Frontliners are not superheroes. They are humans. Humans who have feelings. Feelings that are sometimes overlooked as they are expected to step up and carry out their duties as normal despite the risks involved. Just when the world stopped, they were asked to work and save lives. Just when others were told to stay home, they cared for patients affected by coronavirus. In between protecting themselves and saving a life, there was no easy route to find peace to settle on the uncertainty of survival and professional obligation they have sworn to do.
We have been told by numerous experts that in order to protect ourselves from contracting the virus, we have to preserve our physical health. Support our immunity and perform good hygiene. But how about our mental health? Are we really okay or are we barely keeping it together? Behind the smile upon arriving to work is fear of the unknown. Behind the casual talks is the worrying thoughts of getting infected. Behind the hugs to a loved one, is the uneasy feeling from fear of passing the virus.
Maybe it’s about time to identify our feelings and make realistic adjustments. Try to be completely honest on how you feel about the situation. Because just as much as we need to take care of our physical health, our psychological well-being deserves to be looked after too. It is also comforting to know that someone has our back. And despite the support we get from our families and friends, we might still need an extra boost to aid our mind health.
The NHS has a team of experts that delved deeper into understanding the impact of the pandemic to health workers and devise a framework that will help them get through their experiences on each phase of dealing with the crisis. They looked closer on understanding the fear and anxiety of staff in the frontline or whoever has involvement in response to the Covid 19 and how it affects them personally and professionally.
According to Dr. Sonya Wallbank, a consultant psychologist and the national lead for Clinical Health and Mental Well-being, there are three phases that will be happening in the lives of healthcare staff during this pandemic. And within these phases, her team have established an evidenced based framework to help staff get through these adversities.
In the preparation stage, health workers are consumed with fears and worries about their safety and their family's health. The emotional burden doesn't stop there. For instance, some have been redeployed and now working out of their comfort zones causing a great deal of stress on whether they can provide care to patients safely and how much support they will get through this unprecedented time.
After the preparation stage, we’ve gone into the active phase. This phase is the time where we are all consumed with work. Everybody is working hard, all the hands to the pump. Dr. Sonya reassured, "We all know it’s really difficult for people to pay attention to their own health and well-being needs at this time. What we are trying to do through the offer is to let the healthworkers know that we are here, we know you are busy but paying attention to this NOW is critical.”
The phase that Dr. Sonya's team is planning for beyond the peak of the activity is the RECOVER PHASE. A time for reflection, on what this journey has meant to teams and individuals and about the decisions they have to make.
“We are on the second dip now and the peak of the active phase (depending on where you are in the country) is passing. This will give us a time really start to think about what we’ve just been through and its impact on us. What we know in the NHS is that there will be another peak: when the system recovers and we put back all the services together. This is going to be hard for some people because, of course, we will still work incredibly hard but we will be out of the limelight and clapping will cease. We will start to think about how hard we've worked up to this point. So having time to rest and recover is really important. We can take this great advice from the military. They know that after deploying people for a specific period of time, they needed a chance to take a breath and rethink what they've been through.", Dr. Sonya explained.
Dr. Sonya and her team expects that after everything has settled, some will be impacted severely with what they've been through despite the teamwork and the support they received. She also emphasised that the experience is individual for people. "There is no real prediction at this stage as to who will be affected but what we have to make sure that we're taking the space to allow people to recover in the way that they need", she added.
Despite the pressing need for mental health support for health care staff, they recognise that there’s no rush for them to jump into psychological intervention. Dr. Sonia explained, “What we are saying at this stage is that these are distressing circumstances, the support of your team and in our office is exactly what we are looking to provide. And that whether you are in the absolute frontline or further away, we know that people have been affected in different ways. Both from guilt for not playing their part, right through not just feeling a hero."
If you need additional support or just need to understand what you've just been through, the Health and Well-being (HWB) encourages to get in touch with all the services offered that’s suitable for your circumstances. There are different ways for health workers to access support during Covid-19.
The listening lines which is a text service, is manned by volunteers with clinical expertise in the background. You can start having a conversation with a person just by texting Frontline so you can voice out your feelings and concerns. Hospice UK also offer bereavement and loss support for the general public. There’s also a host of resources at the www.people.nhs.uk website that may help you think about your needs and the needs of your team during this time.
Well-being webinars are also held every Wednesday at 16.00 about topics that will really help people think about their support needs and recognise the need to seek help. There’s also a range of downloadable applications to help with sleeping or how to process the anxiety that you may be feeling as the result of your work.
Silvercloud, a digital mental health platform, offers full access with mental health modules which are completely confidential. They are designed for you to work at your own pace to learn about mental health such as how anxiety and resilience works.
You are more than welcome to attend “common rooms” which is a safe space online manned by psychological practitioners to support you to have a structured conversation and process what’s happening for you. You can also meet people who are doing similar work like yours and share experiences with one another.
Samaritans are also supporting us, Filipinos, with a listening helpline. Hospice UK, offering bereavement and loss line, have also set up a specific Filipino staffed bereavement service with Tagalog speakers. The team also had Filipino nurse volunteers for peer support conversation.
The Health and Wellbeing Team are also working with King’s College London on a "How am I" and "How are you" tools. This will help you understand what might be happening with your own mental health and the type of support that is available to you. This also gives tools to Line managers on how they can check on their staff and ensure they have that structured mental health conversation with them. The Citizens’ Advice Bureau is also a great support for finances and getting other practical things sorted.
“We knew from other incidents that the effects of something like this can go on for 2 to 7 years. So we really have to prepare for this. All the support and services offered have been commissioned for the longer term. This is not something that will go away overnight.”, Dr. Sonya articulated.
The team is also looking at commissioning a national response to mental health as they anticipate that 30% of the workforce will probably need mental health intervention. Nevertheless, they will ensure that it is appropriate and provide ways for the communities to inform the people how to make those services feel like they’re more accessible.
Now that you are aware that there are support in place to maintain your emotional and psychological well-being, will you consider using these services? As a helping workforce, we are terrible for seeking help for ourselves. We are used to caring for others and putting other's welfare first before our own. Keep in mind that caring for your well-being is not a selfish act. You need it in order to be able to function at your maximum capacity to care for others. Compassionate and inclusive leadership at this time is also the key to successful recovery phase.
You are human. You have feelings too and you're allowed to feel grief, pain and frustration during this uncertain and frightening time. But remember that you are not alone. There is support available. You have someone to talk to and support is at hand beyond what you can imagine.
Source: Slides of NHS Programme were from Dr. Sonya Wallbank, a consultant psychologist and the national lead for Clinical Health and Mental Well-being. Details were discussed during the Filipino-UK Webinar last 11 May 2020.