As winter approaches, efforts in many states across the country to control a second rise in COVID-19 infections also mean continued social isolation and hardship for millions of people. High, chronic levels of stress resulting from unemployment and economic insecurity, school closures, disruption to normal routines, illness, and loss have a negative impact on mental and physical health. In addition to the burden of the pandemic, simmering political and social tensions have left many people feeling distressed and threatened.[1]

As a nation, we face a challenging winter even as coronavirus vaccination news looks promising. It will be months before a vaccine can be widely distributed across the population, and even then, life may not be back to normal. In the meantime, it is important to monitor and care for your mental health as we move through this next phase.

People at Risk

A significant number of Americans report feeling depressed and anxious as a result of the pandemic. People who are already prone to mental health problems, people with low incomes, minorities, young people and isolated older adults (especially those living in facilities) are at higher risk of depression.

If you or a loved one are struggling with persistent feelings of sadness and hopelessness that last for two weeks or more, have lost interest in things you used to enjoy, have thoughts of self-harm and/or experience sleep disturbances and changes in appetite, it is important to see a doctor for an evaluation and possible treatment of your symptoms. There are effective treatments for depression, including medication and various therapies.

Building Resilience

There are several ways to build resilience and prepare emotionally for winter shutdowns. Research shows that resilience skills can be learned and include the following:

• Social connections. A strong social support network is one of the most important parts of building resilience. If face-to-face contact is not possible, stay in touch with family and friends by phone or video. Check in on friends and neighbors who are having a hard time.
• Pay attention to negative thoughts and practice gratitude. Resilient people tend to be optimistic and flexible in their thinking. If the constant negative bombardment of news and social media makes you anxious and unhappy, limit or take a break from your screen time.
• Assess what you can and cannot change. Focus on positive actions that you can take, even if the possibilities seem limited. Tap into your talents: revisit an old hobby or try something you’ve always wanted to do.
• Take care of yourself. Maintain routines, get enough sleep and exercise and eat a healthy diet. Avoid using alcohol or other drugs to combat sadness or boredom.

Having goals and a purpose can also increase resilience. The pandemic has led many to rediscover a new appreciation for their gifts, relationships and the values that give meaning to their lives. If you are doing all the right things to build your resilience and still feeling down, make an appointment with your doctor. You will get through this.

For more information and tips, visit MagellanHealthcare.com/COVID-19.

[1] Nancy Schimelpfening,“This COVID-19 Spike Will Also Hit our Mental Health with a ‘Second Wave,’” September 23, 2020, Healthline, https://www.healthline.com/health-news/this-covid-19-spike-will-also-hit-our-mental-health-with-a-second-wave#Why-is-the-pandemic-putting-our-mental-health-at-risk?

Stress and anxiety caused by the coronavirus pandemic pose a serious challenge for all age groups. A survey published by the American Psychiatric Association in March 2020 showed that more than one-third of Americans (36%) feel that the coronavirus pandemic is having a serious impact on their mental health. Most Americans (59%) report serious impacts on their daily lives.¹ Calls to crisis hotlines have increased exponentially. In recent studies, adults aged 18 to 44 report emotional and mental health problems associated with the pandemic.

Given that mental-health problems among young adults were on the rise even before the pandemic began, some experts believe that the country is on the verge of a mental-health crisis. Worse, quarantine and closures of medical practices have, in many cases, made access to personal treatment difficult or impossible. Fortunately, state and federal regulations have enabled the expansion of telemedicine services, including treatment for mental illness. Virtual therapies may well be the answer to the needs of millions of people in the mental-health field.

Proven efficacy

Research shows that online treatments can have positive results for a range of mental health problems, including depression, panic disorders, PTSD, eating disorders, anxiety disorders and substance use disorders. Telephone and video-based psychological care and evidence-based treatments such as online cognitive behavioral therapy (CBT) have proven to be as effective as face-to-face therapy.²

The benefits for patients go beyond making treatment more accessible. Virtual therapy offers convenient modalities including live chats, text messaging, video and telephone sessions. Appointments are easy to schedule at convenient times. Virtual therapy is an attractive alternative for people with transportation problems or time constraints. People who are worried about being seen in a therapist’s practice, and those who are reluctant to use traditional mental health services may benefit from increased privacy. In many cases, virtual therapy sessions are more affordable than face-to-face sessions.

