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Compassion Fatigue and COVID-19

The COVID-19 global pandemic is taking a physical, mental and emotional toll on doctors, nurses, healthcare workers and caregivers. The long work hours and limited resources are causing overwork, exhaustion and in some cases, compassion fatigue. Not to mention balancing your work with the concerns for your own family and loved ones.

What is compassion fatigue?

Compassion fatigue is a state of chronic physical and mental distress and exhaustion. People with this fatigue often describe a negative shift in their world view and a preoccupation with the illness of others. They may experience stress and burnout, affecting their ability to be effective in their jobs and relate to their loved ones and friends.

Tips for preventing compassion fatigue:

  • Make self-care a priority. Despite your workload, do your best to practice healthy habits. Focus on making sure you are staying hydrated, sleeping as much as possible, eating nutritious meals and getting exercise when you can. Follow the COVID-19 CDC guidelines on keeping yourself and your family’s risk low.
  • Boost your emotional resilience. Deep breathing, meditation, being grateful and allowing yourself some down time are ways to keep your life in balance, so you are better able to handle stress, setbacks and crises.
  • Get social support. Reaching out over the phone or through a text message to supportive loved ones, friends and colleagues can be a calming influence and shift your perspective on what you are dealing with every day.
  • Be proud of your profession. Your work is important. You are caring for people during the first-ever pandemic caused by a coronavirus and giving them hope and strength.
  • Seek professional help. If you are experiencing distress and/or symptoms of burnout, take advantage of your healthcare and employee assistance benefits and meet with a behavioral health professional who can help.

We wholeheartedly thank you for all you are doing to care for others and combat this outbreak.

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




Mitigation and COVID-19

When I was a child visiting my grandparent’s Iowa farm, I would often hear stories of how my mom and her eight brothers and sisters lived during the war efforts of the 1940’s. My grandma described a common purpose—that sense of pride that the family rationed and repurposed. Their singular focus was that the good of the individual was less important than the whole of the country, even the world.

Watching the coronavirus make its way across the world and rapidly grow in the United States, I can’t help but think of those stories. As the shelves of Costco and Sam’s Club stores emptied this weekend, and school closures were announced community by community, it made me realize that our time to step up is now. Our singular, collective focus needs to be mitigation and in order to be successful, mitigation efforts need to be embraced and enacted on by us as individuals.

What is Mitigation?

Mitigation is a strategy to reduce the seriousness or impact of a natural disaster, such as a pandemic. The goals of mitigation include minimizing morbidity and associated mortality, avoiding an epidemic peak that overwhelms healthcare services, keeping the effects on the economy within manageable levels, flattening the epidemic curve to wait for vaccine development and manufacturing to reach populations, and actively pursuing the development of antiviral drug therapies. Practically, mitigation relies on social distancing—measures that are taken to restrict when and where people can gather to stop or slow the spread of infectious diseases such as the coronavirus.  Social distancing measures include limiting large group gatherings, closing buildings and canceling events. However, for mitigation to be successful, individuals, even those who are asymptomatic, must be willing to self-isolate.

Self-Isolation Challenges

In a society as mobile as ours, and where high degrees of social contact is the norm, self-isolation is challenging. For instance, if one has become accustomed to eating meals outside the home, the transition to grocery buying and cooking may seem formidable. If one is used to getting together with friends to play cards, go running, have a beer after work, the loss of those types of activities will create holes in one’s social network.

We are fortunate to have an infrastructure in which many people can work from home and education can be delivered virtually. Workers who cannot isolate because the nature of their work cannot be done virtually, must take precautions. While in the workplace, distancing at least six feet, maintaining high levels of handwashing and the use of hand sanitizers is a must.   When returning home, it is best to avoid being in the presence of those most vulnerable to coronavirus—elders and persons with underlying comorbidities. It is also important to acknowledge that one may feel anxious and may not have all the answers that our members or clients are seeking. Maintain lines of communication with co-workers and supervisors. For those who are new to work at home, talk to coworkers for whom this has been the norm to get some advice on structuring the workplace and the day. And don’t forget that you can use technology to connect with friends. Facetime, Skype and other video conference capabilities are a great way foster your relationships during social isolation.

Mitigation is a critically important strategy to quell the spread of the virus. It has been beneficial in China as new cases are now falling. In areas where community spread is mild, targeted isolation of high-risk people, or those who may have come in contact with the virus, can be implemented. Even inside households, those with symptoms should keep distance from the healthy. And, even if you are asymptomatic, but have been in a high-risk area or where there is growing or wide community spread, it is important to maintain social distancing and self-isolation.

Social distancing and isolation are not easy—but I am trying to look at them as the Victory Gardens of my mother’s childhood. I hope that 50 years from now, my grandchildren will hear stories of how the United States and the world beat back the coronavirus, and I hope that my children who are on this journey with me now will reflect and recognize the importance of a global community, productively working together for the common good.




Addressing anxiety about the coronavirus (COVID-19): Healthcare workers

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.




