The publication of Psychological intervention guide: Intervening in the context of infectious disease outbreaks could not be better timed, as it coincides with the gradual relaxing of confinement measures implemented across the country to mitigate the spread of the coronavirus.
Although COVID-19 is primarily an infectious disease that attacks the body, its variable impact on the mental health of populations is no less significant. “The stress and anxiety caused by the fear of contamination or by the problems of living in confinement have had a major impact on all segments of the population,” says Professor Jude Mary Cénat, the guide’s lead author and director of the Vulnerability, Trauma, Resilience and Culture Research (V-TRaC) Lab at the University of Ottawa’s School of Psychology. The online guide’s turn-key format features educational modules that aim to equip mental health professionals to manage the psychosocial health of communities affected by infectious diseases, such as COVID-19.
Deconfinement and psychological support
Whether they are elderly people deprived of contact with their caregivers, young people affected by social isolation, employees who fear losing their jobs, or essential workers reporting for work under difficult conditions, many people are experiencing psychological distress and traumas that are affecting their mental health. According to the psychologist, this is a genuine public health issue which, given the crisis we are experiencing, must be addressed swiftly.
“In order to protect ourselves from COVID-19, people have had to learn and adopt a series of behaviours that are normally associated with mental health disorders,” says the researcher. “Washing our hands dozens of times a day is a symptom of obsessive-compulsive disorder, other behaviours are related to depression, while some social distancing measures are associated with social phobias.” Moreover, he remarks that social isolation itself may trigger suicidal ideations in individuals who were already vulnerable to such thoughts before confinement.
A guide to fostering resiliency
“Since some provincial authorities are moving to reopen schools, there is, for example, an urgent need to reinforce the psychological first aid skills of school personnel,” says Professor Cénat, to help them identify students who will need to be referred to a specialist. Teachers and support staff returning to school would feel much less stress if they felt better prepared to support students whose mental health may have suffered during confinement. “Some children may have had to deal with parental violence or witnessed domestic violence,” adds the psychologist, who sees deconfinement as both a challenge and an opportunity to help some people find psychological balance with the proper tools.
The range of strategies and tools developed in this guide to foster resilience in the context of a pandemic includes: using a first-contact approach to evaluate the immediate psycho-social needs of individuals, learning active listening skills, assisting families who have lost a loved one transition through the stages of grief, and training in psychoeducation. The guide dedicates an entire module to helping healthcare teams manage the build-up of internal stress and avoid burn-out through coping techniques and self-care, an aspect that is particularly relevant to hospital workers across Canada.
The psychologist reminds us that there is an irrefutable link between therapy and increased individual and collective resiliency in the context of a pandemic. Hence the need to help people adopt measures that will help them improve their resiliency.
Lessons learned during the Ebola epidemic
The Psychological intervention guide: Intervening in the context of infectious disease outbreaks is the result of Professor Cénat’s collaboration with peers from other universities, namely McGill (C. Rousseau), Bourgogne-Franche-Comté (D.Derivois) , Lubumbashi (J.-P. Birangui), and Kinshasa (J.Bukaka). The guide is based on research conducted during the Ebola epidemic that ravaged the Democratic Republic of Congo from 2018 to 2020 and cost the lives of over 3,000 people.
This research project, which was co-funded by the International Development Research Centre, the Social Sciences and Humanities Research Council and the Canadian Institutes of Health Research, has helped develop a tool that is based on the documented experiences of psychologists, health professionals, survivors, victims’ families, as well as community and religious leaders, along with a systematic review of the mental health programs implemented in the wake of the disease caused by the Ebola virus.
According to Professor Cénat, the economic, health, and human costs of the epidemic had such an impact on the population’s mental health that UNICEF recommended the development of a guide for psychological treatment to respond to the needs of communities affected by epidemics of infectious disease.
“There was a dire need for clinical tools, so that’s what we decided to focus on,” says the researcher, noting that studies showed that Ebola survivors were five-to-eight times more likely to suffer depression, anxiety, and post traumatic stress disorder, and were at risk of developing obsessive compulsive disorders and severe psychological distress. Such findings call for related public health programs in Canada and around the world.
A multifaceted, cross-cultural tool for psychosocial intervention
The guide comprises nine modules and takes transcultural factors into account so that it can be adapted to various cultural communities and age groups. It has already garnered interest from many European and low-to-medium income countries around the world, who see the potential multiplying effect of this therapeutic tool. This guide, which is available in French and English, is being provided free to healthcare professionals to train the greatest possible number of medical, social, educational and community workers to manage the impact of the epidemic on the mental health of those who are ill, their families, and those caring for them.
Even though it seems anecdotal, when a doctor or nurse wearing a mask and head-to-toe protective gear pins a picture of their face to their shirt, it injects a bit of humanity into the treatment process, which can make all the difference in relieving the stress of an isolated patient. This is one example of the many practices recommended in this guide.
“The guide must help mental healthcare professionals foster the resilience of communities affected by the pandemic,” Professor Cénat explains, specifying that whether they live in Beijing, New York, Montreal, Kinshasa or Port-au-Prince, groups of people are struggling collectively and that resilience must also be thought of collectively.