Best practices

It is important that therapists have the clinical expertise, licenses and qualifications to virtually treat patients. Reliable technology and secure platforms to ensure customer confidentiality are also crucial. Virtual therapy can solve many mental health problems. However, it is not suitable for patients who are suicidal, psychotic, severely mentally ill or have other illnesses that call for in-person care.

Due to the pandemic, health care is developing rapidly. Magellan Healthcare recognizes the need for additional telemedicine options and is now offering BetterHelp, the world’s largest online counseling service, to help Employee Assistance Program members access convenient therapy options quickly and easily. Click here to learn more about how Magellan is helping our members their mental health, emotional well-being and quality of life.

[1] Psychiatry.org. 2020. New Poll: COVID-19 Impacting Mental Well-Being: Americans Feeling Anxious, Especially For Loved Ones; Older Adults Are Less Anxious. [online] Available at: <https://www.psychiatry.org/newsroom/news-releases/new-poll-covid-19-impacting-mental-well-being-americans-feeling-anxious-especially-for-loved-ones-older-adults-are-less-anxious> [Accessed 13 July 2020].

2 Gratzer, D. and Khalid-Khan, F., 2020. Internet-Delivered Cognitive Behavioural Therapy In The Treatment Of Psychiatric Illness

When your workplace is disrupted by a tragic event, employees may feel overwhelmed, anxious, insecure, and distracted. Everyone reacts differently to stress events, but tragic workplace events are serious and can cause significant physical, cognitive, and emotional reactions. A team of experienced mental health consultants can help reduce the negative impact of the event and its long-term impact on the organization, speed recovery, and return people to everyday life. Critical event interventions can also prevent post-traumatic stress disorder (PTSD).

Types of traumatic events

Tragedies come in many forms. Typical traumatic events include the unexpected death of an employee, a chronic illness of an employee, an injury at work, robberies, shootings and other acts of violence, criminal attacks, industrial or natural disasters, or even organizational restructuring or dismissal. People who have witnessed the event or know the people affected can experience a number of symptoms of the stress response, such as:

• Insomnia, nausea, dizziness, fatigue, racing heart, headache and loss of appetite
• Nightmares, hyper vigilance, panic attacks, intrusive images and poor concentration
• Feelings of anxiety, guilt, depression, irritability, anger and fear
• Social withdrawal and self-medication with alcohol or other drugs [1]

Critical events can also trigger memories of previous intense stressors.

How Magellan’s Employee Assistance Program Can Help

Magellan’s Critical Incident Response (CIR) team consists of specially trained clinical staff who are available 24 hours a day, 365 days a year. CIR Consultants help employees process and manage the emotional and physical effects of a traumatic event.

The first step is to consult with you about what has happened and assess the situation. Once the situation is assessed and an action plan is developed, we will send a CIR consultant to your workplace within a reasonable and agreed time frame. The CIR consultant will carry out a structured intervention on site to help deal with the incident, if necessary, and will also be available to managers and individual employees if needed. Services are confidential and provide employees with the resources and support they need to cope with the stress and anxiety caused by the event and return to normal life.

Our broad spectrum of CIR services includes management consultancy, telephone crisis support, group and individual support for affected employees, as well as follow-up care.

Critical incidents and tragic events occur in all types of companies and industries. Preparation with an existing CIR program is key to effectively managing the aftermath and associated risks.

[1] https: //www.osha.gov / SLTC/emergencypreparedness/guides/critical.html

May is Mental Health Awareness Month. This is an opportunity to increase public awareness of mental health conditions.  We can break down the stigma by ending the silence. About 1 in 5 Americans experience mental illness. It is important to be able to talk openly about it to get people the help they need. It is particularly timely this year, as we are seeing stigma associated with COVID-19, and we must do what we can to stamp out stigma in all its forms.

