The coronavirus pandemic has changed how we live, in order to stay safe. Our normal day-to-day activities have been turned upside down – including how we work, play and relax. The human factors implications of COVID-19 include organisational changes in the workplace, reduced staffing levels, fatigue, risk perception, the key role of leadership and issues of compliance with rules and restrictions.
Many people have lost loved ones, and millions of people have lost their jobs. Across the globe, working from home, temporary unemployment, home-schooling children and separation from friends and family are the new reality. Those working in healthcare and other essential services are experiencing extreme work pressures and workloads.
Although governments and the media have provided information on how to stay physically safe during the pandemic, guidance on looking after our mental wellbeing has been less visible. However, the actions taken to stay physically safe, such as isolation and physical distancing, may be having a harmful effect on our mental health. Unfortunately, the increase in people needing mental health support may be compounded by the interruption to mental health services.
Even when the pandemic is under control, countries around the world will be dealing with the impacts on mental health for many years to come. Research on previous disasters shows that they create a long shadow of mental health issues, trailing the disaster by months or years. For many people, the effects will be temporary, but some will develop serious issues.
In the US, each percentage point increase in the unemployment rate during the recession of 2007-2009 led to a 1.6 percent increase in the suicide rate. Current projections for the COVID-19 pandemic suggest that a five-percentage point increase in unemployment could lead to an additional 4,000 suicides and 5,000 drug overdose deaths across the US. These impacts do not take into account a potential increase in mental health issues resulting from bereavement, threat of illness, lockdowns, isolation and constant change.
Dr Adrian James, President of The UK Royal College of Psychiatrists has stated that the COVID-19 crisis poses the greatest threat to mental health since the second world war. In the coming months and years there will be a wave of mental health problems, placing significant demand on professional support.
Two keywords that summarise 2020 are ‘unprecedented’ and ‘change’. Given the change and uncertainty, it’s likely that almost everyone has felt anxious, depressed, stressed, fearful, confused or overwhelmed at some point recently. These feelings are a normal part of being human. Mental health issues are widely prevalent in society at the best of times, but during this pandemic these issues are likely to be more widespread. Those with pre-existing mental health conditions are particularly at risk.
“Good mental health is absolutely fundamental to overall health and well-being. COVID-19 has interrupted essential mental health services around the world just when they’re needed most”.Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO)
Mental wellbeing in the workplace
These issues do not just affect our individual health. When experiencing mental health issues, people find it hard to concentrate or remember things, they get distracted and they may withdraw from team interactions. Changes to roles, responsibilities and relationships can lead to a lack of clarity and confusion. For organisations around the world, 2020 was not ‘business as usual’.
Mental health issues in the workplace can mean that errors and mistakes become more likely. Mental wellbeing is a Performance Influencing Factor and it can have a significant impact on human reliability. These human performance issues can in turn lead to accidents, reduced quality, lower productivity and so on.
A workplace risk assessment should consider the risks to health – including mental as well as physical health. Note that in many countries, employers have a legal duty to assess the risks of work-related mental health issues (such as stress). Health and safety laws require employers to provide a workplace that is both physically and psychologically safe. See this article for more information on the steps that employers can take to support mental wellbeing in the workplace.
Maintaining mental wellbeing during COVID-19
The risk of physical illness, concern for friends and families, financial worries and other impacts may have changed your mood or feelings. You may have noticed changes in your sleep patterns or your appetite; you may feel stressed or worried, or find normal activities and routines difficult. Rest assured that many people are having the same feelings. They are normal reactions to a situation that is not normal. Remember that there are links between your physical and mental health.
Here are eight tips to maintain or improve your mental wellbeing during the COVID-19 pandemic:
1. Connect with friends and family
Keep in regular contact with those you are close to (by telephone, text and online channels if your movements are restricted). Sharing your thoughts and feelings with others can make you feel better. Talking things through can help you to bounce back quicker than if you kept your feelings bottled up. Also, try to encourage and enjoy conversation unrelated to the pandemic. There is a distinction between physical distancing and social distancing – remaining socially engaged is critical for wellbeing.
