A recent survey in the Journal of the American Medical Association of 1,275 healthcare workers on the frontlines of China鈥檚 COVID-19 response finds significant symptoms of 鈥渄epression, anxiety, insomnia, and distress鈥� among respondents. What鈥檚 more, the authors suggest the closer to the epicenter of the virus, the more acute the symptoms tend to be.[1] As someone who has worked with American first responders for nearly 15 years, this doesn鈥檛 surprise me. Stress and trauma are occupational hazards for those called to the front lines, even in the best of times.
There鈥檚 no question about it: COVID-19 has added a layer of complexity and concern to the work of America鈥檚 first responders as well. finds that 92% of cities have inadequate personal protective equipment (PPE) for first responders. A similar percentage of cities, they find, are lacking test kits. The result is policy that often changes daily, sometimes more, depending on current availability of supplies to fire, emergency medical services and law enforcement. 鈥淚t seems right now that the people at the top issuing decrees are more concerned with conserving PPE for than with protecting us out on the street,鈥� a firefighter at a major metropolitan station told me.
Concern for Family
Uncertainty, a lack of support, fear鈥攁ll feelings that contribute to a first responder鈥檚 emotional valence.[2] And the fear is not just for themselves. In fact, found the most common concern (27%) of respondents is 鈥渂eing away from/infecting my family.鈥�
Families are feeling it too. 鈥淚 fear for the physical safety of our first responders,鈥� says Dianne Bernhard, executive director of . 鈥淏ut for the people at home, especially those who have lost a family member or colleague in the line of duty, who find themselves quarantined with nothing to do but watch cable news and check the internet鈥攖his is devastating from a mental health perspective. And we know the families of our law enforcement and first responders are their first line of defense when it comes to mental and emotional health.鈥�
What are our ?
The Importance of Self-Care
鈥淚t鈥檚 critical for first responders to take care of themselves during the COVID-19 crisis,鈥� says Dr. David Black, CEO of Cordico and a clinical psychologist who works with first responders. 鈥淥ur heroes on the front lines are always seeking to help others, but it鈥檚 more important than ever that they also prioritize taking care of themselves during this very demanding time.鈥�
Dr. Black makes some concrete suggestions to among first responders and their families:
- Follow COVID-19
- Maintain healthy routines: Get exercise, eat well and prioritize sleep.
- Maintain supportive social relationships鈥�.
- Prioritize taking care of your family and ensuring their cohesion, health, wellness and safety.
- Avoid falling into negative patterns of behavior, such as drinking too much alcohol, overeating, skipping out on sleep or obsessively consuming news.
- Be proactive and purposeful so that your habits and routines embody your core values and ideals (e.g., family, health and wellness, faith, safety, service), rather than reactive responses to stressful circumstances (i.e., alcohol, junk food, excessive screen-time, social isolation).
- Now is a great time to emphasize your or to create one if you don鈥檛 already.
Bernhard concurs with Dr. Black鈥檚 advice. 鈥淪tay healthy. Have purpose,鈥� she says. 鈥淎nother thing we really recommend here at COPS is deep breathing. When you feel stress coming on or anxiety or feel overwhelmed, it鈥檚 a good idea, we鈥檝e found, to take some nice, deep breaths and let those feelings pass. I find that, generally speaking, breathing deeply is calming.鈥�
Mindful Moments
As I discuss in , breathing is an excellent entry point into a meditative practice as well鈥攆or you and your family.
Here鈥檚 how. Find a quiet and peaceful place to sit comfortably but with proper posture (your personal vehicle, before or after shift, might work). Let your eyes rest and settle unfocused, but open. Have a few good, deep breaths as you settle into yourself and transition from 鈥渄oing鈥� into 鈥渂eing.鈥� If this doesn鈥檛 work for you, maybe go for a quiet walk鈥攚hatever it is that brings you personal equanimity and peace. This is a time to tap into the vast reserves of strength and understanding within yourself and the world around you. It鈥檚 still there, as always, despite coronavirus.
References
[1] Lai J, Ma S, Wang Y, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3):e203976. doi:10.1001/jamanetworkopen.2020.3976
[2] Citron, F.M., Gray, M.A., Critchley, H.D., Weekes, B.S., & Ferstl, E.C. (2014). Emotional valence and arousal affect reading in an interactive way: Neuroimaging evidence for an approach-withdrawal framework. Neuropsychologia.
