Will Medical Workers Deal With PTSD After COVID-19?

Post-traumatic stress disorder (PTSD) is commonly linked with war veterans. This mental health condition however can be triggered by suffering or witnessing any terrifying event like accidents, natural disasters, violent experience – or a disastrous pandemic. It comes as no surprise that medical health professionals and other people in the frontline of the fight against coronavirus are expected to have a surge in trauma-related illnesses, particularly PTSD. Beside protecting and helping personnel physically as well as mentally, there are also digital health solutions that can come to the rescue.

A Canadian research on PTSD among nurses estimated a prevalence of as high as 40 percent. With COVID-19, these numbers will surely rise, and not only in the Great White North. There’s a shortage of protective equipment for hospital workers practically all over the world, and although the cheering of the crowds may sound elevating, that won’t ease the fear and anxiety these people have every time they enter the hospitals. Experiencing the everyday horror of the virus, the death toll it takes and the loss of medical staff and others in the frontline further elevates the stress levels, adding further tension to this high-pressure job. And there’s also the fear of working next to fellow staff members who might be COVID-19 positive.

Source: https://time.com/

At first Chinese nurses shared their pictures of the marks their protective gears had left on their faces. In Italy, there’s a regularly updated website listing the names of the doctors who have died of coronavirus infection. As of mid-April, the number stands at 131. It sounds incredibly weird that these people need to use the media and the social channels to try to push their governments to protect them while saving lives. In fact, ten Californian nurses have just been suspended for refusing to work without proper protective equipment. Theresa Fyffe, director of the Royal College of Nursing in Scotland recently said, summing it up, that it is "inevitable" more health workers will die from coronavirus. That’s not very comforting for medical staff dealing with this highly contagious illness with no known cure yet. 

Protection inside and out

To protect hospital staff from PTSD, people first need to feel protected physically. “It is vitally important to provide high quality protective equipment for frontline staff," pressed Dr. Michael Duffy, who has been at the forefront of work in trauma and Post Traumatic Stress Disorder (PTSD) for 22 years. Without the sense of safety and security, he added, staff will not be able to cope with the psychological challenges their job brings about.

But even with all the gears available, medical professionals can’t be saved from the trauma they directly experience, and the consequences are long-term. Many countries therefore have already set up helplines for medical staff to call for support if they feel they need it. In China, the hotline is operated with counselors all over the world. A psychotherapist from Washington who volunteered for the line mentioned in an interview that “some of the calls that we're getting are of health workers being very stressed out, very exhausted. (...) Some people were suicidal when they were on the phone because they're so stressed out.” So how can health workers be given a mental break? 

The need to talk

After making sure people working on the frontline are all given the necessary equipment, they must also be given straight, clear and honest communication. In an article in the British Medical Journal, Neil Greenberg, professor of defence mental health and his colleagues set out measures that healthcare managers need to put in place to protect the mental health of healthcare staff having to make morally challenging decisions. They include that hospital management must be clear and frank about the situation with the staff, with honesty about what they are going to face. The staff should be supported by mental healthcare professionals available for calls/other forms of early support, who can check on staff’s wellbeing regularly. 

Interestingly, many institutions fail to communicate with the staff properly, leading to even worst cases of mental health issues and feelings of isolation. The WHO put together a brief on mental health considerations during COVID-19, with separate sections of messages to the general public, healthcare workers and team leaders or managers in health facilities. The organisation here also recommends to ensure that good quality communication and accurate information updates are provided to all staff.

And sometimes people just need a simple solution. Staff at Bradford Teaching Hospitals NHS Foundation Trust allocate a room each day where they can go to share worries, say it out loud, have a little cry, shout or scream – or just sit quietly. Restoring your mental wellbeing begins with a simple step, and such solutions should be available everywhere.

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Technology to the rescue? Online counseling, telehealth and other digital resources

Digital therapeutic apps and solutions are also there to support medical staff in dealing with the trauma. To start with the most advanced solutions, medical virtual reality is already used in helping overcome stress and fears. Psychologists have positive results with overcoming fears and phobias with VR, and the results are also convincing regarding PTSD. The virtual version of the exposure therapy that is often used trying to help people with PTSD-symptoms can reduce the fear by helping overcome the avoidance behaviour under controlled circumstances. Hopefully these digital solutions will soon be more widely available.

Source: https://haptic.al/

Alongside a national hotline for healthcare workers, NHS England has partnered with three companies specialized in meditation, to offer a suite of apps for no charge to assist staff with their mental health. These will help staff in need of help with ways to battle anxiety, relax, and also help with sleep problems. UK-based startup UnMind provides a platform for workplace mental health, Headspace is specializing in meditation, while Big Health offers a digital sleep improvement program to help overcome poor sleep without pills. 

In the United States Talkspace, an online and mobile therapy company from New York announced that it will donate 1,000 months of free online therapy to medical workers all over the U.S. who are helping respond to the COVID-19 crisis. What’s more, the company also called on its network of thousands of therapy providers to donate their time for additional free services to medical personnel.

All around the world universities, institutions and even private companies are providing free mental health and wellbeing solutions as well as counseling for medical staff. The University of California in San Francisco created a whole set of online support, webinars, list of apps, handbooks and advice. UNC Health also offers online help and its database, and the International Society for Traumatic Stress Studies (ISTSS) has a complete digital toolkit called Emotional Coping for Healthcare Staff, along with live Q&A sessions and telehealth resources.

Source: bbc.com

The question is, will medical staff have the energy to open and use these apps after long shifts and exhausting experiences? Digital technology in this case only works if staff also receive the human support: be it a family member or a colleague in a buddy-system, somebody eventually must be there. These are definitely difficult times we are currently living in. Doctors, nurses and medical personnel are in the first line of trenches, taking care of all in need. We as a society must ensure they are also being taken care of, for we are in these trenches together. Not just now, but in the months to come, when we will already have forgotten the horror we saw on TV, but they will see it every night behind their closed eyelids.

So keep up the evening cheers, let’s show them our appreciation now. But let’s not forget this once all this is over.

Dr. Bertalan Mesko, PhD is The Medical Futurist and Director of The Medical Futurist Institute analyzing how science fiction technologies can become reality in medicine and healthcare. As a geek physician with a PhD in genomics, he is a keynote speaker and an Amazon Top 100 author.

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