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Submitted by Dr S. Patel on 14 July 2020

Since the outbreak of the COVID-19 pandemic, doctors, nurses, attendants and other healthcare workers are actively engaged on the frontlines to manage patients. They have a high risk of developing anxiety, depression and stress during this period. Dr. Milan H Balakrishnan MD DPM, Consultant Psychiatrist and Counsellor at Bombay hospital and Masina hospital, Mumbai helps us understand the issues better. 

 A few studies have been carried in the recent months to assess the mental impact of this disease on healthcare professionals.

What are some of the mental health issues that a healthcare worker is facing during the COVID pandemic?

About 11-20 % of Health care workers (HCWs) have depression and anxiety in the current pandemic, but much larger numbers close to 80 % have subsyndromal symptoms which would impact their performance and also impair communication with their co-workers.

The common problems that are found in HCWs:

Combination of anxiety and burnout is impacting most healthcare workers. How can they recognise signs and what steps can they take to prevent these issues?

Early signs to be recognised include:

  • Increased irritability
  • Anger outbursts
  • Feeling overwhelmed
  • Palpitations
  • Excessive worry

In order to prevent mental health concerns, follow these steps:

  • Have clear guidelines while working and clear instructions from superiors and to subordinates
  • Have adequate feedback.
  • Clear communication of directives and precautionary measures
  • Support from Family
  • Have someone to talk to and share their experiences.

How can family and friends support them?

One of the biggest fears for HCWs is a fear of infecting their family members so family members must help in terms of taking care of self and using handwashing hygiene, use of mask and avoiding unnecessary exposure.

Family members willing to listen to the stories of HCWs and their experiences is important.

Put full faith in the HCW and support him/her.

What are the main reasons for frustration amongst healthcare professionals who are on COVID duty?

  • Fear of infection and even more fear of infecting others
  • Uncertainty
  • Disruption of schedule
  • Financial Concerns
  • Difficulties of losing serious patients

Are there any factors (such as gender or age) that are associated with higher levels of anxiety or depression among the staff?

Younger staff and women are found to be more at risk according to studies in China (Lai et al and Liang et al)

What kind of social support can be given to medical staff? What resources are available for psychosocial help?

Continuous education and provision of all protective equipment to staff is a must. Availability of mental health resources for easy access and awareness about when to access these resources is required. Resources like Bombay Psychiatric Society (BPS) Cares (https://bombaypsych.org/images/BPS-cares.pdf), Project Mumbai (https://projectmumbai.org/), Hitguj (Hitguj Helpline 02224131212) are available.

What coping mechanisms would you suggest for medical staff?

  • Increase physical reserve. Do some daily walking or any form of exercise.
  • Avoid nicotine and alcohol.
  • Increase emotional reserve.
  • Understand that we are all in this together.
  • Worrying is good for you to take precautions but don't worry excessively.
  • Remember many things are beyond our control. Focus on things we can control.
  • We must support each other and listen compassionately to each other.
  • Be kind to self and others.
  • Do your best, accept the rest.
  • Spread hope and optimism.
  • Do not spread doubt or cynicism even on social media.
  • Start short meditative practices even 1-2 min to begin.
  • Seek help if feeling overwhelmed or having serious depressive symptoms like sleep/ appetite changes or suicidal thoughts.

Dr. Milan H Balakrishnan MD DPM, Consultant Psychiatrist and Counsellor at Bombay hospital and Masina hospital, Mumbai