Understanding mental illness

According to the National Alliance on Mental Illness (NAMI), a mental illness is a condition that affects a person’s thinking, feeling or mood. Such conditions may affect someone’s ability to relate to others and function each day. Each person will have different experiences, even people with the same diagnosis. If you have — or think you might have — a mental illness, the first thing you must know is that you are not alone. Mental health conditions are far more common than you think, mainly because people don’t like to, or are afraid to, talk about them.

Mental illness can affect anyone regardless of age, gender, income, social status, religion or race/ethnicity.

• 1 in 5 U.S. adults experience mental illness each year
• 1 in 25 U.S. adults experience serious mental illness each year
• 1 in 6 U.S. youth aged 6-17 experience a mental health disorder each year
• 50% of all lifetime mental illness begins by age 14, and 75% by age 24

Depression and anxiety disorders are the most common mental health disorders worldwide.

The exact causes of mental illness are not fully understood. However, factors that can contribute to mental health problems include:

• Genes and family history
• Biological factors such as brain chemistry and brain injury
• Serious medical conditions
• The use of alcohol or other drugs
• Traumatic life experiences
• Isolation and other social factors

Mental illness is not a character flaw or something that a person can just “snap out of.” For many people, recovery — including meaningful roles in social life, school and work — is possible, especially when you start treatment early and play a strong role in your own recovery process.

Sadly, many people never seek treatment out of fear and shame. The stigma of having a mental illness or substance use disorder is two-fold: people suffer needlessly even though effective treatments are available, and they’re also at higher risk of premature death. For example, people with depression have a higher risk of heart disease and cancer. Studies also show that people with severe mental illness have a higher incidence of chronic diseases and tend to die 10 – 25 years earlier than the general population.¹

Stamping Out Stigma

Everyone experiences the ups and downs of mental health. Many people have a mental illness or know a friend or family member who has struggled with one. To stamp out stigma and get people the help they need NAMI offers these practical tips:

• Talk openly and honestly about your own experiences with mental illness and addiction.
• Educate yourself and others about the facts of mental illness. Mental disorders are treatable just as physical diseases are, and people with mental illness are not to blame for their condition.
• Recognize the signs of mental illness and seek professional help when needed.
• Show empathy for those living with mental health and substance use disorders.
• Be aware of your attitudes and language used to describe mental illness and people with mental illness. Jokes and name-calling are hurtful and perpetuate demeaning stereotypes.

Let’s work together to Stamp Out Stigma!

Sources:

[1] Management Information Sheet. (n.d.). Retrieved from https://www.who.int/mental_health

²Social Stigma associated with COVID-19. (2020, February). Retrieved April 10, 2020, from https://www.unicef.org/media/65931/file/Social%20stigma%20associated%20with%20the%20coronavirus%20disease%202019%20(COVID-19).pdf

As the pandemic grows, healthcare workers are experiencing a new level of stress and fear. Since our first piece about healthcare workers and mental health, the toll that COVID-19 cases have taken on them has become more difficult than any could have imagined.

First, let us again say thank you to all of you, from EMTs who answer the first calls to the doctors and nurses who tend to the sickest. Your selflessness and heroism is inspiring.

We’ve set up a counseling hotline for healthcare workers and first responders at 1-800-327-7451 (TTY 711). Your call will be answered by our licensed mental health clinicians. Our team is trained and ready to listen and help during this difficult time.

There are so many things that are out of our control. We are dependent on others to address many aspects of the big picture, but there are things outlined below that we can do for ourselves and those close to us. No single recommendation is enough by itself, but when taken together, they may help.

Talk about it

Acknowledge your anxiety, fear and grief, and talk about it.

Many of our colleagues and friends say that leaning on fellow healthcare workers is very difficult. Everyone’s heart beats a little bit faster when they greet a COVID-19-positive patient, so how can we ask them to support one another? Yet this is what we do as a medical community daily. Peer support is key.

