Opinion: Mastering Mental Health For Frontline Healthcare Workers

New Delhi: Over the years, data from across the world has shown that healthcare workers are at a considerably higher risk of mental health disorders than the general population. Previous studies have indicated that nearly half of all physicians experience burnout and have higher rates of suicide than the population. The nature of the work with changing shifts, quick decision making, dealing with exposure to suffering and death sometimes sets in helplessness, guilt, depression and anxiety particularly in those on the frontlines. The pandemic has exacerbated and highlighted these concerns, especially in the context of the reports of increasing suicides in healthcare workers over the past few months. Research studies during past pandemics have demonstrated that the mental health effects in frontline healthcare workers can persist long after the pandemic.

Also Read: COVID-19 Is Causing Disruption To Critical Mental Health Services: World Health Organisation

Extended Work Hours

There has been compelling evidence that extended work hours have adverse effects on the efficiency and mental health of medical personnel. It has resulted in courts restricting the length of shifts for healthcare workers. Despite these advisories, frontline workers across the world are expected to put in unhealthy hours of work resulting in considerable stress that can impair their immunity and decision making abilities. It is illegal for a flight attendant, leave alone a pilot to work for more than a few hours on a shift! Yet there seems to be no such consideration for healthcare workers in a pandemic.

Risk Of Infection To Self And Family

Being ringside witnesses to the ravages of the pandemic and acutely aware of the risks they face with over 200,000 healthcare workers being infected with COVID-19 across the world, those on the frontlines are bound to be anxious about their own safety as well as that of their families. Many healthcare workers live in extended families with elders. Every death they see may make them feel, ’There but for the grace of God, go I.’

Also Read: Expert Suggests Five Simple Ways That Can Help Take Care Of Your Mental Health Amid COVID-19

Hostility From Patients and Relatives

Health care workers face the added stress of being abused and even assaulted by the very people they are risking their own lives to help. Numerous instances of frontline workers being stoned when they have merely one on a survey to a slum and being assaulted by relatives of COVID patients have been documented in India. The showering of petals and positive messages on the media does little to motivate those who work out of a sense of duty and responsibility.

Forced Work With No salaries

There have been numerous instances of senior doctors who have succumbed to the virus after being forced to work involuntarily in high risk areas. Added to that, many doctors have been unpaid for several months and have to bear the financial burden in addition to their physical and mental stress.

Also Read: How To Take Care Of Mental Health Among Children During Coronavirus Pandemic And The Lockdown

Helplessness And Guilt

The lack of basic facilities including safety measures such as masks and PPEs leaves healthcare workers across the world with a sense of helplessness. Witnessing many preventable deaths can induce depression and survivor guilt.

Decisions Of Life and Death

In the absence of appropriate facilities, frontline health workers have to often prioritize who should receive treatment and survive and who should be left to die. This is perhaps the most difficult decision that any conscionable human being can be called to make. Repeated and almost daily decisions of this magnitude cause unimaginable mental stress to those at the forefront.

Early research from Wuhan showed that mental health issues are common among frontline workers. Women were far more affected than were men. More recent studies have amplified these findings. The data is congruent with past research into previous pandemics such as that of SARS. The following measures have been shown to be effective in past pandemics:

Appropriate And Adequate Facilities

Healthcare workers are always fully aware of the shortcomings in the system and cannot be persuaded as can the general public that everything is going well when things are deteriorating. They need foremost to have adequate resources such as PPEs masks, medicines and ventilators available for their patients and for themselves.

Reasonable Hours Of Work And Pay

It is unreasonable to expect workers in any field especially those involving life and death decision to work extended hours cheerfully without adequate sleep, rest, food and salary.

Early Recognition And Treatment Of Vulnerable individuals

Several healthcare workers across the world have attempted suicide. Many deaths and suffering are preventable by early recognition and treatment of mental disorders particularly in those at high risk such as doctors and nurses.

Also Read: How Yoga Can Improve Your Mental Health Especially During Coronavirus Pandemic

Counselling Facilities And Time Off

It is important to set up help-lines and counselling services for those in need. The recommendations of the counsellors in terms of time off from work should be implemented.

Psychiatric Care Facilities

Priority should be given to those frontline workers in need of psychiatric intervention both in outpatient and hospitalization facilities. A fully functional healthcare worker can save many lives in the pandemic

Training In Self-Care Measures

Health care workers should be trained to identify symptoms in themselves. Mental disorders need to be destigmatized so that they are treated in time. Among measures that individuals can take themselves in times of mental stress are meditation, mindfulness, adequate sleep, open discussions with family and friends and unhesitatingly seeking professional health.

The University of Queensland has developed recommendations for frontline medical workers after analyzing 59 international studies on the psychological effects of treating viral outbreaks.

Associate Professor Dan Siskind said,

These include clear communication, providing training and education, enforcing infection control procedures, ensuring adequate supplies of protective equipment and providing access to psychological interventions.

The mental well-being of our frontline workers should be a priority in the current pandemic not only because it is the least we can do for those who bravely risk their lives to save our own but also because it is in our enlightened self-interest.

Dr. Rajesh M. Parikh is Director, Medical Research & Hon. Neuropsychiatrist: Jaslok Hospital & Research Centre, Mumbai. He is the coauthor of: The Coronavirus: What You Need To Know About the Global Pandemic (Penguin Random House 2020)

Disclaimer: The opinions expressed within this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

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