Mental Health Response to Disasters in Healthcare Including the COVID-19 Pandemic

Healthcare workers were substantially impacted by the COVID-19 pandemic. Front-line workers continue to suffer higher rates of distress and burnout than they had before the pandemic. In order to heal the front-line workforce and plan for the next disaster in healthcare, it is necessary to carefully reflect on the COVID-19 pandemic and integrate that experience with the existing literature on disaster mental health. In this narrative review, the disaster MH framework for community disasters is adapted to the healthcare setting. The first principle of disaster mental health is to distinguish between normative distress and psychopathology. The second step in the framework includes stabilization, triage, and referral to psychiatry. The third step in disaster mental health framework is intervention for psychological distress and psychiatric illness. Interventions for emotional distress may include psychological first aid (PFA), psychological debriefing, crisis counseling, and psychoeducation, whereas interventions for psychopathology include pharmacotherapy and/or psychotherapy. Unfortunately, many front-line HCWs were indeed damaged by the pandemic and continue to report high levels of burnout and distress, in part because the MH response to the pandemic was lacking or otherwise inadequate. Screening, triage and referral to MH resources, and interventions are fundamental aspects of an MH response to disaster and may be coordinated with formal operational procedures within incident command structures. Setting up these structures in advance, preferentially, and establishing networks of psychiatrists and crisis MH responders who will implement them are essential. By reflecting on the pandemic and learning from prior disasters, we can care for those who care for our sickest patients.