Addressing anxiety about the coronavirus (COVID-19)

As the coronavirus disease (COVID-19) continues to evolve with ongoing media coverage, many people are experiencing anxiety due to the uncertainty about how this will impact them. They are worried about the impact to their communities, how they can protect themselves and their families, and how to be prepared if the situation disrupts the normal course of daily life.

It is normal to feel anxious, unsettled, distracted, scared and/or overwhelmed by COVID-19 and the uncertainty surrounding its impact to communities. Some people may be more vulnerable due to pre-existing physical and mental health conditions, including generalized anxiety disorder.

Feeling stressed can affect the immune system and increase the risk of getting ill in general. That is why it is important to take steps to manage anxiety and reactions to this evolving situation. The following suggestions can help people manage anxiety and stress for themselves and their families:

  1. Seek health information from trusted resources like the U.S. Centers for Disease Control & Prevention (CDC), The World Health Organization and state health department websites.
  2. Plan ahead to feel more in control. Make contingency plans for work, childcare or travel if it becomes necessary.
  3. Wash hands often, get plenty of rest, exercise, eat well, don’t smoke and limit alcohol consumption.
  4. Put things into perspective:
    1. Of the 80,000 confirmed coronavirus cases reported in China, “more than 70% have recovered and been discharged,” according to the World Health Organization (WHO) in a news conference on Monday.1
    2. Per the CDC, only certain groups, such as older adults and people with serious chronic medical conditions, are at higher risk of getting very sick from COVID-19.2
    3. Public health officials are working to mitigate the virus’ spread.
  5. 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.

Magellan Healthcare has resources to help people during crises and difficult times. Our Crisis Communications website provides topical information and connects people with U.S. resources, and our Mind Your Mental Health site addresses many topics related to emotional well-being.

1: https://www.cnn.com/asia/live-news/coronavirus-outbreak-03-09-20-intl-hnk/index.html, “More than 70% of coronavirus cases in China have recovered, WHO says,” posted 3/9/20, 7:25 p.m. EDT, Jacqueline Howard, accessed from site 3/10/20, 12:57 p.m. EDT.

2: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html#who-is-higher-risk, accessed 3/10/20, 12:34 p.m. EDT.

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.




4 Tips to Foster Mental Health in the Workplace

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/

 

 




Public Health Spotlight – Coronavirus

On January 31, 2020, the United States (US) issued a public health emergency for 2019 novel coronavirus (2019-nCoV), a new virus first identified in Wuhan City, Hubei Province, China. This comes on the heels of the World Health Organization (WHO) declaring the coronavirus outbreak an international public health emergency. The disease now called coronavirus disease 2019 (COVID-19), which is a new type of coronavirus without a vaccine or medications to prevent or treat it, has resulted in thousands of confirmed cases and hundreds of deaths in China. This human respiratory illness is moving quickly with cases reported in a number of other countries and continents. In the US, while the number of confirmed cases are currently low, safety measures are being enacted to keep the risk of transmission low. As ongoing investigations seek to learn more about this infection, US public health agencies have dedicated coronavirus sites. They actively update these sites as new information becomes available and communicate up-to-date guidance. 

 

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.




Mental Health in the Workplace: One Size Does Not Fit All

Mental health disorders are among the costliest health concerns for employers in the United States. According to the National Institute of Mental Health, nearly one in five adults live with a mental illness. Depression and anxiety are among the most common mental health disorders but often go undiagnosed and untreated.1

Many factors may contribute to mental health issues, including traumatic or abusive life experiences, biology, and family history of mental health problems. Unfortunately, social stigma and fear of discrimination prevent many people from seeking help.

Employee mental health impacts the bottom line

Poor mental health and stress can negatively affect employee job performance, productivity and relationships. In addition, as physical health is inextricably linked to mental health, many people with mental health disorders are at high risk for chronic physical conditions such as heart disease, diabetes and respiratory illnesses.2

The reverse is also true; physical illness, such as cardiovascular disease, may cause or worsen mental health issues, particularly symptoms of depression.3 Healthcare costs to treat people with both mental and physical disorders can easily be two to three times higher than for people without co-occurring illnesses.4

Employers have a unique opportunity to improve employee mental health

Investing in mental health treatment in general has proven to be cost-effective. Employers can reduce health care costs for their businesses and their employees by addressing mental health issues in the workplace. Many evidence-based treatments can save $2 to $4 for every dollar invested in prevention and early intervention.5 An effective approach is not one-size-fits-all but takes into consideration generational differences and employee diversity.

A recent study published in the Harvard Business Review called “People want their employers to talk about mental health” indicated that millennials (the cohort of people born between 1981 to 1996) were three times more likely to experience anxiety than baby boomers.6 Gen Zers (those born between 1997 to 2012) report even higher rates of anxiety and depression. Millennials and Gen Z employees are the largest demographic in the workforce, and those who took part in the survey indicated an expectation that mental health be addressed in the workplace openly and without stigma.

Develop a customized approach to promoting mental health resources

The Harvard Business Review study recommends a multi-faceted approach that includes a more accepting culture starting from the top, with training and support, as well as clear information about employee resources such as availability of mental health benefits, wellness programs and employee assistance programs.

