COVID-19 Update

Health
A young woman looks solemnly at her phone
A young woman looks solemnly at her phone
A young woman looks solemnly at her phone

Navigating COVID-19's Mental Health Impact

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At a time when everyone has the potential to become sick with COVID-19 and millions have died from the disease, Johns Hopkins psychologist George S. Everly Jr. acknowledges its profound emotional toll. Still, he says, there are strategies to help us cope with our fears — and assist others in finding some peace during this unprecedented pandemic.

Everly draws from more than 40 years of research and experience with survivors of natural disasters, terrorist attacks and other catastrophes. He’s helped first responders and bystanders in 36 countries to provide supportive care to people dealing with the traumas from 9/11 terrorist attacks, the Persian Gulf War, Hurricane Katrina and the SARS epidemic, among other disasters.

A pioneer in the field of psychological crisis intervention and human resilience, Everly is co-author of The Johns Hopkins Guide to Psychological First Aid. He recently answered questions regarding the COVID-19 pandemic.

What makes this coronavirus pandemic particularly unsettling from a mental health perspective?

This is the third pandemic I’ve witnessed, and I believe it’s the most psychologically toxic. Infectious diseases, especially pandemics and bioterrorism, are the most psychologically damaging because they are so deadly, contagious and long-lasting.

Here’s how the coronavirus pandemic measures up on a rating scale I developed to evaluate the psychological toxicity of disasters.

  • Morbidity. How dangerous is the event? How many will it injure and kill? The numbers are already staggering.
  • Duration. This could go on for a long time. It’s very complicated because of the likelihood of a secondary wave of pandemic. The longer the impact of the event, the more toxic it is.
  • Ambiguity/Uncertainty. This is, by far, the most toxic factor. We’re struggling to learn who’s most vulnerable, how the toxin makes you sick and transmission behaviors. The mixed messages we are receiving from leadership and scientific experts cause confusion.
  • Lack of emotional support. Social support is the best predictor of resilience. Unfortunately, quarantine has inadvertently eroded this protective factor.

The coronavirus pandemic is the only disaster I’ve witnessed over the past 41 years with this combination of deadliness, contagiousness and long duration. After 9/11 and Katrina, people came together. But now, in order to save lives, we can’t do that because we’re in isolation.

What are the signs so far of psychological damage due to COVID-19?

Every disaster brings psychological casualties that far outnumber physical ones. Common reactions include depression, grief, guilt, generalized anxiety and post-traumatic stress.

With regard to this pandemic, we’re seeing all of these things. If that weren’t enough, many people have lost their jobs, and they may have preexisting psychological problems. There could be an uptick in physical, emotional and sexual abuse, causing more angst.

What’s the best way to help someone experiencing emotional distress?

Some key steps to follow to help someone are:

  • Listen sympathetically — without judgment — and don’t interrupt.
  • Remain calm.
  • Help them prioritize.
  • Find out what they need most now, and encourage them to seek psychological help.

Anyone can practice the RAPID approach. This method, which stands for rapport, assessment, prioritization, intervention and disposition, was developed after 9/11. We need to teach everyone how to support others emotionally through this crisis. Begin by introducing yourself in a calm way, meet any basic physical needs, determine if there’s an urgent need for intervention and end with a plan for following up.

What shouldn’t we say to people who are distraught?

Don’t be dismissive of their concern. This is not a time to argue. This is not a time to point fingers and show political partisanship. Anything that divides us, hurts us.

Are health care workers more vulnerable to burnout due to the coronavirus pandemic?

They certainly can be. To address this risk at Johns Hopkins Medicine, Albert Wu and Cheryl Connors developed the extraordinarily successful Resilience in Stressful Events (RISE) team at The Johns Hopkins Hospital and throughout our health system. The RISE peer support program trains health care professionals to provide skilled, nonjudgmental and confidential support to staff members currently struggling with psychological problems related to their work. In addition, the RISE team works in conjunction with the wellness, spiritual care and psychiatry departments, as well as the employee assistance program, to offer Johns Hopkins employees a fully integrated spectrum of confidential emotional support.

All that said, I really believe we can all come out of this pandemic stronger.

Scientist carefully insets a pipette into a test tube.

Coronavirus (COVID-19)

What you need to know from Johns Hopkins Medicine.

Posted June 3, 2020