Physician Health

Well-being resources should extend beyond a crisis to include PTSD

COVID-19 has taken a toll on physicians and other health professionals on the front lines of care. But the crisis few are talking about is the mental health and well-being of health care workers beyond the pandemic. While post-traumatic stress disorder (PTSD) is commonly linked to war veterans, this mental health condition can also be triggered by suffering or witnessing terrifying events such a disastrous pandemic. Getting ahead of traumatic stress will be key moving forward.

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Rush University Medical Center Chief Wellness Officer Bryant Adibe, MD, commissioned a special Wellness Task Force to focus on well-being as the COVID-19 pandemic emerged. Five wellness task force tactics were designed to prioritize physician health, including an outlook on preventing PTSD after the pandemic ends with the development of an advanced emotional well-being screening tool.

“We know that the psychological impact is only now beginning. This is something that we have been preparing for over the past several weeks, which really was the impetus for launching the task force in the first place,” said Dr. Adibe, vice president of Rush University System for Health in Chicago. “Just as Rush has been innovative in addressing the clinical side of COVID-19, we are also striving to be proactive in addressing the psychological impact over the long-term.”

“After a disaster like this, it takes time for people to come down from the adrenaline high and emotionally process all that they have experienced,” he said. “The literature tells us that most likely over the next several months, or longer, many people will begin to really feel some of the emotional impact of this pandemic.”

“Our job is to be prepared for that in advance and to take steps to mitigate issues that could occur without intervention,” said Dr. Adibe.

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Identifying PTSD therapies

To identify acute and chronic stress disorders, including PTSD, an advanced emotional well-being screening tool was developed. Originally designed for military personnel returning from deployment, this tool has been adapted for health care workers on the front lines of the COVID-19 pandemic. The broad dissemination of the tool will have a special focus on clinical areas most directly impacted by the pandemic.

“We are working closely with the clinical experts in our Road Home Program, which is a federally-funded initiative to assist veterans who are transitioning from active duty back into civilian life,” said Dr. Adibe.

The tool is being deployed over the next few weeks as a way to assess the emotional well-being of those on the front lines of COVID-19 care. “It’s not just the identification of pathology or emerging issues,” said Dr. Adibe. “Embedded within it are tailored therapeutic interventions.”

As physicians and other health professionals complete the survey, “it recommends, based on the answers that you’ve input, evidence-based interventions, which can be shared directly with an experienced therapist, in order to treat any underlying issues that may have been identified as part of the screening,” he said. “Treatment and intervention are really important components, particularly now as we look at the downstream impact of COVID-19.”

“We have a number of therapists available on-site, and remotely, with extensive experience working with our veterans, patients, and others following traumatic events,” he said.

“Just as we were able to level the curve with our clinical cases, so to speak, through hand-hygiene, social distancing and by being proactive, we think if we can start early and be innovative with our approach to well-being we can also level the curve relating to psychological trauma,” said Dr. Adibe.

The AMA is offering a free survey to help health care organizations monitor the impact COVID-19 has on their workforce during this pandemic. The survey can be used to track trends in stress levels, identify specific drivers of stress, and develop supportive infrastructures based on these drivers. Organizations that use the survey will receive free-of-charge support from the AMA in launching the surveys and access to data through an easy-to-use reporting dashboard.

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Getting ahead of the problem

Many health professionals worry they will get sick and infect others, which has caused many to self-isolate to keep their families safe after providing COVID-19 care. It can weigh heavy on mental health, potentially leading to long-term consequences after the pandemic. The tool will work to provide care for these individuals proactively.

“There will be significant downstream impacts when you have a pandemic of this scope.” said Dr. Adibe. “One of the largest of these is the psychic trauma or the psychological impact, which can be widespread. That can include things like substance misuse, exhaustion, burnout, and acute and chronic stress disorders.”

“Some of the conceptual frameworks that experts have developed during this timeframe show the reverse surge, as I call it, now starting to pick up and accumulate as we look to the weeks and months ahead of us,” said Dr. Adibe. “Our job at this state is to identify those segments of our population who may be disproportionately impacted and provide interventions to mitigate long-term effects.

“That is identifying, preparing and addressing the reverse surge before it gets here,” he said. “That’s really what’s driving a lot of our work. We want to ensure that those who need help the most can get it; quickly, consistently, and without fear of stigma.”  

The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.