Physician Health

5 ways to protect mental health now and during a future crisis

Tanya Albert Henry , Contributing News Writer

With the COVID-19 pandemic’s profound impact on mental health, the subject deserves attention early—and often—from individuals and leaders who can help mitigate the havoc wreaked on their own and other people’s well-being, said a psychiatrist who specializes in trauma and disasters.

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The pandemic’s psychiatric impact is likely to have a “long tail,” but there are evidence-based interventions that can reduce distress and foster resilience. Capt. Joshua C. Morganstein, MD, deputy director of the Center for the Study of Traumatic Stress at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, discussed these strategies and more during an AMA STEPS Forward® webinar, “Protecting Mental Health in Disasters: COVID-19 and Beyond.”

“The mental health effects of crisis and disaster are profound. Most of what happens to people requires a collaborated, coordinated approach,” said Dr. Morganstein. “The things we really need to be focused on and make sure we have at the ready are mechanisms by which peers and organizations and leaders can early and often provide ways of supporting individuals within a community.”

Learn more with AMA STEPS Forward toolkits that offer strategies on how to engage health system leadership, understand and address physician burnout, as well as develop a culture that supports physician well-being.

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Physicians, of course, know how to refer patients for treatment for mental health disorders. But, he said, it’s essential with disasters such as the COVID-19 pandemic to take an approach that focuses on well-being and prevention, in addition to ultimately having to treat illnesses.

“These kinds of approaches protect health and enhance functioning,” Dr. Morganstein said.

One way to reduce stress is through interventions that foster five essential elements known as “psychological first aid.” It’s an evidence-based framework that supports resilience in individuals, communities and organizations, Dr. Morganstein said.

The five elements are:

  • Safety.
  • Calming.
  • Efficacy.
  • Social connections.
  • Hope.

Vietnam fighter pilot, prisoner of war and Medal of Honor recipient Rear Adm. James Stockdale “described the tension between the idea of sustaining a sense of hope while acknowledging and addressing the reality in front of us,” Dr. Morganstein said. “Both are critical in our ability to persevere in prolonged crisis, to sustain a vision of a better tomorrow and perhaps emerge even stronger.”

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Here are some ways to foster psychological or stress first aid personally, in the workplace and community.

Limit media exposure. Too much media is consistently linked with worse mental health outcomes. People who consume more media during disasters are more likely to feel unsafe, use more alcohol and tobacco, and have more symptoms of post-traumatic stress and depression and get less sleep.

Communicate thoughtfully. The words people use have power and a profound impact on community well-being and perceptions of risk. Messages developed using effective crisis communication and delivered by a trusted voice help people feel calm and safe.

Create a buddy system. This is a peer-support program that is more formal and can be especially helpful in areas where people are less likely to ask for help, such as the health care setting. Studies show health care workers are likelier to seek support from a trusted peer.

Embed a mental health professional. In a practice adapted from the military, a mental health professional works as part of the team, functioning more as a trusted colleague and less like a clinician. The professional provides encouragement, directs people to resources and helps them take steps toward self-care and advocacy.

Prepare for reintegration. After prolonged and high-stress events, some workers have difficulties similar to military personnel returning from deployments. For example, they may have a decreased sense of meaning for routine things or feel more irritated by routine, daily concerns. Anticipate the challenges of reentry and provide education to help reduce their stress and enhance their function.

“Crisis leadership involves both holding onto a vision of where things need to go, while taking steps to foster recovery in the present moment,” Dr. Morganstein said. “In any crisis, it’s important to remind ourselves and others that this will end, and most people will be OK.”