Mental Health During the Pandemic (by Jonathan Temte, MD/PhD)
It’s happened to me three times so far. I get a text message from the US Census Bureau requesting, “Please answer survey on COVID19 crisis.” Although my mind initially said, “scam,” I connected using the hot link to find that there is an ongoing assessment of the American population. Among the questions related to employment, changes in income, health care utilization, and food security, I immediately recognized four from the PHQ-2 and GAD-2; these are validated screening instruments for depression and anxiety, respectively, in primary care.
Upon tracking down the Census results, I found that almost 30% of responding adults reported feeling anxious or nervous and 23% reported not being able to stop or control worrying more than half the days or nearly every day in the preceding week. Moreover, 19% reported feeling down and 21% reported having little interest or pleasure in doing things more than half the days or nearly every day during the previous week. Anxiety and depression are following in COVID-19’s wake.
A recent research letter compares the rates of serious psychological distress in early April 2020, using data from a reliable survey platform representing the US adult population, and in 2018, using data from the National Health Interview Survey (NHIS) and yields similar results. Between 2018 and 2020, the estimated prevalence of serious psychological distress increased by 3.5 fold, from 3.9% to 13.6%. The groups with the highest current rates are young adults (age 18—29 years: 24%), those with household incomes of <$35,000 per year (19%) and Hispanic adults (18%). The lowest levels were for individuals aged ≥55 years (7%) and with household incomes ≥$75,000/year (8%). In addition, one in seven respondents reported that they always or often feel lonely, increasing from one in nine in 2018.
COVID-19 Resources from the Massachusetts Attorney General’s Office
A plethora of resources for physicians and other healthcare providers include Self Care (ranging from resiliency strategies, mindfulness tools, stress management, and more), Priority Testing, PPE access, opportunities for free or discounted meals (by region) and additional COVID-19 guidance and resources, just to name a few.
Stories of the Pandemic from the Heart of the Commonwealth
Workers of Worcester is a documentary photography series of portraits and interviews of frontline workers to honor the humanity of those who risk their lives and provide a space for their voices to be heard. Read More
Physician Health First
If you want to maintain good health, then it all starts with small decisions you make each and every day. Mental health is just as important as physical fitness. In times like these, stress can be heightened by a number of factors. The AAFP Physician Health First initiative is devoted to improving the wellbeing and professional satisfaction of family physicians by addressing the causes of physician burnout, including the broken U.S. health care system, the organizations employing physicians, the practice environment, individual wellbeing, and a physician culture of self-sacrifice over self-care. Learn more
Check out great resources available to help you practice self care, including opportunities for CME credit!
Apps for Mindfulness & Wellbeing
Family Physicians are working tirelessly to provide critical support to patients and families in their communities during this time and the added challenges you’re facing during the pandemic add a lot of additional stress. There are several recommended apps available to support the wellbeing of healthcare providers:
Calm (free options, can pay for additional features)
CBT-i Coach (free)
Happify (free options, can pay for additional features)
Headspace (free for providers for the rest of the year with verification by NPI; otherwise 2 week free trial for non-providers)
Healthy Minds (free)
Insight Timer (free)
Recovery Path (free)
Ten Percent Happier (free options, can pay for additional features)
Sanvello (free premium during COVID-19 crisis; additional features available with qualifying insurance)
Stop, Breathe & Think (free options, can pay for additional features; free kids version)
Wysa: Mental Health Support (free options, 20% off subscription cost right now)
Support for Healthcare Providers Coping with the Pandemic
The COVID-19 pandemic is taxing the human, material and financial resources of individuals, communities and countries around the world. This unprecedented public health crisis is impacting every aspect of daily life, but the toll on healthcare professionals in particular is immense.
There are many tips and resources to help caregivers find information they need to continue supporting each other and caring for themselves during this extremely difficult time on The Schwartz Center for Compassionate Healthcare website.
The Schwartz Center’s mission to put compassion at the heart of healthcare holds true no matter how extraordinary or difficult the circumstances.
COVID-19: Stress and Coping (CDC)
– Acknowledge that secondary traumatic stress can impact anyone helping families after a traumatic event.
– Learn the symptoms including physical (fatigue, illness) and mental (fear, withdrawal, guilt).
– Allow time for you and your family to recover from responding to the pandemic.
– Create a menu of personal self-care activities that you enjoy, such as spending time with friends and family, exercising, or reading a book.
– Take a break from media coverage of COVID-19.
– Ask for help if you feel overwhelmed or concerned that COVID-19 is affecting your ability to care for your family and patients as you did before the outbreak.
– Seek additional information about stress management for first responders from the Disaster Technical Assistance Center(SAMHSA)
Be sure to check out AAFP’s Focus on Wellbeing page dedicated to family physicians. This site is full of content and includes inspiring stories from fellow family physicians, blogs, AAFP news coverage and tools.
Deep breaths are like little love notes to your body.
Mental Health of Healthcare Workers Podcast
In this podcast, The Happiness Lab host, Dr. Laurie Santos of Yale, talks to doctors on how they cope with isolation and lack of self-compassion. They explore doctor’s mental space as they explore advocacy in crisis, meditation, courage and more. See how here.
Physicians Support Line
Support line service made up of 600+ volunteer psychiatrists, joined together in the determined hope to provide peer support for our physician colleagues as we all navigate the COVID-19 pandemic.
During this time it’s emotionally difficult for everyone and physicians are not exempt. Mental Health First Aid has a website full of articles available that are specific to COVID-19 and mental health; relevant for anyone including physicians, family & friends and patients.
Another source for now and anytime you may want to consider is an app to help routinely practice mindfulness and medication. Check out Headspace, an app that teaches you how to meditate. Headspace is offering free access to Headspace Plus for all US. healthcare professionals working in public health settings during the crisis.
Be gentile with yourself. You’re doing the best you can.
Four principles for handling stress during a crisis:
In times of crisis, such as the COVID-19 public health emergency, stress can be heightened by a number of factors. AAFP offers advice for physicians to address their stressors and support their own well-being in the midst of a pandemic in this week’s AAFP FPM Journal blog.
“Self-care means giving yourself permission to pause.”