Mental health amid COVID-19: ‘No wrong time’ for health care workers to seek help
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Jessi Gold, MD MS, does not consider “OK” or “fine” to be emotions.
“We use these [words] all the time — maybe because they encompass a neutral emotion or allow us to hide our emotions — but they’re not actually emotions,” Gold said during a presentation at Women in Medicine Summit. “If someone asks us how we’re doing, we say we’re ‘fine’ or ‘OK’ because, otherwise, it feels like it’s going to open a floodgate and we won’t be able to control it. It’s like saying ‘Fine, let’s just not have that conversation.’”
Gold, assistant professor and director of wellness, engagement and outreach in the psychiatry department at Washington University School of Medicine in St. Louis, discussed the need to have these uncomfortable conversations — particularly in light of the COVID-19 pandemic.
“Pausing to have that conversation means you have to acknowledge everything that has gone on for the past 3 years or so, even before COVID,” Gold said. “People don’t want to talk about feelings. So, I am starting with data because we are science people.”
COVID-19’s footprint
Gold discussed the mental health impact of the COVID-19 pandemic on health care workers, particularly women.
“We know what the medical footprint of this looks like,” she said. “So, if you think about the psychological one being that much bigger, that’s scary for us — as humans and as practitioners.”
She cited data from Ari Shechter, PhD, and colleagues — published in General Hospital Psychiatry — related to the mental health of health care workers in New York City during the pandemic.
Of 657 workers surveyed, 57% had acute distress, 48% experienced depressive symptoms, 33% had anxiety, 75% reported insomnia that they characterized as moderate or worse, and 65% felt lonely and isolated.
“The insomnia number is very important, because not sleeping is a risk for everything,” Gold said. “If nobody’s sleeping, other things are going to become problematic.”
Gold also considered the rate of loneliness and isolation to be particularly concerning.
“People wonder how someone can go to work and be around people, yet still feel lonely,” Gold said. “If you go to work every day and you’re feeling horrible but everyone else seems like they’re fine, you’re going to feel lonely. You’re not going to feel like part of a group in that sense, and no one is there to support you.”
She also discussed findings from Elena Frank, PhD, and colleagues published in JAMA Network Open. The paper showed women physicians were more likely to experience a loss of childcare, to be designated the primary provider of childcare or schooling, perform most household tasks and have reduced work hours.
“We’re transitioning to being at home, to trying to do all these other tasks and reducing work hours in order to do them,” Gold said. “Male physicians didn’t report having to do those things.”
A path forward
Gold discussed how health care workers can begin to recover from the mental health impacts of COVID-19, starting at the individual level.
The first step is a “self-check-in,” Gold said. This enables a person to identify and understand how they are feeling at a given moment. physicians may find it helpful to use an objective measure, such as the Mayo Well-Being Index.
“It’s important to notice warning signs and symptoms, and take the time to ask yourself how you are doing,” she said. “Objective measures are often needed, as we often don’t recognize change or symptoms in ourselves.”
A willingness to ask for help also is essential to healing from mental health issues. Because health care workers traditionally define themselves as helpers, they may have difficulty seeking help for themselves. Gold encouraged physicians and other providers to move past stoic stereotypes associated with their profession.
“Ask for help if you need it,” she said. “There is no wrong time to get help — especially therapy.”
Checking on and supporting colleagues can also help foster a healthy workplace environment, Gold said. This has the potential to improve mental health for everyone.
She encouraged physicians to create a safe space at work, ask open-ended questions without making assumptions and normalize difficult experiences. During the pandemic, social support had the biggest impact on health care workers, Gold said.
“We need to refrain from problem-solving and giving advice, but know about available resources,” she said. “If it comes down to it, be ready and willing to help your friend.”
References:
- Frank E, et al. JAMA Netw Open. 2021;doi:10.1001/jamanetworkopen.2021.34315.
- Gold J. How are you, really? Debriefing the past few years and thriving in the next ones. Presented at: Women in Medicine Summit; Sept. 16-17, 2022; Chicago (hybrid meeting).
- Shechter A, et al. Gen Hosp Psychiatry. 2020;doi:10.1016/j.genhosppsych.2020.06.007.
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