Tips to Help Public Health Professionals Cope with Stress, Fatigue, Burnout During a Pandemic Response

In this episode, we talk with licensed clinical psychologist Tammy McCoy–Arballo about the physical, emotional, and psychological toll this prolonged pandemic response has taken on public health professionals.  Listen as she offers her thoughts on practical ways to achieve work- life balance and provides professional advice on ways to protect your physical, emotional and mental well-being. 

Transcript

EP 3:  Tips to Help Public Health Professionals Cope with Stress, Fatigue, Burnout During a Pandemic Response  

Host:  Joining me today is Dr. Tammy McCoy Arballo, a former journalist turned at licensed clinical psychologist. Dr. McCoy-Arballo is an expert in trauma and has worked with both civilian and sworn emergency responders in the wake of numerous mass shooting incident and natural disasters.  Over the last seven years, she has worked with the counseling team international organization. Thanks for being with me today, doctor.  Thank you for having me, Robert, this is exciting. 

You bring a unique perspective to this podcast because of your background in journalism. And I understand you sometimes engage with journalists in your role as a clinical psychologist and your husband is also a public health communicator, what does that work entail? 

Guest: We spend a lot of time breaking down stigmas.  I think that for journalists, as well as people in public health, it's the stigma of, I'm an accomplisher, I'm a doer, and giving them permission to acknowledge that their own challenges are and defects. I think that's probably the biggest challenge we have working with people in public health, as well as journalists.

Host:  Great. So like many health officials, public health communicators have been personally targeted because of the interventions put in place to slow the spread of COVID-19.  Are  there strategies they can take to make it not feel so personal and to protect their physical, emotional, and psychological wellbeing?

Guest:  That's a great question. Living with somebody in public health, I think as a wife and as well as a clinician, I've had to struggle with this issue. Reminding my husband, when somebody's calling him and screaming at him at three o'clock in the morning that it's not their fault because you are the public face. So you are the one they're most likely to lash out at. And when people have no control over what's going on around them, it's not uncommon for them to react in some kind of verbally threatening or harassing way. So not personalizing it sounds really easy. It's incredibly hard when you're on the receiving end.

And I think that the challenge is keeping yourself healthy enough, where you can put yourself in their shoes, but working the hours of public health officials have been working, working under the stressors and the strains, it is really hard to maintain that on a daily basis. So that really goes back to making sure that you're getting room to refill your tank because we're all running a little bit empty right now by a little, I mean, a lot.

Host:  So that leads right into my next question. What advice would you give to those who say they feel guilty about taking a vacation or other time off during this emergency response? 

Guest:  And God bless the people in public [service] who feel guilty because they want to keep doing and they want to keep giving.  I want to remind you about that old adage, about putting on the oxygen mask for yourself before you can help others.  Right? If we're not taking care of ourselves, we're not going to be effective. We're going to make mistakes. We're going to lash out at our teams. We're going to say something goofy when we're talking to people who try. So I would say for your wellbeing, for your team's wellbeing, for your family's wellbeing, take the time off, get the break, get out of the house, get out of the routine, put the phone away for a half an hour.

I know that's an eternity when you work in public health, but give yourself permission to take those breaks because we have what becomes just an endless cycle of burnout and compassion fatigue when we don't and people are really struggling with that. That's not just I'm tired. I need a break.  It’s I've given and I've given and I've got little left to give.

Host:  Hmm, good advice. And things are now reopening. And our response is changing. It feels like we are supposed to go back to normal, but how can we do that after the events of the past two years? 

Guest:  I don't think you can just snap your fingers and go back to normal. We've been through something revolutionary, something that has changed all of us, something we've yet had an opportunity to process.

So very similar to a grieving process, we all need to give ourselves a chance to come to terms with what's happened to us. A lot of people are struggling with feelings of betrayal and anger and helplessness and powerlessness. And that's not going to go away overnight. We have to address it and deal with it before we can start this next chapter.

Some of us deal with it and our own spiritual means some of us get some couch time with the mental health professional. Some of us do take a break. Um, but we've got to reconcile that before we can move forward. We can't just flip a switch and just go, okay, we're all open. Everything's fine. That's not realistic.

Host:  So under this stress, what do you say to those frontline public health professionals and public health communicators who feel they are ready to find another job because of the overwhelming nature of this pandemic response? Is it wise to make such life-changing decisions on the heels of events like these? Or is there a need for a cooling off? 

Guest:  The first thing I would say to everyone in public health, I would say, thank you for everything that you've sacrificed and everything you've dealt with. Even though there's been a vocal group of people who have not been grateful for what you've done, there's a lot of us who have been, so please keep that in mind.

You're not always seeing the full picture and it is completely appropriate and understandable that people are burnt out and they want to leave the field, but like anything else in life, we need time to calm down.  Cool out, reconcile what's happened before we make choices. We don't want to make choices when we're at our most emotional, it's completely understandable that people are leaving the field, but I would submit that you give yourself six months before you make any life altering decisions, unless you are absolutely positively, sure.  But give yourself time, give yourself room. The reactions that a lot of people are having are completely understandable. And there's a lot of feeling of why am I still doing this? And the reality is that public health do more on a daily basis to affect change in the community than they even really, really, really realized, to give yourself a chance to kind of step back from that.

Host:  And speaking of stepping back since we are working from home and always at work, what advice do you have to help people disconnect? 

