Creating a mentally healthy workforce; the health workplace and coronavirus crisis

The arrival and the rapid spread of COVID-19 pandemic has reinforced the importance of mental health and the critical need to create a mentally healthy workplace for the workforce.

Healthcare providers and managers in the healthcare industry cannot ignore the mental stress that COVID-19 has presented to the workplace adding to the already existing psychological and emotional challenges faced by healthcare workers. Today, the healthcare industry, especially traditional care providers, are experiencing one of the most disruptive periods in time.

The health workforce has over the years suffered both emotional and psychological stress related to providing care and restoring health of the sick and vulnerable in addition to the physical, biological and chemical hazards they face in their daily work. The healthcare work environment is dangerous and exhausting and there is a ‘tough guy’ mentality which may discourage healthcare workers from discussing issues pertaining to mental health because of the false assumption that they can handle their mental health challenges better than any other group of workers.

Many workers experience damaging levels of stress due to problems they experience in their home or work lives. These challenges may result from marriage and relationship, the time and energy required to care for old parents or young families, financial stress, legal matters, career-related challenges, working in teams, significant role changes and challenges that come with people management. In addition to the above, healthcare workers are faced with the stress of caring for patients with terminal ailments or in critical conditions, children born with complicated congenital defects, patients with co-morbidities and their families in the midst of unavailability and insufficient supplies to help in delivering quality care. These aggravate the stress faced by health workers, impacting negatively on their mental and emotional health.

Like all other workers, the mental wellbeing of health workers inversely determines productivity levels and quality of care hence the urgent need to prioritize the mental wellbeing of the workforce. In this era of COVID-19, health workers are faced with fear of the unknown as they work tirelessly every day in the frontline to provide care to patients suffering from the infection. However, the health system continues to face the heavy burden of communicable and non-communicable diseases, leaving workers with high workload and eventual burnout. This creates huge levels of fear, anxieties and agitations among workers in hospitals and unions in the healthcare industry. There are several instances where workers have threatened to leave their work, some units in hospitals have been temporarily closed down while a number of them also have had to deal with stigmatisation from family and society because of being infected with the new coronavirus in the cause of offering care, or just the fact that they work in hospitals, COVID-19 treatment or isolation centers.

To reduce the impact COVID-19 has on the mental health and wellbeing of frontline health workers, some have had to isolate for days from their families, others have had to send their children to stay with their extended families rather than to risk exposing them to COVID-19.

Says one of the doctors in my COVID-19 frontline team: “I swore the oath to protect and save lives myself and alone. My wife and children have not sworn that oath and I can’t risk endangering their lives should I be exposed.”

However, separating from family and friends in pandemics like we face now can also introduce different levels of stress and anxiety.

The World Health Organisation (WHO) estimates that for every $1 invested into the treatment and support of mental health-related issues, there is a return of $4 in improved health and productivity. This indicates a high-level Return on Investment (ROI), a good business sense to ensure the mental health of employees.

Way Forward

In achieving a mentally healthy workforce, these are recommended in hospitals and healthcare facilities.

Mass testing of critical staff and provision of timely and direct psychosocial support which may include pre-test counselling which extends to cover periods when tested staff await their results, confidential communication of test results, adherence counselling and support for family and contacts as well as timely contact tracing and isolation are highly recommended interventions in hospitals. A programme like an employee assistance programme, which offers round-the-clock psychosocial support and professional assistance to employees, is one of the very effective workplace interventions to improve the psychological and emotional health of employees.

It is critical to also provide, make available, and ensure use of adequate Personal Protective Equipment (PPE) for health workers per their various job roles. In addition to PPE, it is very essential that facilities for safe and proper hand-washing are provided at vantage points in hospitals and at the various work areas with reinforcement of Infection Prevention and Control (IPC) measures that keep healthcare workers and their patients safe.

Again, appropriate systems must be created in the healthcare setting to enable healthcare workers to monitor their health more closely and get immediate access to testing during an exposure. This reduces the mental stress that exposed staff might suffer. Poor testing among healthcare workers with inadequate protective equipment puts not only the lives of workers at risk but the entire community of patients and their relatives.

To reduce the emotional stress on workers who might test positive for the coronavirus, it is important that hospitals provide an in-house isolation bays/centres for both symptomatic and asymptomatic staff. Though this may be ideal, many have also argued the fact that in-house isolation accommodation may breach the laws of confidentiality and may be the starting point of stigmatisation and discrimination. While this point remains debatable, I go for the former as a significant number of positive health workers I have encountered prefer to be cared for within their own facilities by their colleagues provided the needed logistics and supplies are available.

Lastly, it is imperative to create a positive culture which is conducive for healthy conversations. We should formalise the fears and anxieties we are going through and create a safe platform wherein the work environment we can all discuss these fears as we normalise the feelings and seek appropriate help.

The general world of work is undergoing dramatic changes with the insurgence of COVID-19. These changes will continue Post COVID-19. Industries that will be well-positioned to manage the distractions and shocks presented by the COVID-19 crisis will be those that are resilient. The design of work needs to address worker safety, health and wellbeing as well as attending to the needs of individual workers and foster support from both co-workers and managers. Though hospitals might have some programmes in place to deal with improving the mental health of the employees, there is a lot of opportunity for improvement as we deal with the NEW NORMAL.

The author is the Occupational Health and Safety Professional Employee Assistance Programme Practitioner, Korle-Bu Teaching Hospital. Email: h.adjeimensah@yahoo.com