As the pandemic grows, healthcare workers are experiencing a new level of stress and fear. Since our first piece about healthcare workers and mental health, the toll that COVID-19 cases have taken on them has become more difficult than any could have imagined.

First, let us again say thank you to all of you, from EMTs who answer the first calls to the doctors and nurses who tend to the sickest. Your selflessness and heroism is inspiring.

We’ve set up a counseling hotline for healthcare workers and first responders at 1-800-327-7451 (TTY 711). Your call will be answered by our licensed mental health clinicians. Our team is trained and ready to listen and help during this difficult time.

There are so many things that are out of our control. We are dependent on others to address many aspects of the big picture, but there are things outlined below that we can do for ourselves and those close to us. No single recommendation is enough by itself, but when taken together, they may help.

Talk about it

Acknowledge your anxiety, fear and grief, and talk about it.

Many of our colleagues and friends say that leaning on fellow healthcare workers is very difficult. Everyone’s heart beats a little bit faster when they greet a COVID-19-positive patient, so how can we ask them to support one another? Yet this is what we do as a medical community daily. Peer support is key.

• If a compassion fatigue group isn’t available at your workplace, work with your employer to put one together.
• If a group option isn’t available, talk to your co-workers about what you are seeing and how it is affecting you. You’ll be surprised at how many share your feelings but have been afraid to say anything. Hospital workers have talked about how a quick meeting at the beginning of their shift, during a break or at other times—to talk, pray, or have a moment of silence—has helped them tremendously.¹
• Many hospital systems have been deploying their psychiatric workforce as volunteers to help colleagues who need it.² Ask your employer if this is available.
• If you don’t want to talk about it at work, find a former co-worker or friend from school or training to talk to, or contact Magellan Healthcare at the phone number above.
• Finally, if you are at a point where your feelings impact your ability to perform or feel comfortable in your role, talk to your supervisor or your organization’s human resources group about your employee assistance programs. Monitor your physical and mental symptoms. You may reach a position that you need to be treated by a behavioral health professional. If that happens, contact one as soon as possible.

Make your voice heard

Some healthcare workers are feeling betrayed by their employers and others.² Whether it’s lack of PPE, feeling unappreciated or being expected to work excessive hours, these feelings can make an already untenable situation worse. While there is much you cannot control, don’t let that stop you from advocating for yourself and others.

• Ask for more PPE or the protocols for how it is allocated. Understanding why things are happening can help people accept them and enable you and your colleagues to offer suggestions from the front lines.
• If you are frustrated about things that you see, think about how you would make them better. Make a list and discuss them with coworkers to come up with solutions. Once things slow down, you’ll have strong suggestions for improving your work environment.

Maintain focus

• Remember why you became a healthcare worker. Maybe you watched a family member battle an illness, or you felt a calling to help people. Think about that during these times.
• Remind yourself that what you are doing is noble. The cognitive impact of recognizing the value you offer will help you serve your patients in a positive way.
• Consistent with your training and dedication, keep your focus on the patient in front of you, on protecting yourself to the best of your abilities and extending those protections to the home setting when you are off work.
• When you are off work, turn your focus to what is happening in the moment.

Take care of yourself

• We acknowledge that recommending meditation or focusing on breathing in the midst of chaos and fear may not seem helpful for some. Think about how you breathe when you are stressed. Some of us hold our breath without realizing it; others breathe very shallowly. We don’t realize it until we get around to taking a real breath.
• As you work around people with COVID-19, you might be afraid to breathe deeply. If you can, try to go to a place where you feel comfortable doing so, and take a few deep, slow breaths. Something as simple as this can release stress and clear your mind.
• Exercising may feel like a lofty goal as well. Try to find 10 minutes for a brisk walk, or a quick set of jumping jacks, sit-ups and push-ups.
• If you don’t have time or energy to cook, find easy-to-eat fresh foods like bananas, oranges and carrots.
• To help you relax and get to sleep, try apps like Headspace, Calm and Balance. AMA members can access these for free.
• Finally, if you are on medications for a pre-existing behavioral health condition, don’t stop taking them, and contact your provider if your symptoms are getting worse.

For more information and tips, visit www.MagellanHealthcare.com/COVID-19.

As more people are working from home to limit the spread of the novel coronavirus (COVID-19), what was once a perk may now seem like a punishment. It can be hard just to find and set up a workspace and connect with work, let alone deal with the isolation.

