Mental health on the COVID frontlines: Our next crisis?

Nurses, doctors and hospital staffers who have been on the frontlines of the COVID-19 pandemic have witnessed some incredibly tough moments over the past year, many involving death and despair.

It’s probably fair to say that many health care professionals go into the career because they are the type of people who want to help others. And for many, that means being hands-on with patients.

Health care turned upside-down

In March 2020, the world was flipped upside-down, and because of that, there have been and continue to be many who have experienced difficult moments, some of which have led to real mental health crises.

A few of their stories are documented in the video above, but we wanted to tell you a little bit about the situation here, too.

In a mental health and wellness poll from the American Nurses Foundation, results in early March 2021 showed that:

  • 51% of nurses feel overwhelmed
  • 60% of nurses have difficult sleeping
  • 48% feel anxious or unable to relax
  • 48% feel irritable
  • 40% feel sad
  • 23% are optimistic about the future

Help us report the story: Poll -- How are you doing with your mental health?

For Dr. Lorna Breen, the stress that came along with caring for patient after patient with COVID-19, then trying to recover from it herself, became too much for her to bare. More on Breen’s story and circumstances in a bit.

Taking on a new stress

As a whole, health care professionals have spent a better part of the past year struggling with how to deal with the stress of their work environments as the COVID-19 pandemic raged on.

“To try to use words to explain what it was like, it feels really impossible sometimes,” said Maureen Biddinger-Grisius, a registered nurse with Beaumont Health in Michigan. “There’s a lot that you don’t share, and there’s a lot that just stays rolling around up in your head.”

In the documentary above, she said that, in the beginning, attempting to know how to deal with COVID-19 was a huge undertaking.

“There (are) no peer-reviewed articles or evidence-based practice,” Biddinger-Grisius said. “You just keep trying things. You keep what works and throw out what doesn’t. That’s not a way of practicing medicine that, I think, any of us were prepared for or used to.”

And for those who thrive on caring for others by holding a hand or giving a hug, that was no longer an option. Nurses were essentially kept from doing those things through factors that were beyond their control, which led many to feel frustrated and disheartened.

“You could certainly see those feelings leading to a feeling of depression and lack of meaning,” said Dr. Alison L. Miller, a development psychologist and associate professor at the University of Michigan School of Public Health, adding that it would be especially true if someone is in the helping profession because they get a lot of meaning from helping others.

When there’s not enough staffing, ICU beds or enough personal protective equipment, “it could be a situation where it would threaten your sense of meaning, because you’re not able to help people in the way you’d like to,” Miller said.

“Normally, my bedside manner is, I go to the side of the bed and I sit, and I talk to the patient or I hold their hand,” said Dr. Asha Shajahan, medical director of community health at Beaumont Health in Grosse Pointe, Michigan, who also shares in the documentary above some complex hurdles she met in the last year. “I’m a very hands-on person. And it was like, I’m standing at the foot of the bed and there’s a distance between you and the patient and you just want to go and hug them.”

Doctors and nurses are used to seeing emergencies or people whose vitals are crashing, but it was the quantity of people that made working so hard.

For many, they were dying without any family members at their side.

“Imagine dropping off your loved one, your spouse -- thinking that they’re going to just come right out, and then you never see them again, or talk to them again,” Shajahan said. “And then, on top of that, you can’t even mourn it because you’re fighting for your own life. It was really heavy.”

A mental health crisis

At a time when the entire world was undergoing immense stress, many turned to their social connections to cope with all of it. But as a safety precaution, nurses and doctors weren’t really even able to do that.

“We’re actually denied that coping strategy, so I think that compounds the impact of the stress that we’re all feeling,” Miller said.

As a society, we’re constantly putting an emphasis on physical health, which is important, but somewhere along the way, it seems as though mental health was forgotten.

“Brain health is really important, and so if you’re not sleeping, your mood is going to be affected. If you’re not getting enough Vitamin D and sun, your mood is going to be affected,” Shajahan said. “If you’re not exercising, your mood is going to be affected. Mental health is kind of one-on-one with physical health and emotional health, and I think what’s happened is our society has divided it so that when they think of health, they think only of physical health and they sort of negate the mental health.”

Dr. Lorna Breen’s story

Breen was on the frontlines of the pandemic early, and after contracting the disease herself, she tried to recover from COVID by herself at home while trying to run an emergency room remotely.

“When she went back into that workforce, many 12-plus hour shifts in a row, the volume of just death and dying on an already depleted worker -- because she was not really recovered from COVID -- was just way too much for any one person to bare,” said Corey Feist, Breen’s brother-in-law and CEO of the University of Virginia Physicans Group.

Feist, who shared his sister-in-law’s story with us in the documentary above, said the whole ordeal was kind of a perfect storm, and all of a sudden, Breen became a person who, at the top of her game in every aspect of life, had it all take an abrupt change.

Breen died by suicide on a Sunday. Her self-inflicted injuries have been attributed to the emotional toll her job had taken on her for months on end.

“That was probably one of the biggest lessons we have learned, is how quickly something like this can turn,” Feist said. “It was a complete and total shock in every possible way. This certainly wasn’t someone who suffered from mental health conditions or depression for years. This was really a byproduct of working yourself to the bone, literally.”

A poll done by the American Psychological Association found that, compared with before the pandemic, psychologists are seeing:

  • 74% more patients with anxiety disorders
  • 60% more patients with depressive disorders

Advocating for health care workers

Now, Breen’s family, along with lawmakers, are advocating for the cause of a more humane profession -- one in which mental health challenges are acknowledged, resources are available, and to access those services is encouraged.

Democratic Virginia Sen. Tim Kaine introduced the bill.

“How should we honor the work and sacrifice of Lorna Been?” Kaine said. “How do we honor those frontline workers we call heroes every day? How do we recognize the tremendous work they’re doing, and also the tremendous burden that they carry? Let’s pass this bill and show that we care about our healers and are committed to providing them the resources and the culture they need to keep healing.”

The Dr. Lorna Breen Health Care Provider Protection Act aims to reduce and prevent suicide, burnout and other mental and behavioral health conditions among health care professionals. And more than 70 health organizations are backing it, including services within the federal government.

“We’ve got a long road ahead, but we are, as we’ve said multiple times, we’re just getting started. We’ve got the wind in our sails and we’re going to make this happen for the health care professionals who have given so much of themselves,” Feist said.

Moving forward

As vaccines roll out across the nation, many are now talking about a time when we will move past the COVID-19 pandemic, but we must remember the long-lasting impacts this will likely have on health care professionals everywhere. We must remember the sacrifices they made.

“Just the thought of facing a small part of that again put me into a really bad place, and even just with physical and physiological symptoms,” Biddinger-Grisius said. “So, how long will I deal with that? I don’t know. I think it will probably be a long time of processing before I have complete peace with it.”

To learn more about the Dr. Lorna Breen Health Care Provider Protection Act, visit drlornabreen.org.

If you or someone you know needs help, take action at mentalhealth.gov.

Watch our entire special, What Lies Beneath: Managing Mental Health, above.

Help us report on this story

If you’re open to sharing your own experience (no need to be a frontline worker, we’d like to hear from all of you), take our mental health poll below.

By doing this, you can help us report on the story. If you answer the questions below, we’ll use the responses for follow-up stories.

If you’re struggling with suicidal thoughts, you’re not alone. The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, along with prevention and crisis resources for you or your loved ones. Call 800-273-8255.


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