“Helping People Living Better Lives” | pg. 1
Rev.6/12/2020
Department of Health and Human Services
COVID-19 Coronavirus
Guidance for Behavioral Health Workforce – COVID-19 Frequently Asked Questions
Updated June 12, 2020
Q: How can we, as behavioral health professionals, support individuals receiving care in state psychiatric hospitals?
A: Safety
Caring for the physical and psychological safety of individuals served is paramount during this crisis. Clearly the physical setting must be safe as well as the interpersonal interactions must promote a sense of safety.
Recommendations include:
● Encouragingexercisesonself-compassion,gratitude,andmindfulness.● Providingindividualsaccesstovirtualvisitationviatechnologies/programssuchasFacetime,Skype, phones,etc.● DevelopingasafetyfactsheetonCOVID-19.● Askingstaffandindividualsincarewhatwillenhancetheirpersonalsafetyatthistime.● Encouragingpeerstodeveloppersonalcomfortstrategies.● Offeringinformationalmaterialsandsessionsforpersonsservedtoeducatethemonthecrisis.● Helpingpersonsservedunderstandthedifferencebetweenisolation(confirmedpositivesorpeopleshowing
symptomsconsistentwithCOVID-19)andquarantineforpeopleexposedtoseeiftheywilldevelopsymptoms.(Thisshouldincluderegularmeetingsforinformationandquestions.)
● Explainingvariationsinprotocols(e.g.whystaffanddesignatedpatientsmustwearfacecoveringsandpeopleservedmaynot.)
Empowerment, Voice and Choice
Wheneverpossible,allowingindividualsincaretheopportunityforchoicewillprovideanincreasedsenseofcontrol.Hearingexpressedconcernsandfearsandprovidingsuggestionsforself-soothingcanreducesymptoms.
Recommendations include:
● Givingpersonsservedtheoptiontowearmasksandprovidingtheminformationonthebenefitsofusingmasks.
● Playingsoothingmusicandsoundstosoothetheanxietiesofpersonsserved.● Providingpersonsservedwithvideo-streamingservicesofrelaxingenvironments,suchaszoosorwildlife
preserves.● Engagingpeersindevelopingmeaningfulandrelaxingactivitiesontheunit(i.e.games).● Developingactivitiesforthoseinisolationthatareengagingandmeaningfultoincreaseoverallhealthand
well-being.Onewaytodothisistoaskthepersonsservedwhattheywouldliketohavetohelpcopewith the crisis.● Personsservedinisolationcontinuetoreceiveclinicalserviceseitherinpersonorvirtually.● Givingpersonsservedtheoptionstodoyogaandotheronlineexercises.● Offercreativeexpressionopportunitiestoworkthroughemotionsaboutthevirus,suchasartmaking,poetry,
or other activities that can be accomplished while social distancing.
“Helping People Living Better Lives” | pg. 2
Trustworthiness & Transparency
Duringtheseuncertaintimes,itissocriticaltomaintaintrustthroughregularcommunicationandinformationsharing.
Recommendations include:
● PresentinginformationonCOVID-19inincrements.● Providingupdatedinformationandopportunitytoprocessfeelingsisimportantincalmingescalatingfears.
Anxietyishighforeveryoneduringthisstressfultime.Peersmaywitnessanotherontheunitescortedbyoutside paramedics being transported to the hospital.
● Engaginginhonestdiscussionandallowingfearstobeexpressedcanmitigateescalatingfeelings.● Developingconcreteguidanceanddosanddon’tslistforthecrisis.● Beingtransparentwithpersonsservedaboutfeelingsandfearsoverthecrisis.● Practicingcalmingstrategiesmayalsobehelpful.Pleaseseethemindbodycalmingstrategiesattachedthat
canbeprintedanddisplayed.Theycanalsobepracticedatcommunitymeetings.● Intheunfortunateeventthatapeerontheunitdies,givingthegrouptheopportunitytogrieveandhonorthe
individual in a way that is meaningful to them.● Hostinginformationalsessionstoexplainchangesinpolicy,practice,andclinicalprogramming.Thepractice
guidelinestodealwiththisepidemicareconstantlychangingandbeingrevised.Assuch,itisimportantforpeopletounderstandwhat’sbehindthechange.
