Examining the Mental Health Toll of Disasters

The psychological and behavioral impacts of a disaster are experienced by more people, over a larger geographical area, and for far longer than all other medical effects combined, Joshua C. Morganstein, MD, said at the American Psychiatric Association (APA) Spring Highlights Meeting.

Dr. Morganstein, associate professor and assistant chair in the department of psychiatry and assistant director at the Center for the Study of Traumatic Stress (CSTS) at the Uniformed Services University, presented a session at the virtual meeting on sustaining health care workers and organizations during the COVID-19 pandemic.

“If history is any predictor, we should expect a significant tail of mental health needs that extend for a considerable period of time after this event,” said Dr. Morganstein, who is also chair of the APA Committee on the Psychiatric Dimensions of Disaster.

The effects may be most significant for people who were already struggling before the crisis, he said, and clinicians should begin working with the most vulnerable persons now, to try to prevent longstanding difficulties from developing.

COVID-19 Colors Opening of APA Virtual Spring Highlights Meeting

Health care workers face a unique set of challenges throughout the pandemic, he said, including ongoing concerns about personal and family safety, working outside their scope of practice, and changing policies and procedures.

Also, “frustration, fatigue, and anticipation of ‘the next wave,’ are creating new stressors,” he added. A recent study of health care workers exposed to the novel coronavirus in China found high rates of anxiety, depression, insomnia, and general distress.

People exposed to the most extreme stress during the pandemic, such as frontline health care workers, are at risk for developing post-traumatic stress disorder, Dr. Morganstein said.

Due to the large number of people affected by the pandemic, population-based approaches are needed to supplement clinical interventions from mental health professionals, Dr. Morganstein said. He recommends the use of practical resources such as the APA COVID-19 Resource Page, CSTS COVID-19 Response page, and Pandemics: Health Care Emergencies, and the Department of Veterans Affairs’ Psychological First Aid mobile app.

Dr. Morganstein also recommended the following steps:

• Limit exposure to media coverage of the pandemic and advise patients to use media widely.

• Seek out a “battle buddy,” someone you can stay in contact with regularly who will encourage you to care for yourself and tell you when it’s time to seek help.

• Remind people the crisis will eventually end.

• Look for opportunities to make improvements based on lessons learned during the pandemic.

• Remember the vast majority of people, including those who experience difficulty during the disaster, will ultimately do well in the long-term.

—Terri Airov

Reference

“Preparing for a Marathon: Healthcare Worker & Organizational Sustainment During COVID-19.” Presented at: the American Psychiatric Association Spring Highlights Meeting; April 25, 2020.