Healthcare staff facing Covid burnout?
Although the pandemic curve has flattened and the daily Covid cases have come down, it has left a long-lasting impact on the mental health of the healthcare workers
A 27-year-old resident doctor from BYL Nair Hospital, Mumbai Central always carries a strip of anti-anxiety pills in her pockets. At night, she breaks into a sweat when images of the over-crowded Covid-19 wards flash in her sleep. In May, she had a mental breakdown and had sought psychiatric help from a private doctor.
“I have been taking care of Covid-19 patients since the outbreak of the pandemic in March 2020. The first wave was exhausting and frightening as we didn’t know much about the virus. But by the time the second wave hit us, we were already mentally and physically burnt out, and I couldn’t take it anymore,” she said.
Nair Hospital was the first civic-run hospital that was converted into a dedicated Covid-19 hospital. Since the start of the pandemic, the hospital has treated over 18,000 Covid-19 patients and hundreds of resident doctors like her, have been the backbone of the hospital.
Although the pandemic curve has flattened and the daily Covid cases have come down to below 400 on an average compared to 10,000 cases recorded in April this year, it has left a long-lasting impact on the mental health of the healthcare workers (HCWs) including doctors, nurses radiographers, lab technicians and anaesthetists, Class 4 employees among others. With an anticipated third wave, they urgently need mental health support, claim doctors.
Increased alcohol use
A 37-year-old Class 4 employee who works at the morgue of King Edward Memorial (KEM) Hospital, Parel turned into an alcoholic to cope with the burnout in the second wave. “He has been in the morgue for the past 10 years but I never saw him so distressed. In April, he was handling 10-15 bodies daily. He would maintain distance from us. Soon, he submerged himself in addiction. Now, he is undergoing counselling at the psychiatry department of the hospital,” said his wife.
During the first and second waves, HCWs had to handle grief, console patients’ families, and other issues added to their mental burnout. Many of these workers had to isolate themselves from their families to avoid the chances of transmission Covid-19. This has caused a severe interruption in family life and relationships.
National Institute of Mental Health and Neurosciences (NIMHANS) conducted a survey among 3,083 HCWs across India. They published their findings in April in the Asian Journal of Psychiatry which revealed that 26.6% and 23.8% of the respondents had anxiety and depression respectively.
“In the backward stepwise logistic regression analysis, HCWs with anxiety disorder were more likely to be doctors/nurses/hospital assistants, older, female, unmarried, without a leisure activity, report increased alcohol use and suicidal thoughts after pandemic onset, and having a history of receiving mental health interventions,” reads the study—Mental health issues among health care workers during the Covid-19 pandemic.
Many suffer from anxiety, distress
Even after 18 months since the outbreak of the pandemic, city psychiatrists are getting a lot of HCWs who are suffering from anxiety, distress and depression due to the pandemic.
A psychiatric clinic, Aavishkar Center along with MediaMedic Communication started a mental care helpline number—9172284386 for the HCWs in June. Since, its launch, the helpline has received 632 calls. Almost 90% of the callers complained of anxiety, frustration and fear-related Covid-19 duty in hospitals.
“HCWs are experiencing elevated psychological distress, burnout, and increased risk of mental illness. In April, when cases shot up, there were shortages of beds and oxygen. So, these young resident doctors had to prioritise the treatment of patients. In this, many have lost their critical patients. Now, they feel responsible for their death,” said Dr Nirmala Rao, director of the centre. “They are under too much distress which is also affecting their personal relationships,” she added. Considering the good response at the helpline number, now it is being made available to the public. It will be functional between 9am and 6pm daily.
In many cases, the HCWs who were asymptomatic carriers ended up infecting their family members which further added to their mental health. “My husband and both of my in-laws contracted Covid-19 from me. My father-in-law who was 68-year-old succumbed to the infection. I still feel guilty for it,” said Sunita Rao, 34, a nurse with the government-run JJ Hospital.
No leaves for mental health ailments
Dr Harish Shetty, a well-known psychiatrist said that HCWs aren’t even getting the time for recovery amid the ongoing fluctuation of the pandemic curves. “With rising variants, there may be more pandemic waves like the anticipated third wave. This means that healthcare providers won’t get the required rest for their mental health. While we are focusing on vaccination and more research on the virus, we need to focus on caregivers also,” he said.
Medical colleges have started counselling their HCWs but due to the fear of getting stigmatised, many opt for private counselling. “Mental health still gets stigmatised, hence many of the HCWs avoid getting counselling in their own department and approach doctors outside to maintain their secrecy. Several HCWs from lower working grades don’t even consult psychiatrists or psychologists until it is too late,” said Dr Rao.
Many young resident doctors claimed that there are no leaves for mental health ailments. “Our hospitals talk about the need for mental health but we don’t get any sick leaves for it. We are being denied leaves for recovery from anxiety and depression due to Covid-19 duty for months. No one fights for us,” said a resident doctor from Nair Hospital.