If you are used to going into work, you may miss opportunities for regular social interaction and connection with co-workers. Regardless of which life stage you’re in, working from home may cause feelings of isolation, frustration or stress that can impact your mental health.¹ Here are some tips to help you manage your new work-life balance:

Set yourself up for success

Find the most quiet place you can to set up your home work area. Make sure you have good lighting, a comfortable chair and plenty of outlets to plug in your computer, monitor, phone charger, etc. Put everything you need nearby so that you don’t need to constantly hop up to find a report, get supplies, etc. Maintain as much of an office-like demeanor as you can. If you are using video for meetings, remember, you’re on camera too.

Establish your routine

When you’re away from the workplace, it’s important to set specific hours—and stick to them. It’s easy to work more hours than normal, but that may cut into your family time and affect your sleep schedule. You may also feel pressure to prove that you are spending your time productively, and this can result in increased anxiety and stress. Set your boundaries and develop a routine: wake up at the same time every day, take a shower, get dressed, etc. Keep as much of your non-work life as it was before the pandemic: eat well, exercise and get fresh air—just remember to maintain a 6-foot distance from others.

Practice self-care

Self-care is any proactive activity that we do to take care of our mental, emotional and physical health. Good self-care is the key to improved mood, reduced anxiety and a good relationship with yourself and others. While so many normal activities are disrupted, take some time to practice gratitude, eat healthy, get enough sleep and maintain or start an exercise program. You will feel better for it.²

Increase communication

You might find it easier to be productive without your most chatty coworkers constantly buzzing in your ear. But social interactions—even with coworkers—can alleviate feelings of isolation and loneliness. Try to maintain normalcy by setting up regular check-ins with your team or manager that allow you to provide progress updates, sort through problems or brainstorm ideas.

Cherish children

If you have children at home due to school closings, helping them make sense of what is happening in the world will help you process the situation too. Kids of all ages are as vulnerable as adults to feelings of anxiety, stress and sadness. Do the best you can to manage childcare, plan for different age groups and ask for help from those near to you, while staying mindful about social distancing. Be flexible to accommodate your children’s needs and those of your employer. This is a unique moment in history. Move through it as gracefully as you can and create good memories for your family.

Take breaks

In the office, there’s usually time for coffee breaks, lunch walks and chats with colleagues that give some breathing room from work. Just because you are working from home doesn’t mean you aren’t entitled to the same breaks. Hitting the pause button throughout the workday can be good for productivity. Get up and stretch, take deep breaths and look up from the computer at regular intervals. Remember to eat, and check with your supervisor for permission to take a break for a quick walk.

For more information and tips, visit MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

¹Smith, P. (2020, March 10). How To Deal If Working From Home Is Hurting Your Mental Health. Retrieved from https://www.huffpost.com/entry/working-from-home-mental-health_n_5afd88e2e4b0a59b4e014602?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAALPysx5taWAnltmdXV9uEcuIXzXyRxgs3xGUH0ztFrzmyZfyFKQUQo1BetFTXXoiY1lnEVcXeQbFXLffHW2baI7Yr9eG5nDkYyB5iecH6hx8iRFumbBwpzRVhn1H7uRr-3ZngjIoto2Ctd1o-7Sl4sEDdIr-GAyVlgsNUEul-5MM

²Michael, R. (2018, July 8). What Self-Care Is – and What It Isn’t. Retrieved from https://psychcentral.com/blog/what-self-care-is-and-what-it-isnt-2/

Coronavirus (COVID-19) concerns are growing, and school closures are happening in most states. While grown-ups are anxiously figuring out how to handle the impacts of these decisions, kids are observing everything and may feel just as scared and confused as adults.

Talking with children about COVID-19

Children look to parents, guardians, caregivers and other trusted adults to help them make sense of what is happening in the world. COVID-19 is the topic of conversations everywhere on social media, web news outlets and TV. Everyone is being exposed to the fear and uncertainty of this global pandemic.

Children might find it difficult to understand what they are seeing or hearing about COVID-19, so they can be particularly vulnerable to feelings of anxiety, stress and sadness. As an adult, it’s important to make yourself available to listen to children’s thoughts and communicate in an age-appropriate way that addresses children’s questions without stoking anxiety. Children react, in part, on what they see from the adults around them. When parents and caregivers deal with a stressful situation calmly and confidently, they can provide the best support for their children.

The Substance Abuse and Mental Health Services Administration provides Tips for Caregivers, Parents and Teachers During Infectious Disease Outbreaks that includes information on possible reactions and tips for talking with children and youth of different age groups.

