Supporting mental health and wellbeing through COVID-19: Support for the health workforce
Prepared by Ruth Hennessy, Katherine Coote, Dr Shiraze Bulsara, other members of the Taskforce’s Mental Health Cluster Group, and ASHM.
UPDATED ON: 6 May 2020
Disclaimer: This ASHM document is designed to provide available, relevant information to clinicians and other healthcare providers to optimise the health and wellbeing of people living with HIV, hepatitis B or hepatitis C and those with Sexual Health needs during the COVID-19 pandemic. The recommendations provided are the opinions of the authors and are not intended to provide a standard of care, or practice. This document does not reflect a systematic review of the evidence but will be revised to include relevant future systematic review findings of the National COVID-19 Clinical Evidence Taskforce and other relevant information.
Please note this is the second in a series of resources supporting the blood borne virus (BBVs) and sexual health workforce in relation to COVID-19 and mental health or psychological wellness due to the impact of social distancing or isolation.
Protecting against vicarious trauma and compassion fatigue
Self-care is important at all times, but more so when managing a stressful period that does not have a clear end date. In addition to the tips outlined in the Taskforce’s previous article about providing mental health support to populations living with HIV, BBVs and sexual health needs in Bulletin #4, and webinar slides – here are some further tips:
Access support services
Focus your attention
Look after your physical health
Additional Helpful resources
The LOOK–LISTEN-LINK was described in the previous article
See the Signs
Responding to distress
1. Keep up the communication with your team
2. Supporting front-line staff
3. Daily well-being check-ins
Stepped Care (11) – Not everyone exposed to traumatic events will experience symptoms associated with a diagnoseable disorder; some will experience sub-clinical symptoms and others no symptoms at all. Stepped care is important to ensure all individuals receive the care appropriate to their presentation
The Stepped Psychological Response (3)
Psychological debriefing (12) - Psychological debriefing involves the principles of ventilation, normalisation of distress, and psychoeducation regarding symptoms. It is sometimes referred to as Critical Incident Stress Management (CISM) and can be delivered as a group-based intervention to teams of health practitioners. There are five distinct phases associated with psychological debriefing:
Psychological First Aid (PFA) (13) – this was discussed in detail in Bulletin #4, and outlines the Look-Listen-Link principles to PFA.
At all times, but especially during a pandemic, we need to be mindful that people may be unable to achieve ‘higher order’ needs such as psychological well-being, if their basic (‘lower order’) needs are not met. In this context, this means that people must have needs such as food, water, safety, financial security, and shelter addressed before they can consider the impact of the situation on their psychological well being. It is important that those providing support to health practitioners take note of this so as not to push people too far, too fast.
Telehealth was discussed in the previous in Bulletin #4 but here’s an additional resource:
Additional Resources are available to assist the mental health and wellbeing of health professionals:
1. Mental Health Ramifications of COVID-19: The Australian context, The Black Dog Institute https://blackdoginstitute.org.au/docs/default-source/default-document-library/20200319_covid19-evidence-and-reccomendations.pdf
Chua, S.E., et al., Stress and psychological impact on SARS patients during the outbreak. Can J Psychiatry, 2004. 49(6): p. 385-90.
2. World Health Organization (2020). Mental health and psychosocial considerations during the COVID-19 outbreak. Available at https://www.who.int/docs/default-source/coronaviruse/mental-health-considerations.pdf
3. Anja Greinacher, Cassandra Derezza-Greeven, Wolfgang Herzog, and Christoph Nikendei, Secondary Traumitization in first responders: a systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346705/
4. Interventions for Secondary Traumatic Stress With Mental Health Workers: A Systematic Review, Melissa L. Bercier, Brandy R. Maynard
5. Cocker, F., & Joss, N. (2016). Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review. International journal of environmental research and public health, 13(6), 618. https://doi.org/10.3390/ijerph13060618
6. Kang L., Li Y., Hu S., Chen M., Yang C., Yang B.X., Wang Y., Hu J., Lai J., Ma X., Chen J., Guan L., Wang G., Ma H., Liu Z. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020;7(3):e14.
7. Cabello, impact of viral epidemic outbreaks on mental health of healthcare workers: a rapid systematic review https://www.medrxiv.org/content/10.1101/2020.04.02.20048892v1
8. Chong, M-Y., et al. (2018) Psychological impact of sever acute respiratory syndrome on health workers in a tertiary hospital, British Journal of psychiatry https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/psychological-impact-of-severe-acute-respiratory-syndrome-on-health-workers-in-a-tertiary-hospital/726E5229A319D1B68BC01B4544901D73
9. Wang C., Pan R., Wan X., Tan Y., Xu L., Ho C.S., Ho R.C. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health. 2020;17(5):E1729. [PMC free article] [PubMed] [Google Scholar]
10. Phoenix Australia – Centre for Posttraumatic Mental Health. (2013). Australian guidelines for the treatment of acute stress disorder and posttraumatic stress disorder. Available at https://www.phoenixaustralia.org/wp-content/uploads/2015/03/Phoenix-ASD-PTSD-Guidelines.pdf
11. The British Psychological Society (2020). The psychological needs of health staff as a result of the Coronavirus pandemic. Available at https://www.bps.org.uk/sites/www.bps.org.uk/files/News/News%20-%20Files/Psychological%20needs%20of%20healthcare%20staff.pdf
12. The British Psychological Society (2020). The psychological needs of health staff as a result of the Coronavirus pandemic. Available at https://www.bps.org.uk/sites/www.bps.org.uk/files/News/News%20-%20Files/Psychological%20needs%20of%20healthcare%20staff.pdf
13. The Australian Red Cross (2013). Psychological First Aid: An Australian guide to supporting people affected by disaster. Available at https://www.redcross.org.au/getmedia/23276bd8-a627-48fe-87c2-5bc6b6b61eec/Psychological-First-Aid-An-Australian-Guide.pdf.aspx
14. Maslow, A. H. (1943). A theory of human motivation. Psychological Review, 50(4), 370-96.