Psychiatrist Dr Roger Chau warns of mental health risks from COVID-19
28 May 2020
Dr. Roger Chau is a respected Consultant Psychiatrist with 40 years of clinical experience. He was Director of Psychiatric Services for South West Healthcare and has treated thousands of patients who live with a range of mental health disorders, many of whom have serious psychiatric conditions. For a decade in the 1980s, he worked with Victoria’s Prisons to treat patients suffering from isolation-related mental health problems.
He expects a significant rise in the number of mental health patients seeking treatment in Australia within two years, as a result of COVID-19.
He outlines some of the mental health risks that are likely to emerge because of isolation and extended periods of working remotely during the COVID-19 pandemic. He also provides thoughts on managing fear and anxiety, and explains that employers have a greater responsibility to manage workers in a new working environment.
“Facilitating the transition to working remotely requires planning” he says. “Supporting the logistical demands of this change, guiding and monitoring staff to fulfil their work requirements in a new setting, and then managing their transition back to work is an extremely complex operation. It requires a close eye on a range of risks for employees. In this context, employees face risks to their psychological wellbeing.”
He explains that change can be challenging under positive circumstances, and a burden during times of uncertainty. The COVID-19 pandemic will affect all employers and their staff in some way. Fear about the impact of the virus and the unknown threat of exposure is something we all need to manage and work and live with. Organisations need to understand the psychological impact of the pandemic on their staff, who may be teachers, carers for the elderly or people with disabilities. Everyone working to sustain the community will need to find ways to recognise signs of depression and anxiety in others.
With many decades of experience treating patients for a range mental health issues, he feels concerned about the aftermath of the COVID-19 pandemic and its restrictions on our way of life. The number of cases of anxiety and depression among the population has started to climb already, he explains.
“Right now, so many of us are spending time alone, working alone, and physically disconnected from others. There are mental health risks when it comes to isolation and working remotely” he says.
The mental health impact of COVID-19 on society
“There are many facets to the impact of this pandemic on society as a whole, but the direct impact is on those who are infected. Some people will die, and some will have to deal with grief or grieving family members because of it. The frontline medical staff who are looking after COVID-19 patients are under great stress, mentally. Politicians are facing an unprecedented crisis in our history and have the task of ensuring lives and the livelihood of others. Law enforcement agencies are undertaking tasks they’ve not dealt with before, and family units are facing restrictions on their activity and how they function. Businesses are also facing economic collapse. There is a level of fear and anxiety in general, that everyone is feeling even if they don’t recognise it.”
Dr. Chau warns an invisible impact of the pandemic will emerge over time and take the form of mental health issues.
“There is definitely going to be a significant negative psychological impact on society. The disruption to our way of life will bring about more cases of anxiety, depression, psychosis and bigger numbers of suicide in the future. During the last recession I saw people who were economically impacted, and the result was depression for many people and it emerged for them very quickly.”
“Today people will be fearful, frightened, even overwhelmed. There are going to be more cases of domestic violence due to stress, more arguments in the home. There will be depression among the elderly who have no social contact and young children will struggle because they are missing out on the socialisation that they need, because children learn through play and activities with others. The anguish will become unbearable for some who will turn to substance abuse to alleviate the mental pain.”
Managing mentally while working during COVID-19
The challenges of life during the pandemic will appear in work and home life.
“Those working in aged care have a great challenge right now. They need feedback from others that they are doing a very important job for society. Care workers are the only human contact for some of our seniors. This is not just for the physical needs of the elderly, but also for their comfort and mental stimulation. Care workers must try to lift the spirits of the seniors they care for, and they need to understand and be told that theirs is a vital support role and a comfort to the families of the elderly.”
Dr Chau says we already know that almost 90 per cent of school principals experience offensive behaviour in the course of their work. Half are subjected to threats of violence, with first responders (paramedics, medical staff) now telling a similar story.
“Much liked aged care professionals, teaching is a profession showing declining interest among school leavers and the replacement rate for retiring principals is falling. Managing a large group of students remotely cannot be done without the support of others. Many teachers face the task of managing students who face limitations themselves because parents who are working in changed circumstances. The pressure of managing the concerns of teachers, students and parents is a far greater task for principals under the COVID-19 restrictions.”
The vulnerable are the youngest and the oldest in the community, but those in a position of seniority and leadership, and who are responsible for the working conditions and wellbeing of staff are more exposed to stress now than before the pandemic. Dr Chau says everyone should exercise greater care of others and pay more attention to personal care.
“Organisations have a duty of care to ensure employees can work safely. It’s very important that employers spend time looking at their WHS obligations and thinking about how best to encourage their people to access support programs or help. This may be online or by phone. Identifying high risk employees isn’t enough. Prioritising wellbeing among workers is now the role of all managers, regardless of industry.”
Dr. Chau emphasises the need for employers to provide a clear path to support.
“Some children know about Kids Helpline. If you’re responsible for others, ensure those people know where to get help.”
