As healthcare workers across the world deal with the coronavirus outbreak on the frontlines, new research has come up that points out the mental health outcomes they face.
Here is a look at the kind of mental health issues medical workers may have to deal with, and what can be done to address them.
Can healthcare workers dealing with COVID-19 patients be psychologically stressed?
Yes, the research seems to point in this direction. A recent study appearing in the peer-reviewed journal JAMA Network studied 1,257 healthcare workers in 34 hospitals (20 in Wuhan, 7 in Hubei and 7 elsewhere in China) equipped with fever clinics or wards for patients with COVID-19.
It found that a “considerable proportion” of healthcare workers reported symptoms of anxiety, depression, insomnia and distress. The symptoms were more common among women and nurses in Wuhan and frontline healthcare workers dealing directly with COVID-19 patients.
In this study, over 634 participants reported symptoms of depression, 560 reported symptoms of anxiety, 427 reported insomnia and 899 reported distress. The study also notes that nurses, women and frontline healthcare workers and those deployed in Wuhan, the initial epicentre of the disease outbreak, reported more severe degrees of all measurements of mental health symptoms.
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Another study published in the journal Lancet in February said that medical workers in Wuhan were facing enormous pressure, including a high risk of infection, inadequate protection from contamination, overwork, frustration and isolation. These factors were causing medical workers to feel stressed and anxious. They also reported depressive symtoms, insomnia, denial, anger and fear.
What does this mean?
The psychological impact of infectious disease outbreaks on healthcare workers is not something that is being recorded for the first time during this ongoing global pandemic. During the 2003 SARS outbreak too, for instance, high-risk healthcare workers reported elevated levels of stress, fatigue, poor sleep, worry about health and fear of social contact, according to a 2007 paper published in the Canadian Journal of Psychiatry.
Healthcare workers across the world are providing one of the most important services during this global pandemic. They are not only directly dealing with COVID-19 patients, but are at an increased risk of contracting the infection.
For instance, in China, more than 3,000 healthcare workers contracted the infection and over 22 died. In Italy, another epicentre of the disease, over 20 per cent of the responding healthcare workers contracted the disease and some died because of it.
These factors put a significant amount of pressure on healthcare workers, due to which their mental health might get compromised. Further, while various countries have set up helplines to address the anxieties of citizens ordered to stay home, such interventions for healthcare workers remain scarce.
An editorial comment on the JAMA Network study made by NEJM Journal Watch said the greater impact on nurses than physicians might be because of their closer and more prolonged contact to the COVID-19 patients and also due to their greater inexperience.
“While it may be modestly reassuring that half the respondents on the front lines of this outbreak had minimal or no symptoms, these findings highlight the importance of being sensitive to caretaker distress and of caring for the caretakers as well as the patients,” the comment said.
The aforementioned Lancet study says that mental health problems among medical workers can affect their understanding, attention and decision-making ability, “which might hinder the fight against 2019-nCoV”.
These problems can also have a lasting impact on their overall wellbeing. Therefore, protecting the mental wellbeing of mental health workers is important to not only control the epidemic, but also to protect their own long-term health.
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What can be done to protect the mental health of healthcare workers?
Noting that the coronavirus outbreak is an unprecedented situation, an analysis in BMJ notes that during such a time, healthcare workers have to make “impossible decisions” under “extreme pressure”. This may include decisions such as allocating scarce resources to equally needy patients, balancing their own mental and physical healthcare needs and aligning their desire and duty to patients with those to family and friends.
Some of the measures that can help during such times include preparing the staff so they are able to make sense of morally challenging situations, and requiring healthcare managers to be frank and straightforward about the situation the workers may need to face.
Once the crisis is over, the analysis suggests that healthcare workers should be actively monitored, supported and provided with evidence-based treatment.
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