Tips for staying at home with children during the outbreak

• Focus on the uniqueness of the moment. This situation has never happened before. How can you make the best of it? Yes, it is stressful on many levels, but for your children, it is a time they will never forget and there is an opportunity in forced togetherness to reinforce your family bonds.
• Plan for different age groups. Younger children will love being home. Young teenagers may not be as thrilled by not being able to hang out with their friends on a daily basis. High schoolers can handle themselves and may be able to help with the younger kids if you have to work.
• Bend with the wind. Meaning: be flexible with the schedule. Let children play, do a fun project together (make cookies or do a craft), eat breakfast for lunch and make room for downtime to read and hang out. Your kids may have quite a bit of time at home, so try to maintain your patience and perspective.

To learn more about what Magellan Healthcare is doing to support clients during the  COVID-19 pandemic, visit  MagellanHealthcare.com/COVID-19.

To learn more about Magellan Health’s corporate response to the COVID-19 pandemic and to view Magellan’s available resources click here: https://www.magellanhealth.com/news/covid-19/

Adapted from: Stockwell, A. (2020, March 13). What to do with your kids when schools are canceled. Retrieved from https://www.vox.com/the-highlight/2020/3/13/21178234/coronavirus-covid-19-school-closures-kids-home

The novel coronavirus (COVID-19) outbreak in the United States continues to evolve, with more cases and quarantines popping up on news feeds everywhere. The closer it gets to their homes, the more people are worrying. In our last post, “Addressing anxiety about the coronavirus,” we talked about the things people can do to help feel less anxious and more in control. But what about the people on the front lines? Nurses, doctors, healthcare workers and other medical professionals who are testing for and treating patients with COVID-19 are at a higher risk of contracting it than the general public. What can they do to take care of themselves, physically and emotionally?

As Kushal, Gupta and Mehta stated in Study of Stress among Health Care Professionals: A Systemic Review, “Work related stress is a potential cause of concern in healthcare workers and is associated with decreased job satisfaction, days off work, anxiety, depression, sleeplessness , medical errors and near misses.” Long shifts and working with sick people—some of whom are gravely ill—can lead to burnout and anxiety from their normal jobs. These already-struggling healthcare workers are now faced with COVID-19 unknowns and demands, including taking care of people with confirmed cases of the virus.

While some people may feel they are at the whims of the virus, there are things healthcare workers can do to take some control over their work environment and manage their fear or anxiety.

• Know what your organization’s plans are. Read the business continuity plan and know your role. Talk to your team members about cross-training and covering for each other if one of you gets sick. In addition, ensure you are following proper protocols for cleaning and preventing spread. Visit cdc.gov for helpful information. This is particularly important for behavioral health providers who may not always think about universal precautions.
• Surround yourself with green. If your facility permits, bring in a few plants to liven up your surroundings. Being around plants has a calming effect on people. Employees who work in offices with plants tend to feel better about their jobs, worry less and take fewer sick days.¹ If you can’t have plants in your space, take time to look out the window and find some green. You may find that is enough for a quick mental break and perspective.
• Use small tools to create a calming environment. A small water feature, a sand garden or hourglass, stress balls and other items can provide a quick way to refresh your mind. Or just step back, take deep breaths, stretch and/or meditate.
• Find someone to talk to. Some hospitals have on-site or on-call chaplains; take advantage of them. Don’t be afraid to talk to your coworkers about how you are feeling. Chances are, they are feeling the same way and would welcome a discussion. Many medical settings offer a form of rounds that addresses the emotional impact of caring for a particular patient or theme. Similar semi-structured discussion groups with peers can be very helpful in handling stress and preventing the development of PTSD.²
• Get professional help. Be open to contacting your organization’s EAP, if you have one, or reach out to a therapist if you find yourself developing “compassion fatigue,” where your desire to help others erodes.
• Limit exposure to media. Media outlets have a tendency to sensationalize stories, so it’s important to consume news thoughtfully and with a critical eye.

In addition, do all the normal things to take care of yourself: try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs. Doing these things can have a positive impact on your mental health and help you manage anxiety.

For more information and tips, visit MagellanHealthcare.com/COVID-19. We wholeheartedly thank you for all you are doing to combat this outbreak.

1: https://www.webmd.com/a-to-z-guides/ss/slideshow-health-benefits-houseplants.

2: See Schwartz rounds.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.

As the coronavirus disease (COVID-19) continues to evolve with ongoing media coverage, many people are experiencing anxiety due to the uncertainty about how this will impact them. They are worried about the impact to their communities, how they can protect themselves and their families, and how to be prepared if the situation disrupts the normal course of daily life.

It is normal to feel anxious, unsettled, distracted, scared and/or overwhelmed by COVID-19 and the uncertainty surrounding its impact to communities. Some people may be more vulnerable due to pre-existing physical and mental health conditions, including generalized anxiety disorder.