Collaboration & Mutuality
EveryonehasaroletoplayduringtheCOVID-19crisis.Personsservedandpersonsservingareallexperiencingfear,anxietyanduncertainty.Wearetrulyinthistogetherandyoudon’thavetobeatherapisttobetherapeutic!
Recommendations include:
● Creatingawarmlineforpersonsservedtocalltodiscusstheirownexperiencesandreceiveinformationconcerning the virus.
● Createa“copingkit”composedofstressmanagementandcopingstrategiesfavoredbystaffandpersonsserved.
● Hostingconsistentmeetingstogetherwithstaff,peersupport,andclientsonupdatesconcerningtheCOVID-19crisis.Ideally,thisshouldbedonevirtuallythroughprogramslikeZoomandWebEx;anditshouldendwithabreathingexercise.
● Usingvirtualmeetingstotransitionpersonsservedoutofstatehospitalsintocommunitysettings.● Holdingmorning(daily)check-ins/communitymeetingstospeakwithandcheckonthestatusofpersons
served.Providingaforumforbothstaffandpeopleservedtoprovidesupporttoeachother.
Peer Support
Utilizingtraditionalin-personpeersupportmightbechallengingduringthistimeofsocialdistancing.Whatevercanbedonevirtuallywillprovideimportantconnectionwhenphysicalconnectionisnotpossible.Encouragingmutualself-helpandlearningtocareforonewouldprovideadditionalcomfortduringthisdifficulttime.
Recommendations include:
● Continuingpeersupport,eitherin-personorvirtually(dependingonthehospital’spolicies).● Providingin-unitpeerswithinformationandtools(i.e.curriculum,training)forthemtoassistotherpatients in their units.● Encouragetheuseofpeer-to-peersupportamongpeerworkersatyourfacility.
“Helping People Living Better Lives” | pg. 4
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Cultural, Historical & Gender Issues
Familyandculturalconnectionsareimportantforthewell-beingofpersonsserved.
Recommendations include:
● Informingpatientsthatallpeoplecanbeaffectedbythiscrisis.Educatehonestlythatwhileolderpeopleareathighestrisk,evenyoungerpeoplewithpre-existingconditions,includingcurrentandformersmokersorpeoplewithdiabetes,areathighrisk.
● Encouragingindividualstosharetheirtraditional,culturalhealingritualsandvalues.● Attendingtoissuesofstigma.Mediacoverageoftenfocusesoncertaingroupsbeingmoresusceptible
toCOVID-19thanothers.Assuch,itisimportanttoprovideaccurateinformationinordertopreemptivelyaddress issues over misinformation.
We also encourage the behavioral health workforce to visit these resources and remember to practiceself-care:● Mind Body Skills(linkisexternal)● Rethinking Crisis: Crisis Strategies to move from Crisis to Empowerment(linkisexternal)● NASMHPD All Facilities Manual(linkisexternal)
May 1, 2020
Q: Guidance was requested by a provider (appeal the unit designation) and NABHO on the DBH medication management unit of service.
A:The4/9/2020BehavioralHealthFAQstatedthattheunitofserviceformedicationmanagementis15minuteswithtelehealthandthattelephoneappointmentsarenowpermissibleroutesofservicedelivery.Ingeneral,providerscontractedwiththeRegionsareencouragedtoworkwiththeRegiontohandleuniquecircumstancestothatexpectation.Thereareuniquecircumstancesforwhichtheprovidercoulddocumentone-timeoccurrencesinthemedical record.
TheDivisionofBehavioralHealth(DBH)isuncertainastothefrequencyofthemedicationmanagementunitissuebroughttoourattentionbytheprovider;however,withrespecttoappeals,unitsofserviceareacontractissuenotaregulatoryissue.Thereisanappealprocessforregulatoryissues.DBHsolicitsRegionfeedbackforcontractupdatesonanannualbasis.Atthistime,themedicationmanagementunitwillremain15minutes.
Theprovider’soriginalconversationwithDBHdidnotindicatetheconcernwasspecificallyrelatedtoCOVID-19.TheinformationsubmittedtothemailboxdidreferenceCOVID-19.DBHwillestablishaminimumof10minutestobillforone15-minuteunitduringtheCOVID-19PublicHealthemergency,effectiveApril1,2020.