And this is one I've seen in my own personal life, too, with my husband where I have to tell him, you know, let's go sit in the backyard for 15 minutes and you can just leave the phone in the house.  And his first reaction is no. If they need to get ahold of me, I need to be able to respond. And then I remind him that 15 minutes, isn't that long, a period of time. And it's acceptable that you can take a break. So for those of you working out of a home office, don't live in that home office, take your lunch break and get out of that room.  Get out of the house. Maybe take a walk around the block.  Leave your phone on the kitchen counter, go in the backyard, turn on some music, engage with your pets. Work is work. Life is life. And, yes, it can wait for a few minutes. It can wait for you to get something to drink and to wash your face and to put your feet in the pool for a few minutes.  You’ve got to take care of yourself if you're going to be of any use to anyone else. And that's not you being selfish, that's about you being smart and healthy. 

Host:  So when people say to you, they feel like they are going through the motions at work and that they don't really care about much of anything is that normal.? 

Guest:  That's not only normal, it's appropriate. There's a level of, I don't care. I don't feel.  That comes with burnout and compassion fatigue, and we can't expect anything less from people in the field experiencing that. So recognize that’s your body's way of saying, hey, I need to do a better job of taking care of myself, that these are appropriate reactions to an insane set of circumstances.

But it's also a flag to say, maybe I need to do a better job of taking care of myself. Maybe I need to make sure I'm sleeping right. I'm exercising. I'm not using alcohol the way maybe some other people in our communities might be using alcohol, three or four drinks that are sitting kind of getting us into some dangerous territory.  So watch the alcohol, watch the sugar, but also make sure that you don't have your blinders on. 

Make sure that you're reminding yourself that there's more to life than gesture. That there are people in your life that have nothing to do with your work and that there is a big world out there full of wonderful and adventure and enjoy, you know, so tune out of work and tune back into those hobbies, those things that we're passionate about.  Read a book that has nothing to do with anything. Take a break. 

Host:  So we're hearing a lot about employers not being able to find workers these days and. If our listeners are now content with their current work-life balance and see a new normal for themselves, which may be working less and being more with their families, what advice would you give them to move forward?

Guest:  I think the pandemic has given us an opportunity to all see things a little differently. And for some of us working from home as really been less stressful than working in the office and working fewer hours is more. And there's no right and wrong in this stuff. This is your life. You have the power to affect any change you want.

So if you want to work a four, 10 schedule instead of working seven days a week, because that makes you happy. And so be it.  Have conversations about new ways to be creative with your time. Find, you know, find that balance that works for you. But also remember the life is an evolving target, right?

Things change over time. So this might work for you now in six months, you might be dying to get out of the house six months from now. You might not ever want to leave the office. We're all subject to change. So do what works right for you have important conversations with the people you work with and the people that you…

Host:  Many of us want to help others, cope, employees, family, friends, et cetera, and put ourselves second.  When should we focus on our own wellbeing? And what are some of the signs that we may need to seek professional help? 

Guest:  The time is now the time is every day. You can make 15 minutes for yourself every day. To do some deep breathing exercises, breathe in for a count of five, breathe out for count of seven. You can make a gratitude list of all the things that you're grateful for in your day. Every single day, you can take a walk with a family member and get away from work every single day.

There is this wonderful care-taking nature. The problem is, is that caretakers are most vulnerable to all kinds of challenges because they don't put themselves first. Now, as far as red flags or concerns that you need to get a little couch time with a mental health professional, it’s listening to your body because a lot of us over intellectualize our stress and say, oh, I'm fine.  

I've got this I'm superwoman. I'm superman.  And yes you are, but you're still human. So listen to what your body's telling you. Lack of sleep or difficulty getting a good night's sleep whether you're restless or you just can't shut your brain up, your mind keeps going and going. You're more irritable.  You're drinking more. You're eating more. You're starting to experiment with other substances. Obviously that's a huge red flag. That feeling of being numb, that feeling of, I don't care, that feeling of anger, that a lot of people are struggling with where it's coming out in all the wrong places.  Human beings leak when they don't let things out in a healthy, appropriate way, it comes out in other ways.

So if you noticing any of those behaviors, if your friends, your family members, your significant others are saying, hey, you’ve been kind of weird lately. Things are a little different. Listen to that, take that in.  It doesn’t hurt you to go in and talk to a mental health professional. The worst thing they're going to say is, you know, I think you're okay.  I think everything's fine. Let's work on some coping skills, right? That's the worst case scenario. The best case scenario is you get a little bit better every time you go. 

Host:  That is excellent advice. And so I have one last question for you.  In your opinion is there more public health can do to provide needed guidance and resources to help our communities recover from this significantly traumatic experience?

Guest:   From what I've been seeing with public health, at least here in Southern California, the outreach for behavioral health services has really been remarkable. The Y. Um, I think sometimes public health looks at a plus or minus equation. Well, we're only having so many people come in as a result.

We're failing in our campaign. Remember that stigma still exists about mental health. And I think we all are very aware of that when we think about it on a one-on-one basis, um, we have to work on reducing stigma and that's not something we're going to cure overnight. I think making those services available.  You know, reminding people, educating them that they're afraid that it's healthy, inappropriate. That's a wonderful thing to do, but don't equate, the busy-ness of your public health department with your own success. 

Host:  Well, thank you. And that about wraps up our time today. And I want to thank you again for joining us today, doctor.

Thank you.