From the Pennsylvania Department of Human Services, Office of Mental Health and Substance Abuse Services
As a behavioral health provider, you are likely experiencing additional challenges during the COVID-19 infectious disease outbreak. This may include concerns about your own health, your family’s health, stigma from within your community, and managing the distress of people you support in your professional life.
We acknowledge the risks you take every single day, and we recognize that with the COVID-19 outbreak the world feels upside down. You are shifting your office setting to telepractice, learning new technologies, determining who needs a face to face appointment and how to do that safely, and where to send people who may be in more distress. We recognize that with all the changes comes increased stress.
We also recognize the increased risk and burden placed upon you and your family. If you are still needing to see people face to face for support of their behavioral health condition, your duty to serve can put you at increased risk of getting sick and conflicts with your own safety. That is a stress most will never understand. We thank you for showing up day after day, or for shifting to work through technology, while the rest of the community may not understand all the nuances of what you do. We thank you for your bravery and dedication to serving others every day, and especially during this crisis.
The intention of this kit is to provide resources to help preserve your own resilience and mental health, as well as that of your family. Additionally, it highlights areas you can monitor for yourself and your peers during this crisis, in order to seek help early in coping with the unique stress you experience. Many front-line behavioral health providers are experiencing increased levels of depression, anxiety, insomnia and stress. You are not alone in these feelings, and there are resources to help you get through them.
First – Be safe!
The best way to prevent the spread of illness is to use frequent, consistent hygiene practices as you enter and exit settings and to stay home when you are sick. Behavioral health providers have shifted so much to technology, but even doing that work emotionally supporting others can be exhausting.
If you are still engaged in face to face encounters, you may have direct contact with sick and otherwise vulnerable populations. Screening staff and making sure staff have and use personal protective equipment (PPE) such as cloth face covers or masks while interacting with others or at a work location and follow effective entry and exit hygiene when they report for duty reduces the risk to patients and other employees.
Every healthcare worker, including behavioral health workers, should screen themselves every shift. If you are feeling ill or experiencing fever, cough, fatigue, or loss of smell– stay home and contact your employer for further direction regarding potential testing, isolation and shift coverage, in accordance with their COVID-19 Plan. If you work in an adult foster care setting or a residential facility, identify a coverage plan in case you become ill, so your patients know where to go.
We encourage the following protocols when working at a quarantined location that include:
- Try to wear a specific pair of shoes that you can leave in a safe place as soon as you arrive home (don’t walk through your home with the same shoes you wear at work).
- If possible, take your clothes and mask off and straight to washing machine (garbage bag/laundry bin).
- Shower before interacting with others or touching items in your home.
Have a Plan In Case You Develop Symptoms
Discuss with your manager or supervisor what will happen if you develop symptoms of COVID-19. If symptoms occur while at work, notify your manager, LEAVE the workplace and contact a medical professional for screening. Have answers for the following questions:
- Where will you isolate?
- How will you isolate from your family to protect them?
- How will you be compensated during isolation?
- How long will your employer expect you to remain off duty? What is the policy for returning to work?
- Are there tasks you can do from home if you must isolate?
Plan to Prevent and Manage Illness at Home
Find ways to get your family involved in routine and emergency activities that prevent the spread of illness in your home.
Prevent illness in your household:
Teach your family best practices for hand washing, cough and sneeze hygiene, and surface cleaning.
Plan for illness in the household
Behavioral health workers have unique needs when it comes to planning for illness in the household. Discuss with your family what to do if you become ill, or if another family member becomes ill. By participating in creating the plan, your family members may feel less overwhelmed and empowered to follow through if it is needed.
- Consider separate living spaces and bathrooms.
- Create a plan for childcare and pet care if you become ill.
- Create a family plan for where you will isolate (at home or away from home) if you become ill.
- Discuss the possibility for increased shifts, longer shifts, schedule changes, increased travel, or telework during this crisis.
- Update your emergency contacts.
- Fill out your emergency plan.
- Review supply checklists.
Recognize When You Need a Break
Stress is easiest to manage when there is time to rest, recover and then to re-engage in a better frame of mind. But when stress is persistent and chronic, we must be proactive and intentional in managing it for ourselves and in our efforts to support those who rely on us to encourage healthy coping, self-care and maintenance of hope.