Q: With the changes to delivering care virtually, are there resources that address how to best engage consumers using this route of service delivery?
A: Kenneth Zoucha, M.D., has provided the following resources to help in asking questions to patients:
Weusedifferentscreeningquestionnairesforourpatients.Oftenthosearegiveninthewaitingroomorintheroombeforetheproviderenters.Wehavestartedtodotheseon-linewiththepatients.Itdefinitelyopensupquestionsanditems/issuesthatthepatientswanttotalkabout.Alotofthespontaneityoftheencountergoesawaybytelehealth and this opens it up.
EPIC(OurEMR)hasscreeningquestionsbuiltintothem.
“Helping People Living Better Lives” | pg. 4
FirstistheSheehanDisabilityScale:http://www.cqaimh.org/pdf/tool_lof_sds.pdf
Iaskthesequestionsofthepatientsduringtheinterview.Iputitinatvarioustimesthroughouttheinterview.Itisawaytotrackimprovementovertimeaswell.Again,oftenthesequestionswillelicitotherconversationswiththepatients.
IaskthePHQ-2questions:http://www.cqaimh.org/pdf/tool_phq2.pdf
Ithasvalidityandsciencebehinditasagreattoolfordepression.IftheyarepositivethenImovetoPHQ-9:http://www.cqaimh.org/pdf/tool_phq9.pdf
Finally,IasktheGAD-4:https://www.mdcalc.com/gad-7-general-anxiety-disorder-7
Youdon’thavetoaskalloftheseeverytime,andyoucantailorittoeachindividualpatient.
AlloftheseexceptforGAD-4canbefoundforuseatthefollowingwebsite:www.cqaimh.org
Justsomesuggestions.IhavefoundthemveryhelpfulandagaintheyareinorcanbebuiltintoanEMRandscoredwhiletalkingwiththepatients.
Teresa Bledsoe, PLMHP, Community Alliance, has provided tips to help engage consumers:
Iwouldliketosharesometipsasclinicaldayrehabstaff.Wehavebeenattemptingtocontactconsumersafewtimesaweekinordertohelpthemstayontrackwithmeetinggoalsontheirdayprogramtreatmentplans.Ofcourse,thiscanbechallengingsincetheyarenotabletoengagesociallywiththeirpeersorparticipateinaclassroom/groupenvironmentrightnow.I’vebeentryingtopreserveasmuchofthataspossiblebyfindingmaterialsthatIcanuseforeducationalpurposesastheyrelatetotheconsumer’sgoals.Itrytofindmaterialsthatareinteractivewheretheconsumerhastoprovidesometypeofresponseanditwillfacilitatefurtherdiscussion.OnetoolIutilizedlastweekwas“positiveaffirmationjournalprompts”,inwhichIwouldgiveastatementlike“SomethingIlikeaboutmyselfis…”or“onethingIaccomplishedtodaywas…”.Activitieswhichengagetheconsumeraremuchmoreeffectiveandhelpustobetterassesshowtheyaredoingbasedontheirresponses.
Otherresourcesaddressingtipsandguidelinesfordeliveringonlineservicesinclude:
https://store.samhsa.gov/product/TIP-60-Using-Technology-Based-Therapeutic-Tools-in-Behavioral-Health-Services/SMA15-4924?referer=from_search_result
https://www.integration.samhsa.gov/operations-administration/practice-guidelines-for-video-based-online-mental-health-services_ata_5_29_13.pdf
https://higherlogicdownload.s3.amazonaws.com/AMERICANTELEMED/618da447-dee1-4ee1-b941-c5bf3db5669a/UploadedImages/Practice%20Guideline%20Covers/NEW_ATA%20Children%20&%20Adolescents%20Guidelines.pd
https://higherlogicdownload.s3.amazonaws.com/AMERICANTELEMED/618da447-dee1-4ee1-b941-c5bf3db5669a/UploadedImages/Practice%20Guideline%20Covers/NEW_ATA%20Children%20&%20Adolescents%20Guidelines.pd
“Helping People Living Better Lives” | pg. 4
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https://www.integration.samhsa.gov/hit/telehealthguide_final_0.pdf
https://www.researchgate.net/publication/340066049_COVID-19_Tips_Building_Rapport_with_Youth_via_Telehealth
https://www.ncbi.nlm.nih.gov/books/NBK344045/
April 20, 2020
Supporting Emotional Health of the Behavioral Health Workforce During COVID-19Thereisnohealthwithoutbehavioralhealth.Asabehavioralhealthprovider,thankyouforyourcommitmenttoservingNebraskans.It’sessentialyoutakecareofyourselfduringthishealthcarecrisis.YouarelikelyexperiencingadditionalchallengesduringtheCOVID-19infectiousdiseaseoutbreak.Thismayincludeconcernsaboutyourownhealth,yourfamily’shealth,stigmafromwithinyourcommunity,andmanagingthedistressofpeopleyousupportinyour professional life.