• If a compassion fatigue group isn’t available at your workplace, work with your employer to put one together.
• If a group option isn’t available, talk to your co-workers about what you are seeing and how it is affecting you. You’ll be surprised at how many share your feelings but have been afraid to say anything. Hospital workers have talked about how a quick meeting at the beginning of their shift, during a break or at other times—to talk, pray, or have a moment of silence—has helped them tremendously.¹
• Many hospital systems have been deploying their psychiatric workforce as volunteers to help colleagues who need it.² Ask your employer if this is available.
• If you don’t want to talk about it at work, find a former co-worker or friend from school or training to talk to, or contact Magellan Healthcare at the phone number above.
• Finally, if you are at a point where your feelings impact your ability to perform or feel comfortable in your role, talk to your supervisor or your organization’s human resources group about your employee assistance programs. Monitor your physical and mental symptoms. You may reach a position that you need to be treated by a behavioral health professional. If that happens, contact one as soon as possible.

Make your voice heard

Some healthcare workers are feeling betrayed by their employers and others.² Whether it’s lack of PPE, feeling unappreciated or being expected to work excessive hours, these feelings can make an already untenable situation worse. While there is much you cannot control, don’t let that stop you from advocating for yourself and others.

• Ask for more PPE or the protocols for how it is allocated. Understanding why things are happening can help people accept them and enable you and your colleagues to offer suggestions from the front lines.
• If you are frustrated about things that you see, think about how you would make them better. Make a list and discuss them with coworkers to come up with solutions. Once things slow down, you’ll have strong suggestions for improving your work environment.

Maintain focus

• Remember why you became a healthcare worker. Maybe you watched a family member battle an illness, or you felt a calling to help people. Think about that during these times.
• Remind yourself that what you are doing is noble. The cognitive impact of recognizing the value you offer will help you serve your patients in a positive way.
• Consistent with your training and dedication, keep your focus on the patient in front of you, on protecting yourself to the best of your abilities and extending those protections to the home setting when you are off work.
• When you are off work, turn your focus to what is happening in the moment.

Take care of yourself

• We acknowledge that recommending meditation or focusing on breathing in the midst of chaos and fear may not seem helpful for some. Think about how you breathe when you are stressed. Some of us hold our breath without realizing it; others breathe very shallowly. We don’t realize it until we get around to taking a real breath.
• As you work around people with COVID-19, you might be afraid to breathe deeply. If you can, try to go to a place where you feel comfortable doing so, and take a few deep, slow breaths. Something as simple as this can release stress and clear your mind.
• Exercising may feel like a lofty goal as well. Try to find 10 minutes for a brisk walk, or a quick set of jumping jacks, sit-ups and push-ups.
• If you don’t have time or energy to cook, find easy-to-eat fresh foods like bananas, oranges and carrots.
• To help you relax and get to sleep, try apps like Headspace, Calm and Balance. AMA members can access these for free.
• Finally, if you are on medications for a pre-existing behavioral health condition, don’t stop taking them, and contact your provider if your symptoms are getting worse.

For more information and tips, visit www.MagellanHealthcare.com/COVID-19.

With stock market volatility and worrying headlines about how long the pandemic will last, it’s hard not to feel uneasy and question what the future holds. Consider these tips and resources to help you work through financial decisions and challenges that you may face in the weeks ahead.

Create a budget

Make a list of your regular monthly expenses, like rent, loan payments, utilities, food, etc. Compare that with your household’s take-home pay. If you are bringing home more money than your expenses, consider putting a bit of the extra to the side as a financial cushion. If your budget is more than you bring home each month, look for places you can cut to make ends meet. For help, visit www.consumer.gov.

Control your spending

Being isolated and bored at home can give you a lot of time to shop online. With so much uncertainty, it’s important to resist the urge to buy impulse items. Prioritize your most important financial obligations such as food, shelter and transportation first, and items like household décor and extra clothing last. If necessary, consider pausing automatic bill payments so you can control the payment timing until you are on better financial footing.

Contact your lenders (mortgage, car, rent, utilities, student loans, etc.)

