Before starting her next shift in the emergency room at Howard University Hospital in Washington, DC, psychiatrist Dr Danielle Hairston tries to calm her own anxiety by taking deep breaths.
“These days you really don’t know what you’re going to encounter when you go to work every day,” says Hairston.
Along with working overtime and serving a wave of patients in dire distress, Hairston fears for her own health and that of her oldest mother, who lives with her.
“The stress definitely led to a number of sleepless nights,” Hairston says. “It can be very overwhelming. “
Along with the lasting toll Covid-19 has taken healthcare workers, as global cases climb to 18.8 million and countries experience second waves, mental health workers have also faced challenges without previous.
“Everyone’s sort of exhausted,” admits Dr. Manuel Pacheco, chief emergency psychiatrist at Tufts Medical Center. “The increased volume of patients, the financial strain on hospitals and not knowing what will happen as the pandemic continues can make you feel like you’re walking on water. ”
Just as physical health workers are working overtime to treat a spike in patients and alleviate the ever-confusing coronavirus deaths, so too are mental health workers.
In May, the nonprofit Well Being Trust, in collaboration with the Washington-based Robert Graham Center for Policy Studies in Family Medicine and Primary Care, published research this suggests that conditions arising directly from Covid-19 – including widespread unemployment, social isolation, fear and a bleak future – could result in an estimated 75,000 more deaths in addition to those caused by physical illness. Deaths from drug overdoses, alcohol abuse, and suicide (also known as “deaths of desperation”) are what people on the front lines of mental health strive to fight.
Pacheco, who worked at Tufts for nearly a decade and is also a member of the executive committee of the American Psychiatric Association Assembly, says his department has seen up to 20% more patients than was typical before the pandemic.
Dr Hairston, who is also president of the American Psychiatric Association of Black Psychiatrists, echoes this experience; she noted a slight increase in the number of patients with more serious mental health problems.
“There has definitely been a wave of crisis patients,” says Hairston. “By working in particular with those of underserved communities, there is further housing distress, fear of eviction, and unstable unemployment resulting from the virus. All the uncertainty certainly makes many of these cases more difficult. It can be difficult to reassure patients.
Dr Shabana Khan, director of child and adolescent telepsychiatry at NYU Langone, reiterates this challenge of not being able to give patients a definitive affirmation on when things could get better. “I have seen a number of patients experience increased anxiety and stress levels and deteriorated moods due to the pandemic and social isolation,” Dr Khan said. “Some people used to do pretty well before, but because of this crisis, they had to resume treatment or increase the time they spend seeing me. “
Khan explains that the increased workload for mental health workers comes not only from the increased number and severity of cases, but also due to the reality of caring for patients in a socially remote world. .
Telehealth in the Covid-19 era has become a welcome and necessary tool for psychologists and psychiatrists to continue seeing patients, but it also lends itself to an already intensified workload.
“Appointment presentation rates are much higher because telehealth visits reduce typical barriers such as travel time,” says Khan. “This, aside from anything else, means clinicians are seeing more patients in many practices. This is also accompanied by significant fatigue from videoconferencing which can also isolate us. “
Describing a darker symptom of social distancing measures, Dr Pacheco explains that to temper the spread of Covid-19, inpatient psychiatric units have had to limit the number of patients allowed to be admitted so that everyone can be isolated in their room. . This has resulted in longer wait times for hospital emergency department patients to visit treatment centers to get the care they need.
Dr Hairston points out how overwhelmed emergency services have been with the shutdown of major agencies, which provide essential services to people with serious mental illnesses, severe emotional disorders, or alcohol or drug addiction. “Anyone with significant mental illnesses usually have access to group services, a social worker, and case managers who can go and watch them. But because a lot of them aren’t open, a lot of people aren’t getting the right care. For this reason, we will admit people to the hospital just for some stability, which we would not normally do. “
Cancellation of appointments and loss of access to clinicians or social workers due to social distancing measures, especially for those from under-represented groups who do not have access to phones that can be used for counseling. telehealth, has resulted in an increase in the number of suicide attempts, according to Dr. Pacheco.
“It can be quite demoralizing,” he says.
“I increased my hours with my own therapist because of this,” says Dr. Hairston. “I experienced a leap in my own anxiety and insomnia. Medicine, however, is not an area where we discuss our own mental health treatment. It is not normal to admit to asking for help. You’re expected to be a hero on the front lines, but nobody wants to hear that you have mental health issues, suffer from anxiety or depression, or feel traumatized by what’s going on.
Dr Hairston hopes to see this status quo change and destigmatize conversations about mental health between doctors. “Working longer, seeing more patients suffer and fearing for their physical health and that of their families are just some of the anxieties that can weigh heavily on a healthcare professional right now,” she says.
“It’s more important than ever that those on the front lines are mentally supported so that they can take care of others. “
If you or someone you know is thinking about suicide, please call National lifeline for suicide prevention at 800-273-TALK (8255) or text the Crisis Text Line at 741-741.