Feeling stressed can affect the immune system and increase the risk of getting ill in general. That is why it is important to take steps to manage anxiety and reactions to this evolving situation. The following suggestions can help people manage anxiety and stress for themselves and their families:

1. Seek health information from trusted resources like the U.S. Centers for Disease Control & Prevention (CDC), The World Health Organization and state health department websites.
2. Plan ahead to feel more in control. Make contingency plans for work, childcare or travel if it becomes necessary.
3. Wash hands often, get plenty of rest, exercise, eat well, don’t smoke and limit alcohol consumption.
4. Put things into perspective:
   1. Of the 80,000 confirmed coronavirus cases reported in China, “more than 70% have recovered and been discharged,” according to the World Health Organization (WHO) in a news conference on Monday.¹
   2. Per the CDC, only certain groups, such as older adults and people with serious chronic medical conditions, are at higher risk of getting very sick from COVID-19.²
   3. Public health officials are working to mitigate the virus’ spread.
5. Limit exposure to media. Media outlets have a tendency to sensationalize stories, so it’s important to consume news thoughtfully and with a critical eye.

Magellan Healthcare has resources to help people during crises and difficult times. Our Crisis Communications website provides topical information and connects people with U.S. resources, and our Mind Your Mental Health site addresses many topics related to emotional well-being.

1: https://www.cnn.com/asia/live-news/coronavirus-outbreak-03-09-20-intl-hnk/index.html, “More than 70% of coronavirus cases in China have recovered, WHO says,” posted 3/9/20, 7:25 p.m. EDT, Jacqueline Howard, accessed from site 3/10/20, 12:57 p.m. EDT.

2: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html#who-is-higher-risk, accessed 3/10/20, 12:34 p.m. EDT.

Disclaimer: The content in this blog article is not a substitute for professional medical advice. For questions regarding any medical condition or if you need medical advice, please contact your healthcare provider.

Childhood isn’t all fun and games. Even young children can feel worried and stressed.

Stress can come from outside sources, such as family, friends, and school. It can also come from children themselves. Just like adults, children may expect too much of themselves and then feel stressed when they feel that they have failed.

How can you help your child with stress?

Adults can help children and teens with stress in many ways. Three important things you can do are to:

• Try to reduce the amount of stress in your lives.
• Help them build positive coping skills.
• Teach them to let stress out.

Reduce the amount of stress in your lives

• Acknowledge your child’s feelings. When children seem sad or scared, for example, tell them you notice they are sad or scared. If appropriate, reassure them that you can understand why they would feel sad or scared.
• Develop trust, and let your child know that mistakes are learning experiences.
• Be supportive, and listen to your child’s concerns. Allow your child to try to solve his or her own problems, if appropriate. But offer to help and be available to your child when he or she needs you.
• Show love, warmth, and care. Hug your child often.
• Have clear expectations without being too strict. Let your child know that cooperation is more important than competition.
• Don’t over-schedule your child with too many activities.
• Be aware of what your child wants (not just what you want).

Build positive coping skills

It is important to help children learn positive coping skills. These skills are often carried into adult life.

• Provide a good example. Keep calm, and express your anger in appropriate ways. Think through plans to reduce stress, and share them with your family.
• Teach them about consequences. Children need to learn about the consequences—good and bad—of their actions. For example, if they do all of their chores on time, they will get their allowance. If they break another child’s toy, they must find a way to replace it.
• Encourage rational thinking. Help your children understand what is fantasy and what is reality. For example, help them see that their behavior did not cause a divorce, or that they are not failures because they were not picked first for something.
• Provide them with some control. Allow your children to make choices within your family framework. For example, allow them to arrange their rooms, choose family activities, and help make family decisions.
• Encourage them to eat healthy foods, and emphasize the importance of a healthy lifestyle.

Get the stress out

Finding ways to get stress out of their systems will help children feel better. The best ways to relieve stress are different for each person. Try some of these ideas to see which ones work for your child:

• Exercise. Regular exercise is one of the best ways to manage stress. For children, this means activities like walking, bike-riding, outdoor play, and individual and group sports.
• Write or draw. Older children often find it helpful to write about the things that are bothering them. Younger children may be helped by drawing about those things.
• Let feelings out. Invite your child to talk, laugh, cry, and express anger when he or she needs to.
• Do something fun. A hobby can help your child relax. Volunteer work or work that helps others can be a great stress reliever for older children.
• Learn ways to relax. This can include breathing exercises, muscle relaxation exercises, massage, aromatherapy, meditating, praying, yoga, or relaxing exercises like tai chi and qi gong.
  • Stress Management: Relaxing Your Mind and Body
• Laugh. Laughter really can be the best medicine. You can be a good role model in this area by looking for the humor in life. Your child can learn this valuable skill by watching you.

