COVID-19 and Mental Health: Part 1 (Interview with Diana Gonzales)
Diana Gonzalez is a Victim Services Coordinator for the RCMP. As part of her current position in Victim Services, she provides crisis intervention, justice system information, as well as practical and emotional support to victims, witnesses and their families following traumatic events. Most of her professional experience has centred on working with individuals in personal emotional crisis situations. In her previous position as a Coroner, she worked closely with local, provincial, and federal agencies conducting sudden death investigations independent from law enforcement agencies with several cases that led to criminal prosecution. In addition, Diana has extensive professional experience in providing psychosocial care to individuals with life limiting illnesses and to their families and caregivers.
What are the mental health implications of the widespread discussion of COVID-19 and the associated public health measures: social distancing?
The current and recent developments with the COVID-19 outbreak and its effects in Mental Health are analogous to an individual experiencing a traumatic event. Recently, a Trauma Informed Practice (TIP) approach has been integrated in diverse service delivery agencies such as mental health, medicine and the justice system. This approach allows professionals to integrate evidence-based knowledge on how people are affected by an experience that overwhelms an individual’s capacity to cope such as the COVID-19 outbreak.
It is known that individuals with pre-existing mental health issues such as depression are at a higher risk of experiencing anxiety in natural disasters and/or public health outbreaks, such as COVID-19. A person’s ability to cope with social isolation can have short or long term effects depending on their previous experiences of coping skills, or similar situations, social supports and personal circumstances. Physical symptoms of social isolation can include low energy, stress eating or low appetite. Emotional symptoms can include fear of physical separation from family and friends, fear of loss of freedom to go about their daily routine, fear of financial losses and general anxiety, panic-attacks, irritability, insomnia, and feeling lack of control. Cognitive symptoms can include memory lapses and difficulty focusing. Behavioural symptoms include hyper vigilance to any illness, feeling being drawn back to a similar experience/event of isolation which replicates the dynamics of the original experience.
What are some strategies that can be implemented by individuals facing self-quarantine or isolation to promote good mental health during the COVID-19 pandemic?
The following strategies can be used to increase safety and emotional stabilization during the COVID-19 pandemic:
- Re-gain a sense of safety by maintaining regular routines at home, including self-care routines. An example of self care can be doing breathing exercises to calm the nervous system
- Be accepting of what you are feeling
- Get adequate rest, nutrition and exercise and maintain good sleeping habits
- Maintain contact (online) with family and friends and reach out to family and friends who may also feel isolated
- Avoid making important decisions especially if anxiety is very high
What are some measures that can be taken by health care workers and institutions to burnout associated with the COVID-19 pandemic?
Burnout can occur on a continuum and can be influenced by different factors. Some individuals may become obsessed and work beyond the point of exhaustion, while others may experience a decrease in productivity. Strategies for institutions to mitigate burnout include:
- Be aware of the limitations and needs of workers
- Recognize the possibility of vicarious trauma (trauma that can occur when exposed to difficult/disturbing second hand story or witnessing one, it can be a single incident or accumulation of exposure to several incidents
- Implement a buddy system to share upsetting emotional responses
- Perform regular check-in with workers
Strategies for health care workers include:
- Access supervision routinely to share concerns identifying difficult experiences and strategize to solve problems
- Perform regular check-in with colleagues
- If possible take refreshment breaks
- Accept that you may not or cannot change everything
- What are some warning signs of psychological distress that should be kept in mind for individuals facing stress relating to COVID-19?
Most of the adverse effects here can arise from the imposition of a restriction of freedom. These signs include: negative self talk that reinforces helplessness, an obsession with being “online” and informed, decreased productivity and low motivation, suicidal ideation, increased apathy about the future and withdrawal from others
1. Trauma-informed care is a strengths-based service delivery approach “that is grounded in an understanding of and responsiveness to the impact of trauma; that emphasizes physical, psychological, and emotional safety for both providers and survivors; that creates opportunities for survivors to rebuild a sense of control and empowerment.” (Source: Hopper, E. K., Bassuk, E. L., & Olivet, J. (2010). Shelter from the storm: Trauma-informed care in homeless service settings. The Open Health Services and Policy Journal, 3, 80-100).