2. Get enough sleep
Most adults should obtain 7 to 8 hours sleep each night, children need an hour or so more. Sleep plays a key role in our physical, mental and emotional health. Try to maintain a regular sleep routine. See the guidance on good sleep hygiene under ‘Further resources’ below.
3. Keep active
If you are not sick, and it’s safe to do so, get some exercise outside – walking, running and cycling are healthy activities that do not require close contact with others or shared equipment. Otherwise, exercise at home – there are plenty of exercise videos online to help maintain mobility and reduce boredom. Any activity that gets you moving is helpful, such as gardening.
4. Eat healthy meals at regular times
Eat healthy and nutritious foods in a balanced diet. Limit snacks or drinks that are highly-processed, or high in sugar. Drink plenty of water. Plan your meals for the week, which reduces the temptation to fall back on takeaways or unhealthy options. Limit the amount of unhealthy foods stored at home. See the healthy eating guidance below.
5. Reduce alcohol and smoking
Limit the amount of alcohol that you drink. Avoid using alcohol and drugs as a way of dealing with fear, anxiety, boredom and social isolation. If you previously attended self-help groups for alcohol and drug dependence and are unable meet in person, find out their alternative methods of support. Note that the WHO state that harmful use of alcohol is associated with increased risk of infections and worse treatment outcomes. Use of alcohol and other drugs may prevent you from taking physical precautions to protect yourself against infection.
6. Limit your news intake
Although it’s important to stay informed, too much news can be overwhelming. A constant stream of alarming or sensationalised news can impact how you feel, so try taking a break or reduce your time accessing the media (perhaps seek information at specific times of the day).
Access information from trusted sources, such as WHO and your local government or health authority.
Be careful of information on social media: get the facts; not rumours and misinformation. Facts can help to minimise fears. Replace the news and social media with things that you enjoy, such as listening to music, reading, games or meditation.
7. Create regular routines
Routines give us a sense of achievement and accomplishment. Having a regular bedtime and mealtimes can provide a helpful structure. Try to maintain the routines that are important to you and those people closest to you. Think about new activities that you could build into your routine. Build fun activities into your schedule so that you have something to look forward to.
8. Pay it forward
Understand that other people are probably as stressed and worried as you are. Offer to help a friend or neighbour, or check-in on someone who is having problems. A little kindness may be just what someone needs. Assisting others in their time of need can benefit both you and the person receiving support.
Practicing the above tips can help you to become more resilient in future. Your mental wellbeing is as important as your physical health. Take care of it.
If you experience any of the following symptoms for several days in a row, or they prevent you from undertaking your daily activities, then please reach out for professional help. Also, look out for these signs in your friends, colleagues and loved ones:
- changes to appetite (eating more or less than usual)
- difficulty sleeping, or sleeping too much
- losing interest in work or leisure activities
- feeling guilty, helpless or hopeless
- changes in mood (crying, anger outbursts)
- withdrawing from usual routines
- avoiding family and friends
- increased physical symptoms such as headaches or stomach aches
- increased reliance on tobacco, alcohol or other substances.
If you feel like you’re not coping, or feel overwhelmed, get professional advice. It’s OK to ask for help. For example, obtain support from your General Practitioner (GP), or a specialist service:
- In the US: National Suicide Prevention Lifeline, 1-800-273-TALK (8255), suicidepreventionlifeline.org
- In the UK: Samaritans, 116 123, samaritans.org
- In Australia: Lifeline telephone crisis support, 13 11 14, lifeline.org.au
Coping with change during COVID-19. Coming to terms with the ‘new normal’. Published by the Australian Psychological Society. This information sheet highlights some strategies to help you cope with change, deal with uncertainty and boost your resilience as we look to a future beyond the COVID-19 crisis.
COVID-19: Five Tips to Face Your Anxiety. This free online learning package has been produced by Columbia University Department of Psychiatry and AllenComm.
Ten tips for a good night’s sleep, Sleep Health Foundation, 2011.