If you are unable to work due to COVID-19 – you’ve fallen ill, your place of employment has temporarily closed, you have to stay home and take care of children or loved ones who are ill, etc. – you may not be able to pay your bills. Many lenders have set up exceptions, special accommodations and relief funds to support the public during this health crisis. Take advantage of them.

Reach out to your credit card company

Even if your credit card issuer has not formally released a statement of support, if you are at risk of missing a payment, it is worthwhile to contact the company to discuss your options. The Federal Deposit Insurance Corporation (FDIC) advises on its website that during a disaster, “Your creditors will likely work with you on a solution, but it’s important to contact them as soon as possible and explain your situation.” Late payments can hurt your credit score, and pile on extra charges and fees, so getting ahead of the issue will save you down the road.

Be aware of financial scams

If you receive a phone call, text message or email asking for your financial information in exchange for COVID-19 testing or medication, do not provide it. Unfortunately, fraudulent companies are taking advantage of people worried about COVID-19 and trying to steal their money and/or sensitive information by offering unproven cures. In particular, note that the World Health Organization is warning about people posing as their representatives to get sensitive information and solicit donations through emails, phone calls, text messages and even fax messages. You can find links to sources of fraud reports at MagellanHealthcare.com/COVID-19/fraud.

Discuss finances with your partner or someone you trust

Concerns over money is at or near the top of the list of things that stress most of us out. It’s important to communicate with your partner and family about finances on a regular basis to understand your situation and agree on financial priorities. If necessary, consult with a financial professional.

Access community resources

• State and local human service agencies can connect you with public assistance programs such as food stamps or emergency financial funds, Medicaid, housing and the like. Learn more at hhs.gov/programs/social-services/index.html.
• The United Way has information on food banks, clothing closets, shelters, rent and utility assistance, support for older Americans and persons with disabilities, etc. Visit www.unitedway.org.
• Aunt Bertha is a social care network where you can search for services like medical care, food, job training, transportation and more, right in your area. Visit www.auntbertha.com.
• The U.S. Government offers benefit information for individuals younger than age 55. Visit www.benefits.gov.

To learn more about what Magellan Healthcare is doing to support clients during the  COVID-19 pandemic, visit  MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

The novel coronavirus (COVID-19) outbreak in the United States continues to evolve, with more cases and quarantines popping up on news feeds everywhere. The closer it gets to their homes, the more people are worrying. In our last post, “Addressing anxiety about the coronavirus,” we talked about the things people can do to help feel less anxious and more in control. But what about the people on the front lines? Nurses, doctors, healthcare workers and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public. What can they do to take care of themselves, physically and emotionally?

As Kushal, Gupta and Mehta stated in Study of Stress among Health Care Professionals: A Systemic Review, “Work related stress is a potential cause of concern in healthcare workers and is associated with decreased job satisfaction, days off work, anxiety, depression, sleeplessness , medical errors and near misses.” Long shifts and working with sick people—some of whom are gravely ill—can lead to burnout and anxiety from their normal jobs. These already-struggling healthcare workers are now faced with COVID-19 unknowns and demands, including taking care of people with confirmed cases of the virus.

While some people may feel they are at the whims of the virus, there are things healthcare workers can do to take some control over their work environment and manage their fear or anxiety.

• Know what your organization’s plans are. Read the business continuity plan and know your role. Talk to your team members about cross-training and covering for each other if one of you gets sick. In addition, ensure you are following proper protocols for cleaning and preventing spread. Visit cdc.gov for helpful information. This is particularly important for behavioral health providers who may not always think about universal precautions.
• Surround yourself with green. If your facility permits, bring in a few plants to liven up your surroundings. Being around plants has a calming effect on people. Employees who work in offices with plants tend to feel better about their jobs, worry less and take fewer sick days.¹ If you can’t have plants in your space, take time to look out the window and find some green. You may find that is enough for a quick mental break and perspective.
• Use small tools to create a calming environment. A small water feature, a sand garden or hourglass, stress balls and other items can provide a quick way to refresh your mind. Or just step back, take deep breaths, stretch and/or meditate.
• Find someone to talk to. Some hospitals have on-site or on-call chaplains; take advantage of them. Don’t be afraid to talk to your coworkers about how you are feeling. Chances are, they are feeling the same way and would welcome a discussion. Many medical settings offer a form of rounds that addresses the emotional impact of caring for a particular patient or theme. Similar semi-structured discussion groups with peers can be very helpful in handling stress and preventing the development of PTSD.²
• Get professional help. Be open to contacting your organization’s EAP, if you have one, or reach out to a therapist if you find yourself developing “compassion fatigue,” where your desire to help others erodes.
• Limit exposure to media. Media outlets have a tendency to sensationalize stories, so it’s important to consume news thoughtfully and with a critical eye.

