Supporting patient and clinician mental health during COVID-19: Via trauma-informed interdisciplinary systems

Dillon Browne; Sylvain Roy; Marjory Phillips; Sandy Shamon; Michael Stephenson

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Table 1.

Summary of recommendations and additional resources: Trauma-informed suggestions for balancing clinician and patient mental health during COVID-19.

CHALLENGE	SUGGESTION	SCRIPT OR RESOURCES
Balancing patient mental health with COVID-19 best practices	Universal: approaching each encounter open to the possibility that feelings of safety and mental health have become an increasing concern for patients	Psychoeducation and normalizing: “It’s common for people to experience higher levels of anxiety and lower mood during times of crisis like COVID-19. Sometimes this can show up in family relationships that have become more tense and hostile, or distant and cold. Other times people can rely on unhealthy coping strategies, or let their self-care practices slip”
Allocating a realistic amount of time to discuss psychosocial concerns	Universal and targeted: insert a brief conversation around emotional well-being early in patient encounters. If warranted, use targeted follow-up questions via motivational interviewing followed by additional domain-specific psychoeducation and interventions	Supportive interviewing: “I wanted to check in and see how you are doing emotionally in response to the pandemic. Are there any substantial changes in your emotions, relationships, or activities that you think I should know about? What about your relationships at home with your partner, your children, etc?” Miracle question: “If you could change one thing about how things are going at home during the pandemic, what would you change? Why?”
Providing high-quality referrals in a disrupted health care system	Targeted: prioritizing psychosocial, emotional, and medical concerns meriting immediate treatment. Become aware of local mental health professionals providing disaster response services using telehealth	Follow-up or referral: “Those are important concerns. I understand things have been hard for you. We will have time to address all of those issues today and I will be sure to follow up at our next appointment” OR “I want to make sure that we provide adequate attention to that area. That’s why I want to refer you to a specialist who focuses on these sorts of concerns during the pandemic. Even though I am referring you, we can always talk about this issue and I will be following up at our next appointment”
Balancing self-care with increasing service demands	Clinician directed: consider specialized telehealth psychotherapy or counseling for front-line providers, offered free of charge by psychology associations	Free online psychological services (where applicable): Canada: https://cpa.ca/corona-virus/psychservices/ United States (see state-specific board or website): https://www.asppb.net/page/BdContactNewPG