Frontline health care workers have been through tremendous challenges this past year while treating COVID-19 patients throughout the world.
It should come as no surprise that many are having trouble emotionally.
A new study looked at the impact of the pandemic on sleep and mental health among the general population and health care workers by analyzing 55 studies involving nearly 190,000 people worldwide.
For the general population, depression grew almost 16%, anxiety was up more than 15%, PTSD grew nearly 22%, psychological distress increased more than 13%, and insomnia grew nearly 24%. But among health care workers, insomnia rates were more than two times higher.
"Past studies show that for people who are facing a problem, during the time they are facing the problem they do not present a lot of mental health problems, but after they present a lot of mental health problems. I think we have to be aware about that," said study author Jude Mary Cenat, director of the Vulnerability, Trauma, Resilience and Culture Research Laboratory at the University of Ottawa in Canada.
The study, published recently in the journal Psychiatry Research, suggests implementing programs that provide holistic care to all affected individuals, including developing programs quickly for health care workers.
Health care workers were exposed to the worst of the pandemic, Cenat noted. They were afraid of being infected themselves and were afraid for their families. Some have also experienced stigmatization, as people were afraid of being infected by them, he said.
"Our study is the warning to say it is important to put in place a prevention program," Cenat said. "We have to be aware that mental health care… is not a luxury. It is needed. It is needed for health care professionals, for health care workers. It is needed also for our children and it is needed, for example, for our seniors. We need to take care of our people."
The effect of the pandemic on health care workers is profound, said Susan McDaniel, who is the Dr. Laurie Sands Distinguished Professor of Families & Health in the Departments of Psychiatry and Family Medicine at the University of Rochester Medical Center in New York.
"I think it's very sobering," said McDaniel, who wasn't part of the study. "It's very stressful. It's stressful to see patients be so sick and not be able to cure them. We are better at that than we were in the spring."
Physician well-being had already reached a critical point well before the pandemic, McDaniel said, with studies showing that the United States and other countries have plenty of physicians who feel burned out.
The University of Rochester Medical Center embeds psychologists and family therapists in its medical departments for that very reason, McDaniel said.
The medical center created spaces for staff to talk with others from their departments about their experiences, McDaniel said. They have Zoom check-ins with all those who want to call in. They have had as many as 70 staff in a check-in call.
The team has also worked to lift up their health care workers during the pandemic with small gestures and more in-depth check-ins.
"It allows us to provide some emotional support and normalize some of the difficult feelings that people have and just allow them to talk," McDaniel said, "… making it easy for people to have places where they can both unwind and also talk about their distress. And sometimes we can problem-solve."
It serves as a sort of psychological early intervention, McDaniel added. "I can provide this check-in time, but I can also screen for how people are doing and reach out if I'm worried about them early, instead of late in the process," she said. "And I think all of our people have done that in their various departments."
The U.S. Centers for Disease Control and Prevention has tips for coping with stress during the pandemic.
SOURCES: Jude Mary Cenat, PhD, director, Vulnerability, Trauma, Resilience and Culture Research Laboratory and assistant professor, Clinical Psychology Program, School of Psychology, University of Ottawa, Ontario, Canada; Susan McDaniel, PhD, Dr. Laurie Sands Distinguished Professor of Families & Health, Departments of Psychiatry and Family Medicine, and academic chief, Division of Collaborative Care and Wellness, and director, Institute for the Family, Department of Psychiatry, and director, Physician Communication Coaching Program, University of Rochester Medical Center, Rochester, N.Y.; Psychiatry Research, Nov. 26, 2020