Weacknowledgetherisksyoutakeeverysingleday,andwerecognizethatwiththeCOVID-19outbreaktheworldfeelsupsidedown.Youareshiftingyourofficesettingtotelehealth,learningnewtechnologies,determiningwhoneedsafacetofaceappointmentandhowtodothatsafely,andwheretosendpeoplewhomaybeinmoredistress.Werecognizethatwithallthechangescomesincreasedstress.Wealsorecognizetheincreasedriskandburdenplaceduponyouandyourfamily.Ifyouarestillneedingtoseepeoplefacetofaceforsupportoftheirbehavioralhealthcondition,yourdutytoservecanputyouatincreasedriskofgettingsickandconflictswithyourownsafety.Thatisastressmostwillneverunderstand.Wethankyouforshowingupdayafterday,andforshiftingtoworkthroughtechnology,whiletherestofthecommunitymaynotunderstandallthenuancesofwhatyoudo.Wethankyouforyourbraveryanddedicationtoservingotherseveryday,andespeciallyduringthiscrisis.
Theintentionofthiskitistoprovideresourcestohelppreserveyourownresilienceandmentalhealth,aswellasthatofyourfamily.Additionally,ithighlightsareasyoucanmonitorforyourselfandyourpeersduringthiscrisis,inordertoseekhelpearlyincopingwiththeuniquestressyouexperience.Manyfront-linebehavioralhealthprovidersareexperiencingincreasedlevelsofdepression,anxiety,insomniaandstress.Youarenotaloneinthesefeelings,and there are resources to help you get through them.
Resources for Behavioral Health Workers
For Your Family
Nebraska DHHS Guidance & Resources
http://dhhs.ne.gov/Pages/Coronavirus.aspx
OnMarch26,2020,GovernorPeteRickettssignedExecutiveOrder20-10whichsuspendsseveralstatutesandtheirimplementingregulationsfromtheUniformCredentialingActrelatingtospecifichealthcareproviders,includingmentalhealthcareproviders.ForFAQsrelatedtoExecutiveOrder20-10goto:http://dhhs.ne.gov/OEHS%20Program%20Documents/EMS%20EO%2020-10%20FAQ.pdf.
“Helping People Living Better Lives” | pg. 4
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Childcare for Essential Workers in Nebraska
GovernorPeteRickettssignedExecutiveOrder20-08onMarch26,2020waivingcertainrequirementsregardingtheChildCareLicensingAct.TheDepartmentisaskingprogramstoserveasmanychildrenofessentialpersonnelascanbedonesafelyandappropriately,complyingwithallrequirementsoutlinedintheexecutiveorder.
Find Access to Child Care
Respondingtotheneedsofbehavioralhealthcareprovidersandotheressentialworkers,agroupofearlychildhoodstakeholdershascollaboratedtocreatetheNebraskaChildCareReferralNetwork—asearchabledatabaseatwww.NEchildcarereferral.org.
Thewebsiteallowsparentstosearchforchildcareprovidersby:
● address(includingmultipleradiusoptionsaroundyourhome)orzipcode● ageofchild(ren)● providerswhoacceptsubsidypayments● providerswhoarepartofStepUptoQuality
AllprogramslistedonthewebsitehavebeenlicensedbytheNebraskaDepartmentofHealthandHumanServicestocareforandeducateyoungchildrenandmeetsafetyandqualitystandardsoftheStateofNebraska.Providerswillbeencouragedtoupdatetheirinformationastheyfillopeningsorhaveslotsopenup,tokeepthedatabaseascurrent as possible.