Understand that a pandemic is a persistent crisis and as such it will trigger chronic or repetitive stress responses in the body which will need to be managed on an ongoing basis to avoid exhaustion, burnout and compassion fatigue.
Behavioral health workers facing chronic stress with concerns about personal safety, heavier workloads and increasing intensity of demands both at work and at home, may also struggle with feelings of resentment and loss related to changes in the social and economic landscape. The fact that COVID-19 is human-to-human transmissible, relatively unknown, economically destabilizing and potentially fatal may intensify the feelings of personal danger.
It is important to be able to recognize the physical, cognitive, emotional and behavioral signs of stress in yourself and others.
Signs can include worry and irritability as well as defensive or even combative impulses, withdrawal and extremes of emotional sensitivity which may be out of character or unusually evident. At work, people may be more distracted, impatient, critical or argumentative than usual. At home, there may be changes in appetite and trouble sleeping, increased use of alcohol, prescription or other drugs, sense of not enjoying normal activities or difficulty maintaining healthy hygiene, exercise and other self-care routines. Recurring thoughts, dreams, or flashbacks are normal—do not try to fight them.
But remember, if your sleep is so disrupted that it is hard to function, take time off and seek mental help. You cannot emotionally support others as well if you are having difficulties and not maintaining your own balance. Behavioral health workers, their supervisors, and organizational leaders can take intentional steps to help each other de-escalate these normal stress responses in the face of the COVID-19 pandemic and its economic consequences by stopping for a moment to breathe mindfully, doing S.E.L.F. check-ins whenever needed and creating Personal Wellness and Resiliency Plans.
Keep Your S.E.L.F. Healthy
Telling someone the story of what is going on, and giving our narrative a beginning, middle and end is an important part of how the brain regulates stressful or traumatic events. Behavioral health workers provide this support for those in their care every day.
As a behavioral health program leader, supervisor or co-worker, one of the most important things you can do right now is to establish ways for behavioral health workers to access safe opportunities to check in verbally with someone who can provide an active listening presence.
Talking though our experiences and receiving validation, affirmation and support from others “on our team” is how we process stress and trauma. Encouraging a mindful breath and a brief S.E.L.F. check-in and then providing some respectful support for a co-worker, supervisee, or family member’s own problem-solving abilities, once they are
ready to decide what they need and how to move forward, can pay big dividends for everyone as we all navigate this crisis together. Focus on encouraging each other’s S.E.L.F. Care in practical and concrete ways through consistent connection!
Create a Personal Wellness and Resiliency Plan
Behavioral health workers, just like all those in healthcare, need to take care of their own health to be able to provide care for individuals in a high-stress environment. Workers must be able to stay focused on the job in the dynamic, uncertain environment. Creating a Personal Wellness and Resiliency plan helps prioritize both physical and mental health to fight against illness, burnout and compassion fatigue during this time of extraordinary stress.
This pandemic is a marathon, not a sprint.
Wellness & Resiliency Tips for Behavioral Health Workers during COVID-19
- Monitor alcohol consumption or use of prescription or other drugs
- Drink plenty of water & eat healthy food
- Take walks for exercise & fresh air
- Practice Mindful Breathing/ Yoga, etc.
- Keep in touch with friends and family
- Limit media exposure
- Recognize & accept the things you cannot control
- Permit yourself to have your feelings
- Do a S.E.L.F check in when you can
- Lift one another up with presence, gratitude, hope & kindness
- Seek professional help if you are frequently struggling to sleep or to function
More Resources for Behavioral Health Workers
For Your Family
Department of Human Services Support and Referral Line: 1-855-284-2494/ TTY dial 724-631-5600
Statewide Support and Referral Helpline staffed by skilled and compassionate
caseworkers who will be available 24/7 to counsel Pennsylvanians who are struggling
with anxiety and other challenging emotions due to the COVID-19 emergency and refer
them to community resources that can further help to meet individual needs
PA Get Help Now Helpline: 1-800-662-HELP
This 24/7 helpline gives residents of Pennsylvania intervention help for free in drug
addiction and substance abuse. It is managed by the Department of Drug and Alcohol