By Elyse N. Mowle, Ph.D.
April 29, 2020
U.S. Army photo
How Providers Can Support Military Patients and Families
During infectious disease outbreaks such as COVID-19, behavioral health care providers are likely to encounter patients who are experiencing distress about the outbreak and its impact on them and their families. In addition to the regular stressors of military life, service members and their families may be managing the impacts of delayed or cancelled moves, deploying to support the services' response to the outbreak, and providing education and childcare to their families.
Behavioral health care providers play an important role in acknowledging concerns and uncertainty about emerging diseases such as COVID-19. Providers may consider the following recommendations for promoting patients' psychological wellbeing:
- Provide information and education. Behavioral health care providers have the opportunity to provide accurate and timely information to patients. Be sure to update your patients on the status of your clinic and communicate changes to appointment delivery methods. Providers can also promote patient behaviors that protect individual, family, and public health by encouraging recommendations from credible public health resources, such as the Centers for Disease Control and Prevention (CDC).
- Encourage patients to follow steps to promote wellbeing. These steps may include limiting media exposure, checking in with loved ones, using trustworthy sources of information, and teaching patients to recognize and monitor their own distress reactions. Common signs of distress include:
- Worry and fear
- Trouble sleeping
- Difficulty concentrating
- Interpersonal problems
- Increased substance use
- Acknowledge and normalize behavioral responses. While many people demonstrate great resilience in the face of stressful events, it is important to express to patients that it is common to experience a wide range of reactions, including frustration, fear, loneliness, and boredom. Children and adolescents may also be impacted, and may "act out," oversleep, have sleep disruption, have reduced academic performance, and feel isolated.
- Discuss strategies to reduce stress. Strategies include:
- Maintaining healthy behaviors such as sleep, exercise, and regular meals
- Limiting the use of alcohol, tobacco, and other substances
- Talking to family and friends
- Engaging in hobbies and activities they enjoy
- Using calming methods, such as muscle relaxation or other "Chill Drills"
- Using the new Department of Veterans Affairs COVID Coach mobile app to support self-care and overall mental health during coronavirus
- Monitor for signs of more severe emotional distress. While it is normal to experience stress during an emerging outbreak, providers are likely to encounter some patients who have more severe distress. Refer to specialized mental health care when a patient experiences severe emotional distress, develops a recurrence or worsening of symptoms, or is regularly using substances to manage negative emotions. As always, refer the patient for an emergency evaluation if they express thoughts of harming themselves or others.
How Providers Can Take Care of Themselves
In the midst of taking care of others, you can't forget about yourself. Make sure to take care of your own needs, too. Risk of burnout may be higher in the high-stress environment of an emerging disease. Remember: Health care providers are not immune to experiencing distress during high-stress situations such as outbreaks.
While every individual may have their own preferred methods of self-care, here are some general tips:
- Meet basic needs: Make sure you are staying hydrated, eating, and sleeping, and try to make time for rest and relaxation.
- Stay connected: Stay actively connected with your colleagues and other support systems. Checking in with your loved ones may reduce feelings of isolation.
- Take breaks: When possible, avoid overwork and try to make time for breaks.
- Self-checks: Monitor yourself for stress reactions and practice strategies to reduce distress.
- Recognize your service: You are doing important work. Don't forget to reflect on the important service you and your colleagues are providing.
For more strategies for sustaining your own wellbeing, refer to the Center for the Study of Traumatic Stress: Sustaining the Well-Being of Health Care Personnel during Coronavirus and other Infectious Disease Outbreaks. And check out free, evidence-based digital health tools designed by the Defense Health Agency Connected Health branch to promote provider self-care including the Provider Resilience App, Virtual Hope Box app, and Breathe2Relax app (all apps available in the App Store and Google Play), and the Military Meditation Coach Podcast.
Other Coronavirus Mental Health Resources:
Dr. Mowle is a contracted sexual assault subject matter expert at the Psychological Health Center of Excellence. Her specialties include sexual assault prevention and treatment and the consequences of traumatic exposure.