No one knows how long the uncertainty is going to last, and that has had significant impacts on the mental health of healthcare workers.
By Savitha Kuttan
COVID-19: The medical profession is a stressful one even under normal circumstances. The demanding hours, psychological strain and cumbersome work processes can cause burnout, one of the most common conditions affecting doctors across the country. Anyone who has studied physician well-being will tell you that the profession is a combination of cynicism, exhaustion, and perceived inefficiency. A lot of burned-out physicians quit their jobs and the patients of the ones who don’t suffer worse health outcomes. Even so, burnout cannot even come close to capturing what physicians, nurses, and paramedical staff continue to experience as the pandemic overwhelms our overburdened healthcare system.
Mental health issues during lockdown: Difficult to assess the mental toll
As the acute crisis upends almost all aspects of society, frontline workers shoulder the burden of systemic unpreparedness. Inefficiencies in testing and a refusal by the public to follow the recommended safety protocols has allowed the virus to spread. Being used to running lean outfits, a number of hospitals do not have the resources to expand care. The global demand for protective equipment and ventilators led to a scarcity of these crucial supplies. Backup stockpiles proved insufficient, and efforts to bolster the supplies were either uncoordinated or forced hospitals to compete with each other. Hospital staff in areas where the incidence of infections has been low look on silently, wondering if they are going to be hit next. Nurses have to facilitate phone calls between dying patients and their family members, who are denied entry.
No one knows how long the uncertainty is going to last, and that has had significant impacts on the mental health of healthcare workers. More than any other target group, they are in danger of getting sick from exposure to the virus. The fact that hundreds of clinicians across the globe have succumbed to the disease has only increased their worries. Many of them worry about spreading the disease to other patients and loved ones. Clinicians across the country are taking to social media to speak about resource shortages and share their experiences of being mistreated by their neighbours and manhandled by patients. Experts predict that the traumatic effects will linger long after the virus is contained.
The repercussions of moral injury cannot be ignored either. In medicine, it happens when the business aspect of healthcare intervenes with the physician’s ability to provide the right kind of care for their patients. If there are not enough ventilators for COVID-19 patients, physicians have to choose who gets life saving support and who does not.
This is not easy as a vast majority of them have no experience doing triage. Most of them are trained to treat one patient at a time, but in the face of an epidemic, they have to think about maximum good for the greatest number.
The moral injury of these uncomfortable decisions can impede their emotional and psychological well-being, not dissimilar to the ones seen in people suffering from post-traumatic stress disorder.
Mental health toll during COVID-19
No one can predict the long-term emotional toll of COVID-19. In the event of a natural disaster, healthcare workers deliver care after the immediate threat has subsided, and go home to decompress. However, if you are worried about taking the disaster home with you, even home is not a safe place. On top of the daily stress, healthcare workers are dealing with the upheaval of economic and social life with the rest of the country.
Time to expand mental health services
Medical professionals are already at high risk for anxiety, insomnia and depression, and yet unlikely to seek professional help. A lot of them do not have the time or flexibility to visit a therapist during a standard workday, and the stigma attached to psychological problems, especially in caregivers, forces them to suffer in silence. Our mental health system is unequipped to handle the needs of the general population, let alone the population that will need it more very soon. We need to start expanding therapy operations with the help of teleconsultations, flexible scheduling and support hotlines. The right support can foster resilience in healthcare workers, and make them more confident in their ability to manage stressors in the future. We also need to understand that expanded mental health support is an ongoing endeavor, needs to be wide in scope, and address systemic problems like the nationwide shortage of mental healthcare professionals and services. When the medical crisis comes to an end, the mental health crisis is going to emerge, and we need to be ready.
The columnist is Founder & CEO of Omnicuris. Views expressed are the author’s own.