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If there is anything positive to be learned from the pandemic, it may be that the pandemic has finally imposed an hour of reckoning on the mental health crisis in medicine.
One of the most tragic cases of the past year has been that of Lorna Breen, a New York doctor whose death in April 2020 caused a wave of anxiety in the medical community.
Breen, who was 49 and worked as the medical director of the emergency department at Allen Presbyterian Hospital in New York City, had no known psychological issues but began to deteriorate after working tirelessly on the front lines , which led her to contract COVID-19 on her own. .
“What’s striking about this story is how quickly it happened,” says Brian’s son-in-law Cory Faist, whose wife Jennifer arranged for an emergency transfer of friends to take Lorna away. in their hometown of Charlottesville, Virginia, when it became clear how severe her suffering was. For a doctor, this is what he has been trained to do throughout his career. “They” should “be able to keep up.” But Breen never saw withdrawal as an acceptable option.
Since her death, the couple have been at the forefront of the battle against physician suicide, and they created the Dr. Lorna Brian Heroes Foundation, a non-profit organization that advocates for better health. mental in the profession. Faist insists that what needs to change is the system, not the doctors and nurses themselves. “It’s not about trying to make the healthcare worker more resilient,” he says. “We need to start tackling this problem.”
While a revolution in the way global health systems care for their people remains elusive, there are signs of progress. As soon as the Corona virus swept through Wuhan in late 2019, causing a pattern of psychological symptoms among medical staff that faintly echoed the symptoms that emerged over the SARS outbreak nearly two decades ago, the Chinese government acted. to intervene (although he insisted from the start, whistleblowers must remain silent.)
In February, hospitals in eastern China set up emergency psychological response teams to stem the tide of anxiety, depression and insomnia, while the National Health Commission of China published the very first national guide on psychological protection of health workers, which called for early identification. high-risk groups and the establishment of rescue teams for psychological cases.
In the United States, the Biden administration has allocated $ 120 million to support the welfare of medical personnel as part of the Covid-19 relief bill, and in the United Kingdom, the National Health Service and the National Health Service announced the improvement of the NHS last October. Finally, they will invest 15 million pounds in psychological support for employees. Last month, Sir Simon Stevens, chief executive of Britain’s National Health Service, said the service would establish 40 mental health centers across the country to provide advice to workers and refer those in need of specialist services.
Critics argue that these provisions are often too few and too late. “Everyone I’ve spoken to (the new speech) thinks it won’t be enough – and he will be overwhelmed by the flood,” says Andrew Molodinsky, head of the mental health division at the British Medical Association.
“The past year was like no other for our staff,” says Prirana Essar, director of personnel at the National Health Service. “Their response to the care of hundreds of thousands of patients has been truly exceptional. It is absolutely true that the staff receive quality support and care, which is why they are available.” Help and advice (.. .) including confidential counseling line, 24/7 scenario support and access to mental health services.
In some cases, hospitals have taken matters into their own hands. When the virus first hit the UK, Charlie Cole, a psychology intern at Homerton Hospital in east London, who previously worked as a ward for healthcare workers during the Ebola outbreak in West Africa, has set up one of the country’s first psychosocial clinics dedicated to medical personnel. “My biggest learning point is that services like this should have been there before,” says Cole. “We should not have waited for a pandemic to occur.”
Last Tuesday afternoon I attended one of Cole’s virtual wellness sessions for a dozen Homerton community nurses. Nurses, whose job it is to visit patients at home rather than treat them in wards, are often first-time workers and are reluctant to express their feelings publicly. A community leader, Beatrice Osuntuki, laughs and points at her colleague after she kills herself over one of Cole’s questions. “Hey, Kwame! Speak, please!”
Gradually, the group prepares to respond, as Cole guides them through concepts such as emotional harm and empathy fatigue. Delfort Lee, another community leader, remembers the emotional stress of returning home to care for dying patients several times a week, knowing that she is at risk of introducing the virus into her family, one of whom is disabled. “I am capable and efficient in caring for patients at the end of their life. The only problem is the stress that comes with it, ”she says. “I think we have to put up with everything and move on,” she adds.
Some who use the service are directed towards more substantial treatment. After calling Cole’s ward in January, Alfred Batala, a senior nurse in the intensive care unit in Homerton, who began having panic attacks and nightmares after the first wave, was referred to a psychiatrist. He was then diagnosed with severe anxiety and PTSD, and was encouraged to take time off.
“Normally I am that person – to make everyone happy when I’m at work,” says Batala, 32, from his London apartment, wearing a t-shirt with the National Health Service (NHS) logo on it. . When we spoke, he had just returned to the intensive care unit to reunite with his comrades after a four week break at home. “Now when I think about work, I miss it,” he says.
For Patalla and nurses in the Homerton community, there is at least one bright spot on the horizon: vaccine rollout and the UK’s roadmap out of lockdown. “Hurry up, I can’t wait! I’m coming home to Jamaica! ”Says Denise Frances, nurse head of sector.
When I followed Boeing Dean, a resident doctor at Wellspan Good Samaritan Hospital in rural Pennsylvania last month, which collapsed for two hours during a 12-hour shift, she had just arrived at her parents’ home. in Houston, Texas, after driving. 1,600 miles across the country. She is determined to start a new life.
A few weeks ago, she quit her tough “resident” program. After regular consultation with Pamela Whipple, a physician and activist who spent two decades campaigning for Doctors’ Health after experiencing a case of suicidal depression in 2004 while practicing medicine in Eugene, Oregon, Boeing decided to protect his health, whatever the occupational risks. . Pamela used to say things like ‘You don’t need order. The system needs you. You can do whatever you want with your precious life – just know that you only have one life. “”
For now, Boeing Co plans to stay in Houston and spend some recovery time with his family. “I’m going to be spending some time here and after I feel comfortable enough and the weather starts to warm up, I think a road trip to national parks would be really cool,” she says.
Eventually, she plans to open a private clinic in Oregon, to specialize in the area she discovered during the pandemic that was most important to her: trauma. “Often when people know they are about to die, they tell you their story, their regrets and the things they had to endure,” she says. “What I found out is that there are a lot of people who are suffering massively from trauma, and they bury it inside.”
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