Managing Mental Health During a Medical Health Crisis

The COVID-19 public health emergency has highlighted the need for comprehensive mental health treatment, not just for patients and their loved ones but also for the healthcare providers themselves.

This need is particularly acute in rural areas, where access to care is generally more scarce than in urban centers. According to the HRSA’s Designated Health Professional Shortage Areas Statistics, 61 percent of designated Mental Health Professional Shortage Areas are located in rural areas.

Address the Mental Health Needs of Front-Line Healthcare Personnel

Physicians, nurse practitioners, and other healthcare providers on the front line of this crisis may find themselves especially vulnerable to mental health issues, as they juggle the demands of treating more patients with fewer resources while worrying about their own heath, as well as the health of their loved ones.

“Everyone, healthcare providers included, has lost his or her coping mechanisms,” said Roger Barnhart, a consultant and interim CEO who provides C-suite leadership to rural hospitals and skilled nursing facilities. “All of a sudden, you can’t go to your gym, you can’t go to church, you can’t see friends. Without these coping mechanisms, you may wind up self-isolating, which leads to depression, or you might turn to unhealthy behavior.”

With this in mind, it is more important than ever for hospitals to increase their capacity for mental health services. When it comes to effectively addressing the mental health needs of healthcare workers in this pandemic, the following measures are recommended:

Remain transparent with staff. When it comes to treating patients during a public health emergency, worker stress cannot be eliminated. It can be contained, though, often via increased communication among hospital staff and leadership.

Barnhart recommends calling “daily huddles,” wherein hospital staff members come together at the start of each shift to go over challenges, such as equipment shortages, and what can be done about them. These quick meetings remind hospital staff that their concerns are at least being heard.

Remind staff to stay flexible. The healthcare industry is one that depends on organization and protocol. However, as new challenges arise with each day, it is vital that staff members remain capable of improvisation.

“Trying to control something that is uncontrollable leads to great anxiety,” Barnhart said, “but with the pandemic, we’ve had to remind staff that this is all fluid, that different people may have to pitch in to get the job done. I actually think the changes this has forced us to embrace will make for a better healthcare system going forward.”

Beware of information overload. While keeping open the lines of communication between leadership and staff is essential, there is such a thing as “information overload,” where the sheer amount of what’s being communicated can cause stress on the intended audience.

“Because the information seems to be coming from all sides, after a while you’re not actually learning anything new,” Barnhart said. “It becomes just this constant barrage, capable of disrupting caregivers’ thinking, their feelings, their mood, their daily functions, and their ability to care for others.”

Expand Mental Health Service Offerings to Patients

Below are some measures Barnhart recommends for expanding mental health services for patients:

Maintain an effective bedside manner. While healthcare workers have gotten used to donning masks, goggles, and gloves the second they enter the facility, it may be a shocking sight for patients, not just those with possible behavioral issues but also children and the elderly. An effective bedside manner—complete with plainly spoken medical directions—can go a long way toward quelling a patient’s anxiety and letting him or her know there is a human being underneath the gear.

Confirm (and expand) established referral pathways for mental health cases. One possible advantage rural hospitals have over urban hospitals is that they play a larger role in the community, including the community’s overall healthcare network. This means patients can be easily informed of other services, whether state-based or national, that provide mental health services.

If no such pathways exist in your organization, now is the time to reach out to state departments of health, medical societies, and local religious associations for guidance on mental health resources.

Recognize the potential of telehealth. Telehealth has in recent years helped countless doctors monitor their patients’ chronic conditions or deliver care quickly in emergencies. However, the time has come for telehealth to take on a greater role in patient counseling.

Patient transportation issues are removed from the equation, making telehealth for mental health services ideal for rural populations. Furthermore, the stigma attached to mental health issues is minimized, since counseling sessions can be conducted in the privacy of the patient’s home.

“Not to put too positive a spin on this, but I’m hopeful this will promote greater telehealth utilization,” Barnhart said. “There’s no sense in having an elderly person who needs regular counseling drive an hour to see their therapist. Payors weren’t exactly aligned behind telehealth before, but they’re getting aligned now.”

Despite the current coronavirus-induced healthcare crisis being temporary, the measures hospitals and healthcare facilities put in place now can have lasting effects. Successfully mitigating the impact stress, isolation and anxiety can have among healthcare workers and patients now may pave the way for better mental health outcomes for patients long after the crisis has passed.