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Behavioral Healthcare’s Role in Coronavirus is No Fairy Tale

February 28, 2020

By H. Steven Moffic, MD
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The opinions expressed by Psychiatry & Behavioral Health Learning Network bloggers and those providing comments are theirs alone and are not meant to reflect the opinions of the publication.

Do you remember the story of “Goldilocks and the Three Bears” from your childhood? If not, here is a refresher:

Once upon a time, there was a little girl named Goldilocks. She went for a walk in the forest. Pretty soon, she came upon a house. She knocked and, when no one answered, she walked right in.

At the table in the kitchen, there were three bowls of porridge. Goldilocks was hungry. She tasted the porridge from the first bowl.

“This porridge is too hot!” she exclaimed.

So, she tasted the porridge from the second bowl.

“This porridge is too cold,” she said.

So, she tasted the last bowl of porridge.

“Ah, this porridge is just right,’ she said happily and she ate it all up.

But after finishing the porridge and settling in for a nap, Goldilocks later woke up, saw the three bears who own the house, screamed for help and ran out, never to return.

Well, once upon our time, we have a real-life story that might remind you of that fairy tale. Right now, we have an infection of coronavirus (COVID-19) that is near pandemic proportions as it spreads out of China. It has a concerning mortality rate. People found infected have been quarantined. It’s as if we are in a strange house, the house where the surprising virus can be like the three bears, only invisible. And we don’t know where we can run away and hide.

In the United States, there are concerns about a lack of adequate preparedness. Already, as is common in such crises, scapegoating is occurring. Recommendations for making plans for public settings is suggested if our infection rate worsens.

All this should stimulate what we can do on our part with our special knowledge. Though very little on this challenge is coming out of mental healthcare organizations so far, here are 10 initial suggestions for the help we can provide:

  1. Be part of the public discussions about the virus, trying to help the public find the appropriate amount of fear for now and over time—not too much and not too little, as in the story of Goldilocks and the perfect porridge—not too hot and not too cold. Too much fear of coronavirus can create hysteria. Too little can lead to inaction.
  2. In our settings, have discussions with staff about what to start doing about cleanliness and potential transmission of infection.
  3. Administrators and physicians, teach and model the importance of proper hand washing technique, as well as other hygienic techniques so in order to avoid transmission of the virus.
  4. Let patients know what we are doing, obtain their concerns, and be looking out for their overt and covert anxiety about the virus.
  5. Keep up with information from the U.S. Centers for Disease Control and Prevention and the World Health Organization.
  6. Also stay tuned to governmental orders.
  7. Start preparing for what to do if your setting needs to be closed and patients who are too frightened to come in still need treatment.
  8. When applicable locally, provide counseling services online to those directly involved.
  9. Help train any medical personnel involved in the crisis about the likely psychological reactions of their patients and about their own need to stay well.
  10. Counter any inappropriate scapegoating in your setting, community and country.

Share with us and colleagues what else you are doing to help, especially as needs evolve over time. There could come a time when our healthcare ethics come into conflict with political priorities. Prepare for what you would do if and when various scenarios occur.

“Happily ever after” won’t come if we, as a professional community, are caught napping in a time of need.

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