ParentswhowouldlikemoreinformationabouthowtochooseaprovidercancallNebraska’sChildCareResourceandReferralLineat1-800-892-4453or402-557-6880.
For Your Health
EAP (Employee Assistance Programs)
AskyouremployerifyouhaveanEAPforfree,confidentialassessmentsandshort-termcounselingformentalandemotionalwell-being.ManyEAPshelpwithtraumaandotheremergencyresponsesituational.
Finding Better Sleep During COVID-19
https://www.cstsonline.org/assets/media/documents/CSTS_FS_Fight_COVID19_w_Better_Sleep_Health.pdf
Compassion Fatigue Resources
http://champsonline.org/assets/files/ToolsProducts/OEResources/CF-Resources-Handout.pdf
https://www.goodtherapy.org/for-professionals/business-management/human-resources/article/cost-of-caring-10-ways-to-prevent-compassion-fatigue
CSTS (Center for Study of Traumatic Stress) - Provider, Leader and Family Resources
https://www.cstsonline.org/resources/resource-master-list/coronavirus-and-emerging-infectious-disease-outbreaks-response
“Helping People Living Better Lives” | pg. 4
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NAMI (National Alliance on Mental Illness)
https://www.nami.org/Find-Support
The American Psychological Association
https://www.apa.org/topics/stress/
American Psychiatric Association:
http://workplacementalhealth.org/Employer-Resources/Working-Remotely-During-COVID-19
https://www.psychiatry.org/news-room/apa-blogs/apa-blog/2020/02/coronavirus-and-mental-health-taking-care-of-ourselves-during-infectious-disease-outbreaks
Nebraska DHHS Guidance & Resources
http://dhhs.ne.gov/Pages/Coronavirus.aspx
First – Be safe!
Thebestwaytopreventthespreadofillnessistostay home when you are sick.Behavioralhealthprovidershaveshiftedsomuchtotechnology,butevendoingthatworkandemotionallysupportingotherscanbeexhausting.Ifyouarestillengagedinfacetofaceencounters,youmayhavedirectcontactwithsickandotherwisevulnerablepopulations.Screeningstaffwhentheyreportfordutyreducestherisktopatientsandotheremployees.
Every healthcare worker, including behavioral health workers, like those in community mental health clinics, opioid treatment programs, and inpatient psychiatric units, should screen themselves every shift.
Answerthreesimplequestionswhenyoureportforduty:
Doyouhaveacough? Doyouhaveafever? Areyoushortofbreath?
Ifyouareexperiencingsymptoms,feelill,ordevelopafever–stayhomeandcontactyouremployerforfurtherdirectionregardingpotentialtesting,isolationandshiftcoverage,inaccordancewiththeirCOVID-19Plan.
Have a Plan in Case You Become Ill
At work:DiscusswhatwillhappenifyoubecomeillwithCOVID-19withyourmanagerorsupervisor.
● Wherewillyouisolate?● Howwillyouisolatefromyourfamilytoprotectthem?● Howwillyoubecompensatedduringisolation?● Howlongwillyouremployerexpectyoutoremainoffduty?Whatisthepolicyforreturningtowork?● Aretheretasksyoucandofromhomeifyoumustisolate?
“Helping People Living Better Lives” | pg. 4
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At home:Findwaystogetyourfamilyinvolvedinroutineandemergencyactivitiesthatpreventthespreadofillnessin your home.
Prevent illness in your household:
● Washyourhandswithsoapandwater,especiallywhenreturninghomefromwork.● Cleanfrequentlytouchedsurfaceslikedoorknobs,counters,phones.● Teachyourfamilybestpracticesforhandwashing,coughandsneezehygiene,andsurfacecleaning.
PlanforillnessinthehouseholdBehavioralhealthworkershaveuniqueneedswhenitcomestoplanningforillnessinthehousehold.Discusswithyourfamilywhattodoifyoubecomeill,orifanotherfamilymemberbecomesill.Byparticipatingintheplan,yourfamilymightnotfeelasoverwhelmedorasiftheydonothavepowerinthesituation.
