When SARS hit Toronto in 2003, the effects were devastating. The impact stretched far beyond the patients who contracted the infection, and it had enduring psychological effects for health care workers and hospital staff.
“SARS was the perfect storm for traumatic stress,” said Dr. Molyn Leszcz in a recent webinar about the staff at Toronto’s Mount Sinai Hospital, where he served as psychiatrist-in-chief from 2006-2017.
According to a study he co-authored, led by colleague Dr. Robert Maunder, 33%–50% of SARS-exposed health care workers experienced substantial and lasting distress including symptoms of anxiety, depression, burnout and maladaptive coping.
And COVID-19 threatens to have the same effect.
Although the outbreak hasn’t peaked yet in Canada, health care workers are already experiencing emotional impacts. They’re dealing with a high degree of uncertainty, workload demands that are likely to intensify along with ongoing worries about access to personal protective equipment and contracting COVID-19.
Dr. Leszcz, a renowned expert in group psychotherapy, says building organizational resilience, “the ability to maintain or regain mental health in the face of adversity,” is essential to coping in this unpredictable environment.
As a leader or manager, you’re in the best position to foster a more resilient work culture for your staff. And there’s no better time to do it. Supporting your staff in this way now will not only help them cope with the current situation but can also help reduce the risk of long term psychological difficulties.
And there’s mounting evidence that an organization’s culture has a significant impact on clinical outcomes too.
If you have access to mental health professionals or experts in your organization, lean on them for guidance. If you don’t, there are still a few things you can do now to support your staff through this pandemic.
Educate yourself about signs of stress and trauma
Crises take a toll on everyone. Dr. Leszcz says that an important step in dealing with psychological distress is to normalize our responses to the pandemic: “if you can name it, you can tame it.” Do your part by educating yourself to recognize the signs using reliable sources. He says it all starts with being a good student of the self.
If you’re new to this, consider taking a mental health first aid course — it can increase awareness, help decrease stigma and pinpoint appropriate language to use.
Encourage others to do the same (if they can) and recognize their own signs — feeling anxious, stressed, scared, sad, overwhelmed, angry, guilty, helpless or even numb ― all of which are normal responses to this challenging situation. Remember that all of these are ok at any time, and it’s ok to seek support.
Guide them to any resources they may need to take care of themselves and encourage them to use them. Psychiatrist Dr. Caroline Gérin-Lajoie recently wrote an article about how clinicians can manage COVID-19-related stress, but the advice can be applied more broadly. Again, it all starts with self-awareness. There are many self-assessment tools out there (like this one) that can be helpful.
Carve out a regular time for reflective discussions with your team
Pick a time when most team members — both clinical and nonclinical — can meet in person by integrating these meetings into everyday workflows. If your team is already meeting for huddles, add a few extra minutes to check in and get a pulse for how the team is feeling. Actively encourage team members to express their concerns and ask how you can better support them. If this is new to your team, they might not feel comfortable sharing with the group — give them opportunities to speak up elsewhere. Listen with patience and compassion. You don’t need to have all the answers. Do your best to care for them, normalize their fears and convince them that you can weather this storm together.
Every time you meet with your team, Dr. Leszcz recommends that you strive for the “Hobfoll five”:
- A sense of safety: Be transparent. Address the risks and ongoing threat. Make it safe for your team members to speak up and accept reality as it is. Everyone needs the reassurance that people have their backs and that you’re going to work to make your workplace a healthy environment.
- Promote calming: Be clear with your message and make sure your team members feel heard. If you feel comfortable facilitating the group through a simple group breathing or mindfulness exercise, do it. It can help.
- Remind your team members of their sense of efficacy individually and as a team: This is an opportunity to be responsive, ensure cohesion and repair any regression as a group — always without shame or blame. Recall examples where the team worked well in the face of adversity. Encourage them to use the coping strategies that work for them.
- Connectedness: Members of your team have a unique, shared experience you can build on. Focus on communicating in a way that brings them together rather than fragmenting, polarizing or blaming.
- Talk about hope and sense of purpose: Remind your team, time and time again, why their work matters. If you can maintain hope as a group, you can stimulate will and create pathways for action. What you hope for will change over time, but there’s always something to be hopeful for.
Model the behaviours you want to see
This concept is simple. If you want trust, show you’re trustworthy. If you expect transparency, be transparent. If you’re encouraging staff to take care of themselves, remember to do the same for yourself.
According to an article by Nancy Koehn entitled “Real Leaders Are Forged in Crisis,” when leaders model actions like checking in or showing gratitude, team members will begin to do the same for each other, shifting organizational culture.
The British Psychological Society recommends managers take the following 10 steps to help ensure the psychological well-being of health care staff during and after the coronavirus outbreak:
- Provide visible leadership
- Have a communication strategy
- Ensure consistent access to physical safety needs (e.g., personal protective equipment)
- Ensure human connection and methods of pre-existing peer support
- Providing psychological care to patients and families is key to staff well-being
- Normalize psychological responses
- Deliver formal psychological care in stepped ways
- Innovate to implement psychological care
- Come back to your core values in making decisions
- Take care of yourself and pace yourself
Find champions who model these behaviours too
Seek out trusted people who can be spokespeople for better communication within the team. Maybe they’re exceptionally comfortable speaking to the group, or they’re a great “connector” or they have training in psychological first aid. Lean on them to strengthen this initiative.
Ask them if they would be willing to offer themselves up to the group as a “buddy” should someone need individual peer support.
Achieving resilience as a team won’t be an easy feat, but simply making it clear that you care for your team members and you hear their concerns can go a long way. These practices and the work you put in now will continue to benefit your team long after this pandemic is over.
This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including Joule. Feel passionate about this topic? Please connect with us at firstname.lastname@example.org.