How to Use This Guide

  • Within this section of the guide, you will find resources for health care providers
  • Highly recommended resources are denoted with a star (★)
  • Each resource also notes practical recommendations or strategies to help
  • This guide is a "living document" and may be continually updated over time. The date of last update is 6/18/20.

Health Care Providers Summary

Many health care workers are on the front lines for managing a COVID-19 outbreak. Whether due to increased job demands, coping with unusual circumstances and/or fears of contagion to self and others, an outbreak could have a profound impact on mental health and the ability to remain effective in rapidly evolving situations, while increasing the risk of distress, anxiety and burnout. Several resources have been developed specifically to highlight the mental health needs of health care workers. The resources below highlight several recommended strategies for health care workers including: preparing for heightened demands during an outbreak and monitoring own stress/well-being, and engaging in self-care/coping strategies but also: checking in regularly with family/friends/colleagues, pacing work and taking mini-breaks where possible, not overworking or ignoring personal needs, and connecting to a sense of purpose and service.

Note: A number of mindfulness apps have been made freely available especially for health care providers during this time.


In this guide:



Tips and Recommendations

Resource: Helping those who serve: How family members and friends can support healthcare workers during COVID-19
Source: Harvard T.H. Chan School of Public Health

Key points:

  • Oriented toward family and friends of COVID-19 essential workers, this session by Patricia Watson, PhD, introduces how to recognize when a loved one is in need, reviews strategies from Stress First Aid (SFA), and ends with a Q&A session with Karestan Koenen, PhD, and Kristina Korte, PhD

Resource: Caring for Yourself & Others During the COVID-19 Pandemic: Managing Health Care Workers’ Stress
Source: Schwartz Center for Compassionate Healthcare

Key points:

  • Recorded presentation from Dr. Patricia Watson (NCPTSD) on ways that healthcare workers can manage their stress during the COVID-19 outbreak
  • Potential stress reactions include anxiety; sense of helplessness; reduced confidence in self and system; anger; guilt; grief/depression about losses. Values of service and excellence can be strengths but also vulnerabilities for healthcare workers
  • Obstacles to self-care include attitudes (e.g., feeling selfish, ignoring needs, wanting to do more) and behaviors (e.g., working too long alone)
  • Stress First Aid (SFA) approach is based on peer support: recognizing signs of stress in a colleague/peer > approaching to discuss > deciding what support is needed based on presenting concern (e.g., sleep, guilt, anxiety, isolation)

Resource: Managing Health Care Workers' Stress Associated with the COVID-19 Virus Outbreak 
Source: National Center for PTSD 

Key points:

  • Heightened demands for health care workers during an outbreak include: increased workload; potential separation from family/friends; fears about infection to self and others; stigma
  • Preparedness can reduce stress among health care workers managing an outbreak. Specific training in outbreak-related protocols and communication/planning among staff can increase self-efficacy
  • Self-care strategies include:
    1. Self-monitoring/pacing
    2. Checking in regularly with family/friends/colleagues
    3. Taking self-care breaks for relaxation and stress reduction
    4. Practicing healthy self-talk and calibrating realistic appraisals of threat
    5. Balancing acceptance vs. control
    6. Connecting to hope and patience
    7. Avoiding unhelpful coping strategies like substance use or ignoring personal needs by overworking

Resource: Sustaining the Well-being of Health Care Personnel during Coronavirus and other Infectious Disease Outbreaks
Source: Center for the Study of Traumatic Stress

Key points:

  • Unique demands faced by health care workers during an outbreak include increased work demands; fears of infection; limited or uncomfortable equipment; managing patient distress and own emotions
  • Recommendations include:
    1. Meeting basic needs and taking breaks
    2. Connecting with colleagues and loved ones, and using constructive communication
    3. Staying updated while limiting media exposure
    4. Checking in with needs and wellbeing and honoring service efforts

Resource: Coronavirus and Mental Health: Taking Care of Ourselves During Infectious Disease Outbreaks
Source: American Psychiatric Association

Key points:

  • Specific stressors for health care workers include: potential equipment and staffing shortages; fears of infection to self and others; managing patients who may also be in distress; stigma.
  • Recommendations for health care workers include:
    1. Self-monitoring for signs of stress
    2. Prioritizing basic needs like eating and sleeping
    3. Taking self-care breaks
    4. Staying connected with family/friends/colleagues
    5. Accessing reliable sources of information
    6. Honoring the service performed by self and other health care workers

Resource: Mental Health and Psychosocial Considerations During COVID-19 Outbreak
Source: World Health Organization

Key points:

  • Managing mental health is just as vital as physical health during an outbreak.
  • Recommendations for health care workers include:
    1. Resting between shifts
    2. Maintaining positive lifestyle behaviors such as physical activity and eating healthy
    3. Staying connected to family/friends and sharing with trusted colleagues
    4. Leveraging coping strategies that have worked well in the past
    5. Avoiding substance use and other unhelpful strategies
    6. Be prepared for working with patients in distress or exacerbated mental health conditions

Resource: Emergency Responders: Tips for Taking Care of Yourself
Source: Centers for Disease Control & Prevention

Key points:

  • Recommendations include:
    1. Recognizing signs of burnout including sadness or apathy, frustration, irritability, isolation/disconnection, feeling exhausted or overwhelmed, substance use
    2. Creating a “buddy system” to check in with a colleague and monitor each other’s workload and self-care
    3. Engaging in self-care strategies like confiding in others, deep breathing, sleep and healthy eating, setting boundaries where possible
    4. Reminding yourself it is not selfish to take breaks, and working all of the time does not mean you will make your best contribution

Tools

Resource: Resilience Training for Healthcare Workers
Source: MGH Resilience & Prevention Program

Key Points: 

  • Free 3-session video course on resiliency skills for healthcare providers. The sessions are explicitly tailored to building psychological skills (e.g., mindfulness, flexibility, self-compassion) for managing stressors that providers face and feature personal reflections from providers on the front lines

Resource: COVID-Ready Communication Skills for Providers
Source: VitalTalk

Key Points: 


Resource: Clinician Self-Care in the Time of COVID-19
Source: McLean Hospital

  • Recorded webinar by Dr. Blaise Aguirre, medical director of McLean’s 3East dialectical behavior therapy program, on coping strategies for mental health professionals and health care workers during COVID-19
  • An “agitated, irritable, anxious” mind cannot think effectively--whereas a calm mind can help support others, problem-solve and sleep better. Dr. Aguirre summarizes skills for regulating intense distress, tolerating difficult moments, and acting mindfully.

If you have comments or would like to suggest an addition to the guide, contact: Karmel Choi, PhD and Jordan W. Smoller, MD, ScD.