● Considerseparatelivingspacesandbathrooms.● Createaplanforchildcareandpetcareifyoubecomeill.● Createafamilyplanforwhereyouwillisolate(athomeorawayfromhome)ifyoubecomeill.● Discussthepossibilityforincreasedshifts,longershifts,schedulechanges,increasedtravel,ortelework
during this crisis.
Recognize When You Need A Break
ThefactthatCOVID-19ishuman-to-humantransmissible,relativelyunknown,andpotentiallyfatalmayintensifythefeelingsofpersonaldanger.Itisimportanttounderstandtypesofstresssothatyoucanrecognizetheminyourselfand in others.
Burnoutdescribesahumanresponsetochronicemotionalandinterpersonalstressatworksignaledbyexhaustion,cynicism,andworkinefficacy.
Compassionfatigueistheresultingexhaustionfromconstantexposuretothesamestressorleadingtodecreasedcompassion or empathy for others.
Resilienceistheabilitytoadaptsuccessfullyinthefaceoftrauma,adversity,tragedyorsignificantthreat.Creatingastressresilienceplanhelpsyoufightagainstburnoutandcompassionfatigue.
Create a Stress Resilience Plan
1Self-Assess
● Whataremyearlywarningsignsofexcessivestress?● WhatdoIdocurrentlyonadailybasisforself-care?● WhatdoIdoonaweeklybasistoimproveself-care?● WhatdoIdowhenmystresslevelisunusuallyhigh?
2Plan for
the Future
● WhatcanIaddtomyself-careroutine?● HowwillImaketimeforthesenewstrategies?● HowoftenshouldIreviewwhatIamdoing?● WhatchallengesdoIexpecttohavewithmyplanforchange?● HowwillIknowifmychangesarehelping?
3Get Support
● WhocanIturntoforsupportwithmyplan?● HowoftenshouldIcheckinwiththem?● WhatprofessionalsupportisavailableformeifIneedit?
“Helping People Living Better Lives” | pg. 4
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Stay Healthy!
Behavioralhealthworkers,justlikeallthoseinhealthcare,needtotakecareoftheirownhealthtobeabletoprovidecareforindividualsinahigh-stressenvironment.Workersmustbeabletostayfocusedonthejobinthedynamic,crisisenvironment.
Pace Yourself
● Paceyourself,thispandemicisamarathon,notasprint.● Watchoutforeachother.Coworkersmaybeintentlyfocusedonaparticulartaskandnottakeappropriate
precautions to protect themselves.● Beconsciousofthosearoundyou.Youmightbeexhausted,stressed,oreventemporarilydistracted,and that can lead to errors or irritability.● Takefrequentrestbreaks.Mentalfatigue,particularlyoverlongshifts,cangreatlyincreaseworkers’riskof
injuryandburnout.
Prioritize Your Physical Health
● Keepingahealthyroutine,especiallyduringuncertaintimes,willhelpcurbstress.● Drinkplentyoffluids,especiallywater.● Maintainahealthydietandexercisewhenyouareable.Simplytaking20minutesandgoingforawalk can help manage stress.● Takebreaksawayfromyourworkspace,orgooutforfreshair,whenpossible.
Don’t Ignore Your Mental Health
Asabehavioralhealthworkers,youknowhowimportantmentalhealthis,butoftenforgettowatchyourownmentalhealth.Makesureyouthinkaboutyourmentalwell-beingduringthisextraordinarytimeofstress.Someofthefollowing may help:
● Keepintouchwithfriendsandfamily:Asimplephonecall,textmessage,orvideochathelpstomanagestressandkeepsyouincontactwiththosecloseandimportanttoyou.
● Limitmediaexposure:Takesometimeeverydaytodigitallyunplugandgetabreakfromallthemedia.● Recognizeandacceptwhatyoucannotchangesuchastheorganizationalstructure,complexwork
environment,waitingtimes,supplyshortages,etc.● Talktopeoplewhenyoufeellikeit.Youdecidewhenyouwanttodiscussyourexperience● Identifyabuddy,ideallyapeer,whounderstandsyouruniquestresses,andcheckinoftenwithoneanother.
Trytoprocessthedifficultiesofashiftoradayintheclinic,andthenpointoutpositiveelementstoo.Liftoneanotherup!
