Covid-19: Caregivers' mental health under strain

On the front line facing the coronavirus pandemic, doctors, nurses and caregivers are particularly exposed to stress and anxiety. Interviewed by France 24, Bernard Astruc, psychiatrist and mental health specialist, expects caregivers to develop symptoms of "post-traumatic stress disorder" in the weeks or months to come. 

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According to him, "caregivers are often the first and sometimes the only ones in our societies to see people die". This is why their mental health can be threatened.

"A caregiver [...] who has observed signs of Covid-19 on himself, may, surrounded by dozens of people dying, develop what is called a state of post-traumatic stress, the main syndrome that we observe in these cases ", explains the psychiatrist. Usually, this disorder appears in people "who have lived through war or attacks", specifies Bernard Astruc.

"I wish it was just a dream"

A caregiver in the north-east of England, Steve, who contracted Covid-19 two months ago, is one of those caregivers at risk. Healed, he tells of the anxiety of infecting his children. 

"When I returned to work, I couldn't sleep well, I was worried about the risk of bringing the virus home and catching it again," he told AFP.

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"I never imagined having to work on the front line during a pandemic. I wish it was just a dream and that when I woke up, the world would return to the way it was," he added. 

For Xavier Noël, expert in mental health issues at the Free University of Brussels, "we have all the ingredients for a major risk of post-traumatic stress".

Nightmares, Flashbacks, and Escape Reactions 

Post-traumatic stress can manifest itself as "recurring and intrusive memories" and "a sort of state of hyper vigilance" urging to "be constantly on the alert", details psychiatrist Bernard Astruc, who adds that symptoms may vary depending on the patient. 

They may also have "sleep disturbances", such as "nightmares" and "flight and fear reactions". Symptoms which, according to Bernard Astruc, can "really alter the quality of life".

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Even if, emphasizes the psychiatrist, "it is still too early to be able to say what proportion [of caregivers] was affected" by this syndrome, recent studies already give a glimpse of the traumas which affect the caregivers mobilized during the pandemic. 

In Italy, stress detected in nine out of ten caregivers 

One of these studies, conducted in early May among 3,300 Dutch-speaking caregivers in Belgium, shows that 15% of them often think of "leaving the profession" compared to 6% in normal times.

Another, carried out by the University of Madrid, observes that more than half (51%) of the 1,200 caregivers interviewed have "depressive symptoms". Another eloquent figure: 53% presented signs "compatible with post-traumatic stress".

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The Catholic University of the Sacred Heart of Milan has also discovered that seven out of ten health professionals in the most affected regions of Italy suffer from exhaustion, nine out of ten from stress.

According to researcher Serena Barello, the usual work stress has been exacerbated by the increased workload, "seriously endangering their health, not only physical, but also emotional and psychological".

Cascading calls in associations

For their part, specialized associations have noted an increase in requests from caregivers. 

In France, the association of care for health professionals explains that it receives more than 70 calls per day, compared to five in normal times. Some of them testified to a "risk of impending act". 

The latest survey from @ AssoSPS shows that health professionals need psychological support. Find out all about the results at https://t.co/fRm8dxRB8r pic.twitter.com/wWslM40tyi

On the other side of the Channel, in the United Kingdom, the second most affected country after the United States in number of deaths, Laura Hyde, an association which provides psychological support, also explains that she was inundated with calls.

Asking for help can feel tough. We appreciate that. We are working with the Laura Hyde Foundation to encourage anyone who is working in the NHS, who feels that life or work is tough at the moment, to get the support they deserve. @LhFoundation #NHS #MentalHealthAwarenessWeek pic.twitter.com/Wkf4siFhUo

"Health workers everywhere have been truly touched by all the love they have received from the public," said Jennifer Hawkins, one of the leaders of the foundation, founded in memory of a nurse who ended her life. days in 2016. "But the hero label can sometimes lead to additional pressure."

"A Superman does not go to the doctor"

"The harsh reality of their work has important repercussions on mental health," she warns. "Health professionals must not suffer in silence, prescribe what they would prescribe to others and ask for help."

An analysis shared by Bernard Astruc, who encourages caregivers to consult in case of signs of anxiety and stress. 

"One of the peculiarities of this disorder [post-traumatic stress disorder] is that people stay at home and do not consult. This is even more true among caregivers," he explains. "Finally, the hero is the one who will not ask for help. A Superman does not go to the doctor," illustrates the psychiatrist. 

What care can be considered for these caregivers? "We can use drugs but also psychotherapy," says Bernard Astruc. He takes the example of EMDR, "a desensitization therapy that will allow information to be reprocessed", according to the psychiatrist. 

>> Read also: Post-traumatic stress, confusion and anger: the psychological effects of confinement

The doctor also stresses the importance of prevention: it will encourage caregivers in distress to seek help. "It may be entirely relevant to offer, for example, psychological listening lines", adds Bernard Astruc, who has set up this service in his own medical teleconsultation platform, Eutelmed. 

"This makes it possible to make an initial maintenance of descrambling, to direct towards an adapted treatment and to make prevention", he indicates.

Valuable help for these caregivers, while the epidemic is not yet over, according to the authors of the study from the University of Madrid, Lourdes Luceno Moreno and Jesus Martin Garcia: "An urgent psychological intervention is necessary for this group if a much feared second wave materializes. " Otherwise, they warn, "we will see emotionally damaged professionals and a health system with no response capacity."

With AFP

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