Recently, I received a call from a close family friend who was experiencing a psychotic episode in the context of her fears related to COVID-19. She had developed delusions about how certain public figures were using physical distancing and technology to steal physical body parts from the masses. Though new or heightened delusions are known to crop up under stress, my friend had not experienced this type of psychiatric issue in the past and it struck a chord with me. Our collective psyche is under unprecedented siege and will be for some time.
It is completely normal to be afraid in a pandemic, but fear and the disruption of our life structure is exacting a price on our mental health, especially as we recognise that “reopening” will provoke issues anew. All around us, people in our personal and professional lives are experiencing various types of emotional disturbance in response to COVID-19, so it is little wonder that calls to help lines continue to surge.
We are sad, frustrated and irritable because we are isolated. We grieve the lost lives we know about and those we don’t. We fear the consequences of our own exposure to the virus. We fear the risks we potentially pose to others. We worry about our finances in our collapsing economy, about our ability to be employed with dignity and grieve over losing what must be left behind as a result of the unknown future of COVID-19.
Every single person may eventually witness the effects of COVID-19 first-hand. Perhaps then our greater society might finally understand and admit that healthy and unhealthy mental functioning affects us all and that a full human experience requires good mental health.
Researchers have documented the psychological impact of prolonged quarantine, finding negative effects that are commonly associated with exposure to trauma, according to a recent review of 24 quarantine studies in the journal the Lancet. These effects include confusion and anger that are exacerbated by fears of becoming infected, loss of freedom, separation from loved ones and financial loss, among others.
Some combination of these intensifying experiences defines the lives of most every Los Angeles County resident today.
For some, the painful emotions provoked by this collective trauma will recede as the coronavirus crisis ebbs, but haunting memories, negative thoughts and uneasy feelings won’t fade so easily for others. They need to be comfortable asking for help.
In response to the pandemic, Los Angeles County’s Department of Mental Health, which I oversee, is trying to make it easier to access that help.
Delivering emotional support to residents
We are leveraging technology to deliver free mental health assistance to all county residents. Through a partnership with Head space, every resident can get a free subscription to the company’s guided meditation app. Scientific studies have demonstrated that guided meditation is an effective tool for increasing compassion; improving sleep, health and relationships; and reducing anxiety.
We have also expanded and re-engineered the Department of Mental Health help line. Thanks to volunteers and redeployment of select staff who are now working from home, it is now set up to deliver emotional support around the clock to all LA County residents, instead of just focusing on crisis responses.
To help manage the trauma that health care workers are experiencing, we dedicated a portion of the help line staffed by volunteers from the Luskin School at UCLA to meet their needs. The volunteers receive specialised training that allows them to support callers facing harrowing dilemmas with no good choices and no good outcomes, putting them at risk of moral stress and moral injury.
Long before the pandemic, the Department of Mental Health started trying to improve access to care by providing education and staffing to public venues, including at schools, libraries and houses of worship, and linking them to resources.
As part of our response to COVID-19 and to help the county pivot toward reopening and recovery we are attempting to set up a network of grassroots mental health “ambassadors.” Trained to function as a lay mental health workforce, they will reach out across public venues in their communities. This effort could begin as early as August, pending the Board of Supervisors’ approval.
The message of our outreach is simple: Wherever people convene they can connect, and through connection they can heal.
Every single person may eventually witness the effects of COVID-19 first-hand. Perhaps then our greater society might finally understand and admit that healthy and unhealthy mental functioning affects us all and that a full human experience requires good mental health. It shouldn’t have taken a global pandemic to showcase this reality.
— Los Angeles Times
Dr Jonathan Sherin is the director of the Los Angeles County Department of Mental Health.
