Covid-19: Mental health support for frontliners

Health Ministry staff take a break from screening Kampung Baru residents and foreigners for Covid-19 on April 7. Many doctors are suffering mentally and emotionally during this pandemic. — Filepic

Editor’s note: A psychosocial support service run by the Health Ministry, Mercy Malaysia and the Women’s Aid Organisation for frontliners and members of the public affected by the Covid-19 pandemic can be reached at 011-6399 6482,011-6399 4236 and 03-2935 9935 from 8am to 5pm daily.

The doctors who call in are having panic attacks. They are struggling with feelings of sadness.

They are worried about their family members and whether they are putting them at risk by trying to heal strangers.

Doctors are used to dealing with death and pushing through bad days.

But those treating patients during the Covid-19 pandemic are under an unprecedented amount of mental stress.

Many do not have what Northwestern University’s Family Institute psychiatrist Dr Smita Gautam in the United States calls emotional PPE (personal protective equipment).

Dr Gautam is one of five people who launched a confidential and free national support hotline for US doctors on March 30 (2020).

Doctors can speak to therapists across the US who have volunteered their time on the Physician Support hotline.

Physicians tend to think that distress resources aren’t for them, she said.

But during this pandemic, many are dealing with so much anxiety, but do not want to share these feelings with their friends and family, who might be part of their fears in the first place.

Experiencing a patient’s death or counselling grieving relatives weighs on doctors.

“What ends up happening is people go to the bathroom, put some water on the face, shed a tear and keep going, ” Dr Gautam said.

“But this ‘keep going’ can happen only so much.”

With the pandemic, she said, “It’s like day after day you have to do that.

“There’s no room for processing it, sitting with it, because then you go home, and it takes an hour to get all of the gear down.

“Then you want to disconnect and not talk about it.”

So far, on a busy day, the hotline fields about 20 calls. Two volunteers at a time are answering calls.

In just a few weeks, the hotline has acquired nearly 600 volunteers who help with calls every day from 8am to midnight.

Even before Covid-19, doctors experienced depression and burnout.

Nearly half of physicians show signs of burnout, and at twice the rate of the general public.

The peer-to-peer support, and limiting it only to doctors, sends a message that help is something doctors specifically should seek.

“Physicians are really not used to talking about their feelings, especially the ones who are on the front lines, ” Dr Gautam said.

“And so that’s why we kept it purposely only for physicians, so there was this message that this is for you specifically; you also need help.”

Dr Joan Anzia, a professor of psychiatry and behavioural sciences at Northwestern’s Feinberg School of Medicine, said doctors may experience grief or post-traumatic stress disorder (PTSD).

She calls part of this pandemic “moral distress” – seeing such consistent trauma, watching people die without family and attempting to fill that supportive role.

“To see someone who’s your grandparent’s age or your parent’s age dying alone, that’s really wrenching, ” she said.

Other local resources have also emerged to help healthcare workers.

Illinois therapists Allison Levine and Mandy Jones set up ChiHealerHealth to connect therapists with healthcare workers in their state.

Before working in private practice, Levine worked in a hospital.

“Hearing all of my old hospital friends share their experiences on social media was making me feel helpless and enraged, ” she said.

So far, they have matched 27 healthcare workers with therapists and have a wait list of 160 volunteers.

People do not have to be healthcare professionals to qualify; they stress it is also available for those in any hospital job such as registration or housekeeping.

Other resources are available throughout Chicago; Dr Anzia noted Northwestern has a Peer Support Program, a team of doctors in multiple specialties who provide support to colleagues.

Within the hospital, a team of mental health providers volunteered to provide consultations, and said they also have programs for nurses, residents and fellows. – Chicago Tribune/Tribune News Service

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