We are now a little over a week into widespread stay-at-home and social distancing policies. For those of us in behavioral healthcare, whether you are working at live sites like hospitals or using visual alternatives at home, there are changes in our usual practice. As in the Chinese character for crisis, there is both danger and opportunity. We are hearing more than enough about the dangers, so here are a few of the possible opportunities. Among them are the following, in no particular order except as they came ricocheting to mind.
- Research new treatments and treatment processes. Although online treatment had already been increasing, that may be the predominant outpatient modality now. New innovations may emerge, too. Patients, especially those without computers and/or smartphones, are likely to be lost. Can we build in more research on outcomes to compare to the tried and true?
- Reduce burnout and reignite passions. For psychiatrists and other mental healthcare caregivers, burnout had escalated to an epidemic level before the pandemic. Systems that disengaged and blocked clinicians from their healing potential was the main cause. Given the current need for system flexibility, will clinicians be able to become excited and inspired to be able to get closer to their potential again?
- Self-help. Whereas having to stay home may remind us of feeling the “stay in your room” punishment as children, it is also an opportunity for more self-reflection and interpersonal closeness. With so many couples and families needing to stay together at home longer, and some children coming home from college or work, what can we teach them about self-help as new tensions and conflicts re-emerge or develop anew?
- Community involvement. The public seems to be calling for information about what to do about their fears and anxiety in a kind of sudden collective withdrawal from the pleasures of usual life. We can help to reduce fear turning into panic by sharing realistic information and reassurance. The reassurance enhances brain dopamine release, which enhances feelings of pleasure, and the realistic information can enhance oxytocin release and thereby trust. Can we do more primary prevention of mental problems once again?
- Maintaining cooperation and compassion. Usually, we are at our humanistic best right after a disaster. However, as the aftermath and losses drag on, we often regress to treating others as usual or worse. By most accounts, we are headed to more stagnant weeks of coping. Can we find unforeseen benefits as well as reduce the suicide risk?
- Reality and virtual reality. Before this crisis, concerns were mounting about the overuse of technology and social media, including what changes that causes in our brains. For example, new research confirmed changes in the brains of children 3-5 years old who used screen-based media rather than reading picture books: They had less-developed white matter for comprehension in the brain. Now we have a conundrum. We seem to need technology more yet, at the same time, miss live human interaction more. Will the end result make live human interaction more valuable once again?
- Climate change. Climate change was becoming more detrimental to health and mental health as climate instability and warming escalated. Paradoxically, as part and parcel of staying at home, carbon emissions are much reduced. Can we maintain some of that momentum when the pandemic is over, including in our practices and personal life?
- Touching you, touching me. These words, lifted from the song “Sweet Caroline” by Neil Diamond, suggest how important “touch” can be. Not being able to physically touch one another as much is a loss of what most people have craved since infancy. Can physically touching uninfected loved ones more, along with touching each other more psychologically and spiritually, suffice?
- Mourning the losses. Before moving on after a major loss or death, grieving needs to progress. Normal mourning events like live funerals and shivas are being curtailed. Can we find other ways to produce adequate rituals to aid the grieving process?
- We are our brothers’ and sisters’ keepers. No doubt stress will go up for us caregivers and administrators. We in mental healthcare don’t have as much risk to ourselves as far as inadequate supplies of protective gear goes, but there are still difficult exposure, triage and treatment decisions to make. While the public is encouraged to look for the helpers, the helpers will need help too. How can we give it to them?
Perhaps you’ve found answers to these questions and opportunities of how we can improve? If so, let your colleagues and us know. As a colleague wrote me, as undesired as a crisis like this may be, once it is here, “a crisis is a terrible thing to waste.”