In addition, do all the normal things to take care of yourself: try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs. Doing these things can have a positive impact on your mental health and help you manage anxiety.

For more information and tips, visit MagellanHealthcare.com/COVID-19. We wholeheartedly thank you for all you are doing to combat this outbreak.

1: https://www.webmd.com/a-to-z-guides/ss/slideshow-health-benefits-houseplants.

2: See Schwartz rounds.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.

Stress in the workplace can negatively impact job satisfaction and productivity, leading to low morale and employee turnover. In a 2018 Korn Ferry survey of nearly 2,000 professionals, 76% said that stress at work has had a negative impact on their personal relationships and 66% said they have lost sleep due to work stress.¹ Common causes of stress at work include: fear of being laid off, more overtime due to staff cutbacks, pressure to work at optimum levels all the time and lack of control over how work is done.² So what can employers do to support employees and create a culture that fosters mental and physical health?

The Building Blocks of an Emotionally Healthy and Safe Workplace

According to the American Psychological Association, while every organization is unique and faces different challenges, there are five practices that make up the foundation of a healthy workplace: employee involvement, work-life balance, employee growth and development, health and safety, and employee recognition.³

Employee involvement and engagement requires honest and regular communication between top management and all employees. A Gallup poll of more than one million American employees showed that the top reason people leave their jobs is because of their bosses, not because they dislike their position.4 Methods to empower and motivate employees include ensuring they have the tools they need to do their jobs, allowing flexibility, encouraging collaboration and teamwork, and showing appreciation.

Work-life balance is also vital. Programs and policies, such as employee assistance programs (EAPs), offer resources to help employees with all aspects of life, from childcare to financial concerns. Opportunities for employee growth and development include educational offerings, tuition assistance, mentoring, and leadership development. Investing in employee development helps employees develop their skills, increases staff motivation, and attracts top talent.

Health and safety initiatives encourage mental and physical well-being. Examples are wellness programs that promote a healthy lifestyle, such as smoking cessation, stress management, weight loss, and more. Again, EAPs offer a wealth of resources for all employees on how to achieve and maintain physical and emotional health.

Finally, expressing appreciation and recognizing employee contributions go a long way to promote job satisfaction. Recognition does not necessarily have to be monetary. Studies have shown that while compensation and benefits are important to workers, feeling valued and respected is even more critical.

Benefits

It may take time to tailor these approaches to fit with company culture, build trust, and meet the needs of employees. But the benefits of an emotionally healthy and safe workplace are many: higher morale, improved performance, reduced absenteeism and turnover, and a positive reputation that attracts and retains employees. Employees who are motivated and engaged are also better able to handle organizational change and other stressors.⁵

1 (2018, November 18). Retrieved from https://www.kornferry.com/institute/workplace-stress-motivation.

2 Segal, J., Smith, M., Robinson, L., & Segal, R. (n.d.) Retrieved January 6, 2020 from https://www.helpguide.org/articles/stress/stress-in-the-workpalce.htm

3 Retrieved January 6, 2020 from https://www.apaexcellence.org/resources/creatingahealthyworkplace/

4 Retrieved January 6, 2020 from https://www.linkedin.com/pulse/employees-dont-leave-companies-managers-brigette-hyacinth/

5 Retrieved January 6, 2020 from https://www.apaexcellence.org/resources/creatingahealthyworkplace/benefits/