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Read the full article here: https://www.healthwise.net/magellanhealth/Content/StdDocument.aspx?DOCHWID=aba5971#aba5972

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

Stress is a part of everyone’s life in one way or another. But did you ever consider that stress doesn’t always have to be a bad thing? What if you found ways to make stress a positive thing?
Stress is complicated and tends to impact people over a long period of time. Here are a few tips to help you manage your stress.

1. Get organized. Being unorganized creates stress and leaves you feeling out of control and overwhelmed. Get your house or your desk or your car in order and then feel the wave of relief that comes over you.

2. See things from another angle. View stress as an energizer. Consider each new demand as a challenge, no matter how difficult it may seem.

3. Take charge. Although you can’t control other people’s actions, you can control your response to what comes your way. When it comes to managing your emotions, you’re the boss.

4. Think big. Think in terms of long-range goals, not just day-to-day problems so you can see beyond the immediate situation.

5. Find true friends. Having supportive friends is a key to reducing stress. Good friends should recognize your strengths and lend a hand in stressful situations.

6. Learn from it. Look for meaning in the stress you have experienced. For example, a sick family member may have caused a great deal of stress, but the situation brought your family closer.

7. Be proactive. Learn to recognize the early signs of your stress, such as anger, taking on too many things, working too much or irregular sleep patterns. Think about what you can do to reduce the negative stress effects.

8. Accept limits. Understand your boundaries. Set realistic expectations for yourself.

9. Use your strengths. Recognize your strengths and focus on projects that allow you to use them. Taking on too much can make you feel out of control.

10. Make decisions. Indecision increases stress. Start by making small decisions and acting on them.

11. Laugh. Laughter is indeed the best medicine. Laughing at yourself can relieve stress.

12. Keep yourself healthy. Take care of your body by eating healthy foods and drinking plenty of water. Find time to exercise.

13. Pay attention to your body. There are times when our bodies send signals telling us to slow down and take a break. When you experience physical signs such as exhaustion, restless sleep, headaches, body aches and other types of pains, take time to renew your body and your mind.

Resources
National Institute of Mental Health
www.nimh.nih.gov/health/publications/stress/index.shtml

Help is available. For additional information, visit MagellanHealth.com/MYMH

This document is for your information only. It is not meant to give medical advice. It should not be used to replace a visit with a provider. Magellan Health does not endorse other resources that may be mentioned here.

Caring for a family member or friend who has a disability or a chronic illness can be rewarding. But it’s also demanding. One of the keys to being a successful caregiver is to manage stress by seeking support and taking care of yourself. Managing stress is especially important for a caregiver, because stress can weaken his or her immune system. A weak immune system makes the caregiver more likely to get sick.

Think about the kinds of caregiving tasks or situations that trigger stress for you. Then you can focus on one or two things you can do that will help the most to reduce stress. Here are some ideas:

Get support
Ask family members for help. Include them in caregiving decisions.

• Ask family members for help. Include them in caregiving decisions.
• Share the tasks. Make a list of weekly tasks, and share that list with your family. Ask for help with shopping, housecleaning, and errands. You don’t have to do all the work on your own.
• Stay involved. Make time for social activities and friends, even if it’s only a phone call or coffee during the week.
• Join a caregiver support group. Meeting other caregivers helps you know you’re not alone. And it gives you a chance to talk about your worries and concerns with others who understand.
• Find respite care. Respite services provide someone who can stay with your family member while you get away for a few hours or days. Time away can help you manage your stress and be a better caretaker.
• Look up caregiver resources in your community. Hospitals, churches, and other groups may provide transportation or other services that support caregiving tasks. You can reduce stress by planning ahead so you know who to call when you need extra help.

Take care of yourself

• Put your own health first. Be sure to schedule and go to your medical checkups.
• Eat a healthy diet, and get enough sleep. Taking care of yourself will help you deal with stressful situations.
• Get regular exercise. Even a 10-minute walk can relieve stress.
• Take a breath. Try stress reduction techniques like deep breathing and meditation.
• Take a break. It’s important to take time off from caregiving once in a while. Spend some time doing things you enjoy or on things in your own life that need attention.

What to think about
Depression is common among caregivers. It’s emotionally draining to care for a loved one whose health is getting worse. Don’t dismiss your feelings as “just stress.” If you’re having trouble coping with your feelings, it may help to talk with a counselor. If you have symptoms of depression, such as a lack of interest in things you enjoy, a lack of energy, or trouble sleeping, talk with your doctor.

Help is available. For additional mental health information and resources, visit MagellanHealthcare.com.

Source: Healthwise