Feeling anxious? It’s normal, and there are good things you can do

Understanding the likely psychological impacts of a crisis on healthcare workers, Monash Health Head of Psychology, Adjunct Professor Melissa Casey, and her team reached out to offer real and practical support to their colleagues as soon as the scope of the COVID-19 pandemic became clear.

They took the initiative and their considerable experience, with a proposal to establish a free and confidential service for Monash Health employees – Call a Psychologist.

Providing a same-day response, the service has been up and running since 30 March 2020. The psychology team was able to get the service up and running so quickly and mobilise the resources,  thanks to the strength of connections they have within psychology and across Monash Health.

In addition to delivering their usual services via Telehealth and getting used to working remotely, the Monash Health psychology team has been helping their peers process their experiences at the front line and how they may be impacting on wellbeing and mental health.

Call early before the pressure gets too much

The message from the Call a Psychologist team is, get in early! Don’t wait until you are really in distress before you call.

“We’ve been doing Psychological first aid in EDs after critical incidents for quite some time, so we knew what the need would be,” Melissa said.

“If people are under stress for a long time, it wears them down. Their natural resilience and coping mechanisms are reduced.

“Anxiety can have a ‘dose impact,’ and you need specific relief. We know that if we can intervene early, people can stay on top of their mental health.”

Melissa said what the team is observing is that we have amazing people doing amazing things.

“Teams are under enormous pressure, and they are doing very well. But we have a message, and that is reach out early; don’t let the team get dysfunctional before you call.

“People can be in distress and still doing an exemplary job; they might just need some additional support.”

Responses to team and individual issues are targeted based on need. “We go out and listen, seek to understand the situation and then tailor the response. These things are very personal, and one size doesn’t fit all.”

Just in the past three days, the Call a Psychologist team has seen 79 people to provide support.

The phone service is tracking issues such as people’s concerns over managerial handling of the crisis, individual safety at work, the impact of change in work practices due to COVID-19, family and relationship issues and team support.

Anxiety is contagious

Melissa has also been sharing her message that the mental health impacts of the response to COVID-19 are real, and potentially just as damaging as the virus.

She has delivered her presentation ‘Anxiety is more contagious than COVID-19’, to managers, at medical grand rounds, to the Board and the executive. And people are listening.

Melissa opens her presentation with a quote from researcher, Sara Reardon, published in Nature in 2015, having studied the mental health impacts of the Ebola pandemic: “During epidemics, the number of people whose mental health is affected tends to be greater than the number of people affected by the infection.”

Health care workers, particularly those at the front line of treatment, may well experience increases in depression, anxiety, and sleep disorders.

Those with existing mental health issues can be more vulnerable.

There has been a community message which has cut through strongly in this pandemic period and it’s ‘We’re all in this together’. The message rings true for the potential ongoing impacts of this pandemic. We need to keep a close eye on our own psychological reactions to everything from isolation, fear of contagion, increased social adversity, work pressure, right through to potential exposure to the virus.

As teams at Monash Health, we need to look out for our community and spot the signs early. This will be important even as the pandemic starts to plateau, because that may be the time some issues start to emerge.

You can download Melissa’s presentation here. And here are a few highlights:

Spot the signs

As well as recommending basic self-care and psychological first aid for teams, Melissa thinks it is vital we all understand what is normal distress that can be managed by self-help and wellbeing strategies and what psychological distress cannot be  – knowing the signs that indicate when professional mental health input is needed.

What’s normal

  • Fear, anxiety, shock, denial, disbelief, anger, irritability, guilt, shame, sadness and hopelessness
  • Feeling disconnected and numb
  • Difficulty concentrating
  • Insomnia and recurrent dreams
  • Being easily startled
  • Aches, pains, muscle tension, agitation, general fatigue.

Signs that more help is needed

  • Having difficulty functioning at home, unable to rest or take time out (not caused by work demands)
  • Experiencing severe anxiety, fear, depression, excessive irritability and anger
  • Unable to maintain close family relationships, withdrawing and isolating yourself
  • Feeling emotionally numb and distant, emotionally disconnected from work and colleagues
  • Having persistent intrusive memories, consistently feeling overwhelmed and/or out of control
  • Using alcohol or other drugs to manage thoughts and feelings
  • Avoidance “I’m fine, too busy, not available”
  • Feelings of self-blame or guilt if you are unable to act or respond within your own moral code
  • Pre-existing vulnerabilities which may be exacerbated by the intensity of the crisis (for example, you always had a tendency to worry, but it didn’t impact functioning, but now it does).

Help is available

An expanding program of health and wellbeing support is available for you. Right now you can:

  • Call a Psychologist – Call 0418 905 414, 9am – 5pm, Monday to Friday
  • Call the EAP (extra hours and services are available since the start of the pandemic). Your family members can call the EAP too on
  • Access practical resources and links to reputable sources on the health and wellbeing pages of the coronavirus website for employees. You can access these pages inside and outside of work.

A program of wellbeing content will be included in upcoming weekly employee Webex sessions. Keep an eye out for more details.

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