Prioritizing Provider Mental Health during the COVID-19 Pandemic
Prioritizing Provider Mental Health
Clinical Services Department MC-21
The Covid-19 pandemic, which had killed more than 100,000 Americans by June 1, has been compared with Pearl Harbor and September 11 — cataclysmic events that caused long-lasting psychological effects. The covid-19 pandemic has placed healthcare professionals around the world in an unprecedented situation, having to make impossible decisions and work under extreme pressures. These decisions may include how to allocate limited resources to equally needy patients, how to balance their own physical and mental healthcare needs with those of patients, how to align their desire and duty to patients with those to family and friends. Uncertainty is a key stressor because every time one reads the newspaper, or looks online, cases are growing. For the clinicians who are in hot spots, there is the suffering of the patients and of their peers. There also is the trauma of knowing that there is a risk to one’s own health. This experience may lead to serious mental health problems among our healthcare workforce.
The September 11 attacks provide a useful comparison. Confronted by chronic conditions such as post-traumatic stress disorder among 9/11 first responders, Congress established the federal World Trade Center Health Program, which provides medical monitoring and treatment for nearly 78,000 responders and 24,000 survivors. The number of clinicians experiencing long-term consequences from the Covid-19 pandemic is likely to be much greater. Furthermore, WHO and other experts state there is no evidence of coronavirus losing potency. There is no data to show the new coronavirus is changing significantly, either in its form of transmission or in the severity of the disease it causes.
Just as the country responded to provide care for September 11 first responders who suffered long-term health effects, similar actions must take place for the well-being of clinician first responders to Covid-19. Healthcare institutions should begin preparations now for the mental health care needs of the pandemic healthcare workers. In a report by Dzau et al., five high priority action items are recommended in support of clinician well being (Table 1).
Table 1. Five High-Priority Actions to Protect Clinicians’ Well-Being during and after the Covid-19 Crisis.
Integrate the work of chief wellness officers or clinician well-being programs into Covid-19 “command centers” or other organizational decision-making bodies for the duration of the crisis.
Ensure the psychological safety of clinicians through anonymous reporting mechanisms that allow them to advocate for themselves and their patients without fear of reprisal.
Sustain and supplement existing well-being programs.
Allocate federal funding to care for clinicians who experience physical and mental health effects of Covid-19 service.
Allocate federal funding to set up a national epidemiologic tracking program to measure clinician well-being and report on the outcomes of interventions.
- Healthcare staff is at increased risk of stress-related trauma and mental health problems when dealing with challenges of the covid-19 pandemic.
- Healthcare managers need to proactively take steps to protect the mental wellbeing of staff.
- Managers must be clear about the situations staff is likely to face.
- Staff can be supported by reinforcing teams and providing regular contact
to discuss decisions and check on wellbeing.
Once the crisis begins to recede, staff must be actively monitored,
supported, and, where necessary, provided with evidence based
What are some things that healthcare workers can do to look after themselves right now?
Getting enough sleep, using caffeine only strategically, eating well, and exercising.
Ideally, also getting enough time to disconnect from work and re-charge, so that providers are rested when they come back and can bring their best work to the job.
J. Abbasi. Prioritizing Physician Mental Health as COVID-19 Marches On. JAMA Published online May 20, 2020
Dzau, Kirch, and Nasca. Preventing a Parallel Pandemic — A National Strategy to Protect Clinicians’ Well-Being. DOI: 10.1056/NEJMp2011027
Greenberg et al., Managing mental health challenges faced by healthcare workers during covid-19. BMJ 2020;368:m1211 doi: 10.1136/bmj.m1211 (Published 26 March 2020)