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Mental health crisis looms in providers’ rush to care


Health care leaders need to prepare now to ease providers’ trauma

The lasting emotional trauma among health care providers that Connie M. Ulrich forecasts in “Post-coronavirus, how will we address the trauma health care workers have suffered?” (Opinion, April 7) is spot-on, and it illustrates a critical need for health care leaders to take steps now to minimize the immediate trauma and the long-term effects the COVID-19 crisis will have on these providers.

As COVID-19 patients overwhelm hospitals, priorities understandably are critical patient care, personal protective equipment, ventilators, beds, and other tangibles in this fight. The situation leaves little time to ponder the psychological toll on caregivers. However, the emotional distress they are experiencing is immense and will affect individuals, health care organizations, and our health care system for years. The legions of health care workers on the front lines are at serious risk for depression, anxiety, post-traumatic stress disorder, and other mental and behavioral health issues.


We need policies, programs, and resources to address their well-being. Now is the time to strengthen existing programs and create new ones — training for health care professionals in psychological first aid, psychological intervention teams, hotlines for immediate problem-solving, and free access to telehealth counseling, in addition to wellness programs, peer support systems, mentorships, and safe spaces for health care workers to discuss and reflect on their experience of this challenging time.

When the intensive care units are no longer overflowing and the country returns to some sort of post-COVID-19 normalcy, those caregivers on the front lines today are going to need help. Our country’s health care system must be ready to care for them.

Dr. Beth A. Lown

Chief medical officer

The Schwartz Center for Compassionate Healthcare

Associate professor of medicine

Harvard Medical School


Language of resilience is a powerful counter to the victim narrative

As a psychiatrist, I respect a person’s subjective experience as something that a person simply has and that is not open for discussion. However, social conditions and cultural narratives shape our perception of events and emotional responses to them. In the context of COVID-19, I worry that the language of “trauma” and an assumption that health care workers are all being potential psychological victims and should be screened for psychopathology — as expressed, for example, in the recent op-ed by Connie Ulrich — may be counterproductive.


The doctors and nurses I know are dedicated and proud to do their jobs. Are they frightened at times? Do they sleep poorly during this crisis? Or struggle to make sense of our existence in a hostile world? Of course — anything else would be surprising.

The language of resilience — a belief in the ability to tolerate and overcome adversity, in personal responsibility and agency, and in shared sacrifice — offers a powerful counter-narrative that draws on people’s strengths and may even lead to post-traumatic growth or character building. “Per aspera ad astra” — through hardship to the stars, as the old Latin saying goes.

Dr. Oliver Freudenreich


Front-line responders need a different kind of assistance

As a board-certified advanced practice nurse, I was relieved to read Gal Tziperman Lotan’s article “Pandemic heightens fears for first responders’ mental health” (Metro, April 13). I had contacted the New York State Nurses Association just last week, inquiring about hotlines and other services for front-line workers. I was told that professionals could call the general COVID-19 number. I contacted the Massachusetts Association of Advanced Practice Psychiatric Nurses with a similar inquiry, to which I have not yet received a response.


Front-line workers, such as health care providers and police, need a different type of assistance. The same thing that enables us to rush into a burning building, care for an infected dying patient, or stop a robbery are the same qualities that make us reluctant to ask for help. We need someone who’s been there so we don’t feel like a coward asking for help or turn to other means to stop the pain.

We are all used to tragedy — we knew it when we signed up — but not the type that we’re seeing here. How many patients can you see die alone, and then stuff into a body bag, before you crack? How many workers can you see get sick and die before you worry for your own family and yourself?

It’s time to get some volunteers to support the efforts of the police department and various hospitals to provide first-line treatment or referral or even just an ear to the brave people whose code of ethics prevents them from just walking away.

We need to do some preventive work now before we have another epidemic — that of burnout, anxiety, depression, substance use, and suicide in the very people who’ve carried us through this horrendous time.

Laura Logue Rood