Supporting everyone in their daily work routines
- Recognise the importance of frontline workers during the COVID-19 pandemic, and the enhanced physical risks they face
- Acknowledge the vital role of medical workers, carers, educators in supporting daily life routines and helping us to adapt to new ways of organising how we live and work
- Provide feedback to these frontline workers where possible, so they understand that their work is valued and considered important by others
Ensure workers access an Employee Assistance Program (EAP), to support their mental health and wellbeing, and are aware of video counselling options and digital bookings
Empowering people with technology helps manage isolation
Managing how people feel when they can’t see relatives or peers, or their fellow students and teachers, can be challenging for those working in aged care, disability care, and education. Using technology provides clear benefits to workers who need to care for people who feel disconnected or isolated from family and friends.
“Some seniors in aged residential care may not comprehend the significance of COVID-19, and will find it hard not to see relatives. They may not even understand why they can’t see their family. Separation can bring suffering to people who are used to daily visits by a spouse or children. Families who can’t see loved ones will worry more than usual about the health of their relative in care. It’s the perfect time to harness technology, to overcome physical distance.”
- Using technology helps people remain connected, by phone or visually through online methods. Even if there is no camera, hearing a voice is still comforting
- Having images of family and friends nearby can lift a mood, and can help dementia patients to feel secure
- Technology allows teachers and students to stay visibly connected and engaged, and can be comforting to young people are who can’t attend school for an extended period
- Regular use of technology maintains group dynamics and engagement for work teams, promotes feelings of inclusiveness among peers
Building empathy and awareness of others’ wellbeing
- Be aware of symptoms of stress in students and peers including: irritability, anger, greater acne severity, insomnia, loss of appetite, headaches, decreased energy, heart palpitations, sweating
- Ask how someone is feeling, provide positive feedback and understanding, actively comfort others by talking kindly, encouraging words build resilience and promotes feelings of connectedness
- Appreciate time together as a group, as colleagues, as a class
- Encourage the use of EAP and counselling services among staff, and promote mentoring programs among peers
The role of a routine
The power of routines lies in its support of mental health, and a routine will support mental wellbeing while working during the COVID-19 pandemic. Numerous scholarly articles conclude routine is effective for achieving work life balance and healthier sleep. Routines also assist people in feeling engaged, help to establish expectations and facilitate professional work schedules, especially in the care of seniors or people living with disabilities.
“Being isolated and socially distant can be managed with a routine. I’ve worked over the years with prisoners who are isolated from society, and the regulated lifestyle and routine inside a prison is helpful for people serving time. Having a routine helps to support healthy sleep patterns and mental health. It’s enormously underrated, but very important for managing mental health and wellbeing for people working in all kinds of fields. Students can still thrive while learning remotely and having a routine will be an important part of them succeeding in their subjects.”
“The COVID-19 pandemic has separated people physically at a time when we have the technology to be connected in real time, regardless of our location. Despite the challenges of remote work and learning, Australians are compassionate and have an enormous capacity for mateship and support. Understanding and accepting the reality of long-term mental health concerns resulting from the pandemic is something we all need to accept in order to address feelings of isolation. Our employees, colleagues, students, many of our vulnerable members of society who depend on care, indeed those who care for them, will all experience some psychological impact of disconnection and isolation because of COVID-19.”
Helping employees return to work
Dr. Chau believes there will be a large degree of uncertainty for people returning to work, and organisations should apply thorough planning and implement safety measures to protect workers.
“Most people will experience anxiety due to a loss of confidence after not working in their normal environment for a long period. There is also the fear of a second wave of COVID-19 cases. Things are still very fluid. Those who can’t return to work will feel bad about it and about the uncertainty of their employment as they see others going back. Employers need to make adjustments for people returning to work.”
- Plan and implement a return to work with care so that it includes safety measures such as: new seating arrangements, extra cleaning and disinfection of physical spaces, and employee support through access to programs offering counselling, confidential advice, and training
- Consider staff safety and conditions for returning to work, in relation to hygiene. Travel, meetings, and human interaction must be managed to prevent cross-infection and to mitigate the risk of exposure to the virus
“Nobody knows how fast the recovery will be, or all of the additional measures to put in place. As I said, it’s very fluid.”
The COVID-19 virus outbreak was declared a Public Health Emergency of International Concern on January 30, 2020. The World Health Organisation (WHO) hosted delegates at a World Health Assembly in May, where a landmark resolution was reached to bring the world together to fight the pandemic. Global coronavirus cases have surpassed 5 million in May 2020, and in Australia the death toll reached 100, with 7,080 total confirmed cases during the same month.
If you would like additional information about COVID-19 please contact the National Coronavirus Helpline on 1800 020 080.
About Dr Roger Chau MBBS (Melbourne) DPM (Melbourne) F.R.A.N.Z.C.P
Dr Roger Chau completed his medical degree at the University of Melbourne and his
internship at the St. Vincent’s Hospital. He has been in private practice since 1985 and has for more than forty years having treated literally thousands of patients. His passion is in community psychiatry, treating anxiety, depression, and the psychotic mental states of patients suffering through recessions in Australia, among other significant societal changes impacting our lives. He is interested in how technology has changed the way we conduct our daily routines and the impact of technology on mental health. Dr. Chau is focused on the current COVID-19 pandemic, as an unprecedented crisis that he expects will significantly impair the mental wellbeing for the majority of the community. His expertise is helping patients to make adjustments to daily life and livelihood activity, while treating the psychological impact on people that will inevitably emerge in the immediate future because of the pandemic, and in the years to come.