Employers should be cognizant of where their different employee groups seek information and use those channels (whether it’s the intranet, staff meetings, one-on-one meetings, employee resource groups, digital signs and posters, instant messaging platforms, or other social media venues) to provide needed information. Virtual mental health counseling and the availability of mental health apps offer convenient and mobile-friendly emotional support, particularly for younger employee groups accustomed to using their smart phones for everything from texting to shopping.

Dislodging stigma and experimenting with different communications channels to meet the needs of a diverse workforce can be challenging for human resources departments and managers. But the end result will be worth the effort: a healthier work environment that supports healthier employees and enhanced productivity.

Learn more about how your organization can benefit from an EAP solution.

 

1 “Facts & Statistics.” Anxiety and Depression Association of America, ADAA, https://adaa.org/about-adaa/press-room/facts-statistics.

2 “Chronic Illness & Mental Health.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml.

3 “Chronic Illness & Mental Health.” National Institute of Mental Health, U.S. Department of Health and Human Services, https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml.4 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2748662?

5 Lerner D, Lyson M, Sandberg E, & Rogers W.H. (2018). The High Cost of Mental Disorders- Facts for

Employers. Retrieved from https://onemindinitiative.org/at-work/the-business-case/

6 Greenwood, Kelly, Bapa, Vivek, Maughan, Mike (2019). Research: People want their employers to talk about mental health. Retrieved from https://hbr.org/2019/10/research-people-want-their-employers-to-talk-about-mental-health




Teen Dating Violence

Teen dating violence is just as serious as adult domestic violence. And it’s common. About 2 in 10 teen girls say they have been physically or sexually abused by a dating partner. About 1 in 10 teen boys reports abuse in dating relationships.

Teen dating abuse is a pattern of abusive behavior used to control another person. It can be:
•Any kind of physical violence or threat of physical violence to get control.
•Emotional or mental abuse, such as playing mind games, making you feel crazy, constantly texting you, or constantly putting you down or criticizing you.
•Sexual abuse, including making you do anything you don’t want to do, refusing to have safer sex, or making you feel bad about yourself sexually.

Who’s at risk?

Like adult domestic violence, teen relationship abuse affects all types of teens, regardless of how much money your parents make, what your grades are, how you look or dress, your religion, or your race. Teen relationship abuse occurs in straight, gay, and lesbian relationships.
Relationship abuse is not just dangerous for you physically and emotionally. It can also put you at risk for other health problems, such as:
•Eating disorders.
•Depression.
•Low self-esteem.

Teens in abusive relationships are also more likely to take sexual risks, do poorly in school, and use drugs, alcohol, and tobacco. Girls are at higher risk for pregnancy and sexually transmitted infections (STIs).

Is it abuse?
Abusive relationships can have good times and bad times. Part of what makes dating violence so confusing is that there is loved mixed with the abuse. This can make it hard to tell if you are really being abused. But you deserve to be treated in a loving, respectful way by your boyfriend or girlfriend.

Does your boyfriend or girlfriend:
•Act bossy and make all the decisions?
•Put you down in front of friends?
•Try to control who you see and talk to?
•Threaten to hurt or kill himself or herself?
•Blame you for “making” him or her treat you badly?
•Pressure you to have or force you to have unprotected sex?
•Stalk you? This can include constantly texting or calling you to find out where you are and who you’re with. You might think that’s about caring, but it’s really about controlling the relationship.

Do you:
•Feel less confident about yourself when you’re with him or her?
•Feel scared or worried about doing or saying “the wrong thing”?
•Find yourself changing your behavior out of fear or to avoid a fight?

If you answered “yes” to any of these questions, you might be in an abusive relationship. There are people who can help you. You’re not alone. Talk to your parents or another adult family member, a school counselor, a teacher, or someone else you trust. Call a help center or hotline to get help.

How parents can help

Teens may not have the experience or maturity to know if their relationships are abusive. A teen may think of dating violence as only physical violence—pinching, slapping, hitting, or shoving. Teens may not realize that any relationship involving physical violence, sexual violence, emotional abuse, or the threat of violence is an unhealthy relationship.

For example, a teen may think his or her partner cares when he or she calls, texts, emails, or checks in all the time. But that kind of behavior is about controlling the relationship.

Talk with your teen about what makes a healthy relationship. Explain that a caring partner wouldn’t do something that causes fear, lowers self-esteem, or causes injury. Let teens know that they deserve respect in all of their relationships. Think about values and messages that you want to pass on.

You might start by asking your teen:
•Is your boyfriend or girlfriend easy to talk to when there are problems?
•Does he or she give you space to spend time with other people?
•Is he or she kind and supportive?

Hotlines for help
These national hotlines can help you find resources in your area.
•National Domestic Violence Hotline toll-free: 1-800-799-SAFE (1-800-799-7233), or see the website at www.ndvh.org.
•National Teen Dating Abuse Hotline toll-free: 1-866-331-9474 or (1-866-331-8453 TTY) or see the website at www.loveisrespect.org.

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