I have noticed that more and more of us are willing to talk about how we are feeling. This may be one of the more positive changes from the COVID-19 pandemic. So many of my meetings now start with an emotional check in – colleagues will report having an off day, an extra anxious day, or needing to take the day hour by hour. The stigma of admitting that we feel anxious or depressed or helpless feels smaller and less important as we move into this new reality.

The psychological impacts of living through a global pandemic followed by an economic collapse have occupied much of my thinking lately. So many people have lost jobs and lost connections with their social circles. A recent article in JAMA talks about healthcare workers caring for those with COVID-19 in China reporting feeling depression, anxiety, insomnia, and distress. The Veterans Affairs lists information on managing stress associated with COVID-19 on their post-traumatic stress disorder website here.

I look to what we know about the mental health effects of the 1918 influenza pandemic for guidance – the article The Forgotten Flu discusses population-wide reactions that feel very similar to those that we are seeing today ranging from denial, to mistrust of foreign nations, to widespread panic, to depression and delirium (the state of psychiatric research was not very sophisticated). The article The Spanish Flu Pandemic and Mental Health: A Historical Perspective discusses increases in asylum hospitalizations and neurological effects among survivors including sleep disturbances, depression, mental distraction, dizziness, difficulties coping at work, and suicide. We do not know if these are directly related to physiological changes due to infection.

Colleagues who are mental health providers are working with their clients to develop new ways of coping. Our usual means of dealing with stress are more difficult now as we social distance and are cut off from our family, friends, and community groups. I have personally been doing a lot of sourdough baking – resulting in that series of images on our top banner. I recommend Joshua Weissman’s videos. Creating life – although it is a simple yeast – through mixing flour and water and waiting feels like a small miracle.

Our Bree work keeps on keeping on. We have moved our behavioral health summit to be virtual – scheduled for two 3.5 hour days on June 16th from 1:00 – 4:30 and on June 23rd from 8:30 – 12:00. So much of our content feels increasingly relevant as we talk about trauma-informed care, the mental health of our health care workers, suicide care, and changes from telehealth. I hope you will join us for at least one of our days.

Wishing you all health and resilience.

Ginny Weir, MPH
Director, Bree Collaborative