How Covid-19 Has Affected the Mental Health of Frontline Workers

A doctor treating Covid-19 patients says the amount of death her team has seen is "overwhelming and surreal," and new mental health practices have been implemented to help frontline workers cope.

Specializing in the treatment of seriously ill patients, Sonia Malhotra is no stranger to having to care for dying patients.

But the coronavirus pandemic has challenged her and her team in ways she says she couldn't have imagined.

Malhotra is the director of palliative medicine and supportive care at University Medical Center New Orleans and assistant professor of medicine and pediatrics at Tulane University and the director of palliative medicine and supportive care at University Medical Center New Orleans.

"We're still seeing people come in with the coronavirus," she says. "We're still seeing people requiring ICU level care and hospitalizations. I've seen young people die from it. I've seen middle aged people die from it. I've seen old people die from it. There is no rhyme or reason with this virus."

UMCNO is one of the few hospitals in the New Orleans area allowing up to three family members to visit their dying loved ones in full protective gear in the last moments of their fight against the virus.

"In terms of mental health, this has definitely taken a toll on our nurses, our fellow physicians, all of our health care staff, including our trainees," she adds.

Malhotra says one of the areas where medical education and medical curricula need to do a better job is teaching resiliency strategies to better prepare doctors and health care workers to be able to have resilience through moments like this, through a pandemic.

"We've had to be very thoughtful about creating programs to attend to everyone's mental health needs," she says. "Some of those include virtual first aid groups, psychological first aid groups through the Tulane Department of Psychiatry and the LSU Department of Psychology, as well as doing the things such as the daily check-ins with our teams. So, making sure that we're doing daily check-ins with our nurses, our trainees, our fellow physicians."

The hospital has also launched a bereavement program where health care providers stay in touch with families who lost loved ones to the virus for a full year after their loved one has died. It not only helps grieving families but "it's also good for our mental well-being," Malhotra says.

Mental health experts say talking to colleagues and in some cases a psychologist is an important first step, but health care workers may be needing more than that after three months of caring for sick and dying patients and with no end to the pandemic in sight.

"We know anxiety, depression, post-traumatic stress or acute stress and anxiety are all going to be common things that we see occur in first responders as well as folks in the general community, but especially in first responders, doctors, nurses, social workers," says Patrick Bordnick, dean of the School of Social Work at Tulane University in New Orleans. "Over time, we all are vulnerable, and we'll start to break down, no matter how good we are."

Bordnick says in order to build stamina and resilience in the months to come, self-care is vital, and that means a complete mental, physical and emotional break from the job for several minutes each day – and days away when needed.

Bordnick says the stresses of the pandemic don't go away once frontline workers get home.

He and others at Tulane recognized the need for a "onestop" selfcare resource for coping and created to provide free resources with no distracting ads, so that employees and the general public can quickly and easily find something of interest to achieve mindfulness and meditation, whether for a few hours or just a few minutes.

"We intentionally created these videos to be short and guided," he says. "You can look at them on your phone. You can go into a room where nobody is at and just sit there and give yourself that mental and emotional release and break and just to calm yourself."

The site includes a variety of healthy mental "indulgences" such as free concerts, virtual art galleries, cooking and painting segments with New Orleans chefs and artists.

Tulane partnered with the National Mental Health Innovation Center in creating the site, so it also includes resources for parents, teachers and children.

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