Psychological health | A change in healthcare culture is needed

Since the start of the COVID-19 pandemic and the introduction of health measures, we have begun to take stock of the extent of the collateral effects that affect many spheres of our existence, including our psychological health.

Posted yesterday at 10:00 a.m.

Diane Aubin

Diane Aubin
Psychologist, Montreal

Of course, we are not all affected to the same degree or for the same reasons. Among the factors influencing our reactions and behaviors in the face of the challenges imposed by the current context, there are those related to our state of health, to which are added several other individual, relational and cultural variables. Our family or immediate environment also influences how we deal with adversity. We are not equal in the face of the suffering, the losses and the mourning to be done. In other words, not everyone has the same baggage of solutions or the same leeway that allows a person to meet the acute demands for adaptation currently imposed.

Over the past few months, messages normalizing the state of distress that can be felt in the current context and inviting us to seek help have multiplied. Moreover, the population is not always informed of the different forms that distress can take and the ways to react to it.

In our profession of shrink, we know that the manifestations of psychological suffering can be multifaceted. This can be silent, even insidious, imbued with sadness, but not always, heavy with helplessness or unexpressed anger, or even explosive with rage.

It can be deeply repressed, to the point of concealing itself from others and from oneself. The mechanisms to guard against it are powerful: minimization, trivialization, invalidation, denial of reality are mechanisms that our brain has to avoid recognizing the signs, so as not to feel moral or emotional suffering and continue to do facing everyday life, working, studying or performing… until our defenses crumble.

A poorly developed reflex

Asking for psychological help is not a developed reflex in everyone, especially since the behavior aimed at taking care of one’s mental health is not yet well inscribed in our culture of care: access to psychological services is still too often difficult, if not impossible; waiting lists are getting longer; the costs for private consultations are not reimbursed by the public system; the use of pharmacological treatments is an avenue still favored by many, even if a good number of psychic and emotional ailments cannot be treated with medication, at least not only. It therefore takes a good dose of courage, humility and patience to admit one’s own distress and decide to consult, because it will often be necessary to knock on several doors or spend money. Many people have often reached a high degree of psychological distress when they finally decide to consult or when a loved one has sounded the alarm for them.

Distress does not wait to undermine morale, especially when it does not quickly find an attentive listener. The more it nests, the more difficult it can be to pin down the clues of the tipping point towards a state of extreme despair.

Our brain is equipped to send us warning signals, but it’s also equipped to mount powerful defense mechanisms that can steer us in the wrong direction. Distress can conceal suicidal ideation that is fought at the cost of immeasurable effort. Sometimes a single factor (considered trivial to an outsider) is enough to trigger a desperate gesture.

The psychological health of citizens, various stakeholders and health professionals is being tested more than ever at this time. A context of crisis is conducive to the aggravation of forms of distress that affect people who exercise a helping relationship profession: professional exhaustion, compassion fatigue, vicarious trauma – among the manifestations of suffering that are still little openly discussed.

The first signs can make their way slyly in the mental universe and the body of the workers and workers, in the form of various feelings or fleeting or persistent thoughts before transforming into anxious, depressive or post-traumatic symptoms. Fatigue, overwork and lack of hindsight can lead to reduced alertness. Emergency contexts, the pressure of performance and yield generate “blind spots” that can conceal silent distress. A worker aware of the risks on the site is better able to ensure his safety, but he cannot do so by staying alone for too long and without the safety net offered by his team. The critical distance provided by regular in-service training, debriefing sessions and psychological support is also essential.

Before the current pandemic, the announcement of tragedies, suicides and other human tragedies had not convinced us of the urgency of acting collectively to make mental health a priority. We currently have the opportunity to achieve a real change in the culture of care by integrating psychological health at the heart of our services. The costs linked to the setting up of training and prevention workshops, and to the involvement of psychologists within the care teams, are certainly disproportionate to the losses caused by sick leave, death by suicide and retirements precipitated by crisis contexts. Historically, the importance of psychological health has been underestimated, both in terms of its complexity and in terms of its role in maintaining our emotional, relational, social and spiritual balance. Today we realize not only the need to think differently, but the urgency of considering it as an essential component of our individual and social survival. It’s time to stop the bleeding and take informed action.


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