Healthcare providers need behavioral health support during COVID-19 outbreak

Healthcare workers have been on the front lines of the COVID-19 pandemic, providing care to the sick at great personal risk. Most of the proposed policies to protect their health and safety have focused on access to high-quality personal protective equipment (PPE) and other occupational safety needs. However, authors of a new Health Affairs blog post argue that a major component is being overlooked: behavioral health.

The article, written by Regenstrief affiliated research scientist Theresa Cullen, M.D., M.S.; and Andrew Meshnick from Georgetown University School of Medicine and Lilian Ryan from Georgetown University, addresses concerns about the impact of sustained, acute psychological and moral distress on those working the front lines. They have proposed a coordinated national strategy to identify, prevent, mitigate and manage post traumatic stress disorder symptoms in healthcare workers.

"Previous research has shown healthcare providers caring for critically ill patients and disaster survivors experience symptoms of PTSD," said Dr. Cullen. "I personally witnessed the impact a health crisis can have on frontline workers while working in Sierra Leone during the Ebola pandemic. Many U.S. healthcare workers now are facing similar stresses, and they lack access to services to help them cope. Action must be taken to address this, before the nation experiences an unprecedented crisis in its health workforce." Dr. Cullen was recently named public health director of Pima County, Arizona.

The authors present a three-part strategy:

1. Prevention
2. Treatment
3. Managing long-term effects

The authors urge the Occupational Safety and Health Administration (OSHA) to gather stakeholders to develop a critical incident stress mitigation standard for the healthcare industry and implement it. They also urge new PTSD screening measures. Individuals identified as at an elevated risk of developing PTSD should be offered treatment.

The goal of the treatment phase is to build behavioral health treatment capacity through public-private partnerships, creating a coordinated clinical team of primary care and PTSD specialists throughout the country. In part three, the authors state that the coordinated clinical team should use mechanisms developed in part two to guide health providers, as well as work to develop new evidence-based policies to manage PTSD.

"The lasting impacts of this pandemic are unknown," said Dr. Cullen. "As we continue to address this crisis, those providing frontline care must not be left behind. We need to prioritize both their physical and mental health."