applied no matter one’s role in a child or adult’s life. This pandemic is taking a mental and physical toll on professionals—so we offer tools to support employee well-being. Any providers working with youth and families who need trauma-informed resources to inform their work during COVID-19 can access these publicly available resources at our online learning center.