The Mental Health Department at World Health Organization (WHO) has developed a set of guidelines for people to look out for their stress and anxiety levels during the ongoing COVID-19 pandemic.
Ranging from empathetic advice, such as acknowledging the role of healthcare workers, to the more complex, such as refraining from calling the impacted patients 'cases' or 'victims', we believe the following (adapted) guidelines will help calm your mind during this testing time.
1. Don't make it about ethnicity or nationality: COVID-19 has affected people across the world; don’t attach it to any ethnicity or nationality. Be empathetic to those who got affected, in and from any country, those with the disease have not done anything wrong.
2. The affected people are not 'cases' or 'victims': Don’t refer to people with the disease as “COVID-19 cases”, “victims” “COVID-19 families” or the “diseased”. They are “people who have COVID-19”, “people who are being treated for COVID-19”, “people who are recovering from COVID-19” and after recovering from COVID19 their life will go on.
3. Don't stay glued to news that makes you anxious or distressed: The sudden and near-constant stream of news reports about an outbreak can cause anyone to feel worried. Seek information mainly to take practical steps to protect yourself and loved ones. Seek information updates at specific times during the day once or twice. Get the facts.
4. Protect yourself and be supportive to others: Assisting others in their time of need can benefit the person receiving support as well as the helper.
5. Tell positive stories of those who have recovered: Find opportunities to amplify the voices, positive stories and images of locals who have experienced COVID-19 and have recovered, or those who have supported a loved one through recovery and are willing to share their experience.
6. Honour the ones who are working hard on the frontline: Caretakers and healthcare workers supporting people affected with COVID-19 in your community deserve the recognition. Acknowledge the role they play to save lives and keep your loved ones safe.
7. Acknowledge that stress is normal: Feeling stressed is an experience that you and many of your colleagues are likely going through; in fact, it is quite normal to be feeling this way in the current situation. Managing your stress and psychosocial wellbeing during this time is as important as managing your physical health.
8. Take care of your basic needs: Ensure rest and respite during work or between shifts, eat sufficient and healthy food, engage in physical activity, and stay in contact with family and friends. Avoid using unhelpful coping strategies such as tobacco, alcohol or other drugs. Using the strategies that you have used in the past to manage times of stress can benefit you now.
9. Cope with the inevitable social stigma: For healthcare workers, experiencing avoidance by their family or community due to stigma or fear can make an already challenging situation far more difficult. If possible, stay connected with your loved ones, including through digital methods. Turn to your colleagues, your manager or other trusted persons for social support.
10. Think beyond written communication: Use understandable ways to share messages with people with intellectual, cognitive and psychosocial disabilities. Forms of communication that do not rely solely on written information should be utilised.
11. Stay connected and maintain your social networks: Even in situations of isolation or lockdown, try as much as possible to keep your personal daily routines. If health authorities have recommended limiting your physical social contact to contain the outbreak, you can stay connected via e-mail, social media, video conference and telephone.
12. Pay attention to your needs and feelings: Engage in healthy activities that you enjoy and find relaxing. Exercise regularly, keep regular sleep routines and eat healthy food. Keep things in perspective. Public health agencies and experts in all countries are working on the outbreak to ensure the availability of the best care to those affected.
Instructions specific to managers and team leaders
1. Protect your staff from chronic stress: Keeping all staff protected from chronic stress and poor mental health during this response period means that they will have a better capacity to fulfil their roles.
2. Communicate accurate and timely updates: Ensure good quality communication and accurate information updates are provided to all staff.
3. Take proactive measures to manage physical and mental wellbeing of staff: These include the following measures:
- Rotate workers from high-stress to lower-stress functions.
- Partner inexperienced workers with their more experienced colleagues. The buddy system helps to provide support, monitor stress and reinforce safety procedures.
- Ensure that outreach personnel enter the community in pairs.
- Initiate, encourage and monitor work breaks.
- Implement flexible schedules for workers who are directly impacted or have a family member impacted by a stressful event.
4. Provide staff access to support services that manage stress: Ensure staff are aware of where they can access mental health and psychosocial support services. Managers and team leads are also facing similar stressors as their staff, and potentially additional pressure in the level of responsibility of their role, so don't forget about using such services yourself.
Instructions specific to parents/caretakers of children
1. Help children find positive ways to express disturbing feelings such as fear and sadness: Every child has his/her own way to express emotions. Sometimes engaging in a creative activity, such as playing, and drawing can facilitate this process. Children feel relieved if they can express their disturbing feelings in a safe and supportive environment.
2. Keep children close to their parents and family: Avoid separating children and their caregivers as much as possible. Ensure that during periods of separation, regular contact with parents and caregivers is maintained, such as twice-daily scheduled phone or video calls or other age-appropriate communication (e.g., social media).
3. Maintain familiar routines in daily life as much as possible, especially if children are confined to home: Provide engaging age-appropriate activities for children. As much as possible, encourage children to continue to play and socialise with others, even if only within the family when advised to restrict social contract.
4. During times of crisis, it is common for children to seek more attachment and be more demanding: Discuss the COVID-19 with your children in honest and age-appropriate information. If your children have concerns, addressing those may ease their anxiety. Children will observe adults’ behaviours and emotions for cues on how to manage their own emotions.
Instructions specific to caretakers of older adults
1. Older adults, especially in isolation and those with cognitive decline/dementia, may become more anxious, angry, stressed, agitated, and withdrawn during the outbreak/while in quarantine. Provide practical and emotional support through informal networks (families) and health professionals.
2. Share simple facts about what is going on and give clear information about how to reduce risk of infection in words older people with/without cognitive impairment can understand. Repeat the information whenever necessary. Instructions need to be communicated in a clear, concise, respectful and patient way.
3. Display information to reinforce the message: It may be helpful for information to be displayed in writing or pictures. Engage their family and other support networks in providing information and helping them practice prevention measures (e.g. handwashing etc.).
4. Encourage older adults with expertise, experiences and strengths to volunteer in community efforts to respond to the COVID-19 outbreak (for example the well/healthy retired older population can provide peer support, neighbour checking, and childcare for medical personnel restricted in hospitals fighting against COVID-19).
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