● Giveyourselfpermissiontofeelupsetorscared:youareinadifficultsituation.
● Recurringthoughts,dreams,orflashbacksarenormal—donottrytofightthem.But,remember,ifyoursleepissodisruptedthatitishardtofunction,taketimeoffandseekmental help. You cannot emotionally support othersaswellifyouarehavingdifficultiesandnot maintaining your own balance.
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Identifying Stress
Physical
BehavioralhealthworkersexperiencinganyofthefollowingsymptomsshouldseekIMMEDIATEmedicalattention:
● Chestpain● Difficultybreathing● Severepain● Symptomsofshock
Ifbehavioralhealthworkersexperiencesymptomsovertimeoriftheybecomesevere,workersshouldseekmedical attention.
● Fatigue● Nausea/vomiting● Dizziness● Profusesweating● Thirst● Headaches● Visualdifficulties● Clenchingofjaw● Nonspecificachesandpains
Cognitive
Ifthesesymptomsoccuronthescene,workersmaynot be able to stay clearly focused to maintain their own safety or to help patients in distress.
Behavioralhealthworkersmayexperiencemomentarycognitivesymptoms;however,ifsymptomsarechronicorinterferewithdailyactivities,workersshouldseekmedical attention.
Thesesymptomsinclude:
● Confusion● Disorientation● Heightenedorloweredalertness● Poorconcentration● Poorproblemsolving● Difficultyidentifyingfamiliarobjectsorpeople● Memoryproblems● Nightmares
Behavioral
Asaresultofatraumaticincident,behavioralhealthworkersmaynoticethefollowingbehavioralchangesinthemselvesorcoworkers:
● Intenseanger● Withdrawal● Emotionaloutburst● Temporarylossorincreaseofappetite● Excessivealcoholconsumption● Inabilitytorest,pacing● Changeinsexualfunctioning
Emotional
Strongemotionsareordinaryreactionstoatraumaticorextraordinarysituation.Behavioralhealthworkersshouldseekmentalhealthsupportfromadisastermental health professional if distress continues for severalweeksoriftheyinterferewithdailyactivities.
Emotionalsymptomsinclude:
● Anxietyorseverepanic(rare)● Guilt/senseoffailure● Denial● Grief● Fear● Irritability● Lossofemotionalcontrol● Depression● Feelingoverwhelmed● Blamingothersorself
“Helping People Living Better Lives” | pg. 4
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Managing Stress
Recognizing stress in yourself is important. Here are some things you can do for yourself to help you manage your stress:
Talk to your peersaboutthestressesoftheday,jobs,andotherworriesyoushare.Placeanemphasisonvalidatingone-another’sconcernswithoutfocusingonthegrim.Helppointoutpositiveelementsoftheshiftordayfor one another.
Seek help from support systemsavailableinthehealthcareenvironment.Manysystemshavepointpeopleorresourcestohelpwithburnout,fatigueandotherconcerns.Havingconversationsaboutyourworriescanhelpreduceanxiety.Checkoutthelistofresourcesattheendofthisdocumentaswell.
Self-care helps you stay stronginordertobetterhelpothers.Self-carecanbeeatinghealthy,exercisingandgettinggoodsleep.Self-caremayalsoincludetakingcareoffamily,includingchildrenandothers.Makingsureyoufillyourowncupisjustasimportantaspouringfromittoserveothers.
Stay in touch with older parents and family membersyouwouldnormallyvisit.Connectbyphoneorvideochat,writeletters,orsendsuppliessafelytotheirresidencetomaintainyourconnectedness.
Take things one day at a time-stepbackfromthe“sprint”mentality.Rememberthatthispandemicwillnotbesolvedquickly,treatitlikeamarathon.
Take mindful minutes.Slowbreathsonthetopofthehour,takingtimetorecognizeallthesmallthingsaroundyou,acknowledgingthem,andlettingthemgo.Gettingoutsideorsteppingawayfromyourworkspaceregularly.
r(888) 866-8660Information adapted from Michigan Department of Health and Human Services (2020, April 2). Supporting Emotional Healthof the Behavioral Health Workforce During COVID-19:https://www.michigan.gov/documents/coronavirus/Behavioral_Health_Workers_Final_685877_7.pdf