Employers sometimes offer staff tips on self-care to help them cope with stress and prevent depression and other mental health issues. But there also are actions leaders can take to help prevent their staff from becoming burned out or experiencing long-term mental health problems related to the COVID-19 pandemic:

Develop mental health resources for staff. Organizations should propose resources that their staff can turn to for mental health counseling, treatment, and support, says Alison B. Comfort, PhD, health economist with the Bixby Center for Global Reproductive Health at the University of California, San Francisco (UCSF).

Researchers recently studied mental health issues among reproductive healthcare staff during the pandemic and suggested that interventions should focus on reducing stigma as a barrier to health providers accessing treatment for mental illness.1

“Because it [can be] stigmatized to use those resources, we need leaders in organizations to be examples and say they benefited from those resources,” she says. “You need leaders or key influencers within organizations to show it’s OK to use those resources, saying, ‘I really benefited from them, and you can, too.’”

It will take some work to make those resources available and destigmatize them, she adds. “Employers should offer mental health resources without penalty, and leaders should say, ‘Why don’t we all use it,’” says Cynthia Harper, PhD, professor of obstetrics, gynecology, and reproductive sciences, and director of the UCSF-Kaiser Permanente Building Interdisciplinary Research Careers in Women’s Health at UCSF.

Everyone needs to become aware of how the pandemic may affect employees’ mental health and how they should seek as much help as they need. “All of us need a mind shift about mental healthcare,” Harper says.

“Insurance is slightly more likely to cover mental health issues than it was 15 years ago,” she adds. “We have a long way to go before everyone gets the help they need from this global pandemic.”

Manage expectations. A potential contributor to stress over the next year will be the expectation that everything will return to normal.

Continuous change and adaptations have been hallmarks of the pandemic. Reproductive health staff should know that these may continue. As one nurse practitioner told researchers, “This is going to be the new ‘normal.’ Not looking forward to how medicine will be done in the future.”1

Reproductive health providers also need to manage patients’ expectations as things continue with telehealth and other changes. “Healthcare workers had to completely change their workflow, and patients are thinking everything will be the same except for using Zoom, and it’s not. That puts additional stress on clinical interactions,” says Alexander Tsai, MD, PhD, a psychiatrist at Massachusetts General Hospital and associate professor of psychiatry at Harvard Medical School.

Make room for grief. “There have been a lot of deaths that we as a country have experienced,” Harper says. “We have a higher death rate than other countries.”

According to researchers, the pandemic’s overwhelming death toll and healthcare workers’ fears of contracting the virus and infecting colleagues and family have harmed their emotional and psychological well-being.2

Many reproductive health staff personally experienced the trauma of these deaths and COVID-19 illnesses. Some workers’ family members and/or people they knew were infected and harmed or killed by the disease.

“We’ve suffered this [crisis] together, and it has really been tremendous the way it has impacted all these different sectors of society,” Harper says. “The first step is to say it really has affected people and to offer to help,” Harper says.

Tell the truth: Things will not be the same. Leaders should be frank about the situation and not offer false reassurance, Tsai says.

They can help their staff cope with moral dilemmas and the ever-changing work environment by expressing honesty about what the organization can and cannot do for them. “Don’t present things in legalese or euphemism, but give it to people straight,” Tsai says. “Whenever the epidemic subsides, that brings up anger and bitterness.”

Staff will need ongoing support. “They can provide a regular discussion forum for healthcare workers to talk about the challenges they are experiencing, or some sense that employers are aware of these challenges and are trying to do something about it,” Tsai explains. “If they feel like the big boss doesn’t care, that doesn’t feel good. It’s better if the boss does care and there is more of a sense that we’re in this together.”

Healthcare workers recognize that their work during the pandemic will be difficult. But they want to know they will be supported as they experience sacrifice and losses. “Seeing employers trying to mobilize support in tangible ways also is appreciated,” he adds.

For example, employers can try to arrange for safe child care for their employees during times when schools or daycare centers are closed. “To see an employer try to create safe child care would be greatly appreciated,” Tsai says.

Provide aftercare. “What happens when you put people under so much stress for so long is, even when we come out of the pandemic, there could be long-term repercussions for these healthcare workers, who have been under so much stress,” Comfort says.

Employees who do not attend to their emotional health issues now and who delay care may end up with festering problems later. “Providers are delaying taking care of themselves. In the next few years, we’ll see repercussions of that,” Comfort says.

Reproductive health sites that destigmatize mental health treatment and encourage staff to seek assistance can help them prevent long-term problems. “It goes back to the superhero idea, where they’re treated as though they’re super human and don’t need help,” Comfort explains. “But they [should] seek care, too.”

All healthcare employees will need at least some aftercare when the pandemic ends. “Hopefully, employers and supervisors will mobilize some kind of appropriate response once the crisis is over,” Tsai says. “With aftercare, the idea is to make sure the most common reaction to the issues that have come up during the pandemic is not simply avoidance.”

The pandemic will be with the United States and the rest of the world for a long time, but this cannot be an excuse to ignore its mental health repercussions among staff.

“It’s important for supervisors, employers, and leaders to create space to reflect on the sacrifice made and the losses so the predominant story is some kind of meaningful story,” Tsai explains. “Acknowledge the sacrifices, the difficulty, and the loss in a way that doesn’t make people feel you are just papering over whatever difficulties that have been encountered.”

REFERENCES

  1. Comfort AB, Krezanoski PJ, Rao L, et al. Mental health among outpatient reproductive health care providers during the US COVID-19 epidemic. Reprod Health 2021;18:49.
  2. Hossain F, Clatty A. Self-care strategies in response to nurses’ moral injury during COVID-19 pandemic. Nurs Ethics 2021;28:23-32.