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'Over The Top': The Risk of Social Work PTSD During A Pandemic

World - Post Traumatic Stress Disorder (PTSD) is a psychiatric disorder that can occur in people who have experienced or witnessed a traumatic event such as a natural disaster, serious accident, terrorist act, war/combat, rape or other violent personal assault.


Though nobody knows what lies ahead with the Coronavirus crisis, those in the front-line care and health professions could be living through challenging times in the near future.


PTSD is popularly associated with traumatized soldiers who ‘re-live’ stressful events. Every stage of war can be stressful: the anticipation of combat, losing friends, coming under enemy fire. In combat soldiers are living by their ‘fight and flight’ instincts.


Afterwards they may have difficulty forgetting particularly traumatizing moments. They may constantly wonder ‘what if’ they had acted differently.

For many in the health and social work professions, current preparations feel like the calm before the storm. Not only are they anticipating an avalanche of virus victims, but are concerned about their own safety.


This is heightened by the fact that as noted in all news outlets, people the world over have not been provided with adequately supplies of much needed protective clothes and equipment.


With the ongoing changes in working routines and home life, stress is going through the roof for many professionals. And the toll on their mental health may not be apparent until much later.


As David Rissimilar noted in his research into workers who treated SARS;


"the psychological effects on 129 patients quarantined during the SARS epidemic and found that 28.9% met criteria for post-traumatic stress disorder (PTSD) and 31.2% for clinical depression... of 124 hospitalized SARS patients, 35% had clinical depression and 47% had symptoms of PTSD 3 months after discharge. Among those afflicted, there was a high rate of failure to return to work and carry out daily responsibilities at home.


Significant psychological distress was also observed among physicians who provided care to patients with SARS (45.7%) compared with those who did not (17.5%). The reasons included the necessity of wearing protective R-95 inhalators for protracted periods, the exposure to the morbidity and mortality of coworkers, and the fear of infecting family members. The physicians found that evaluating patients and establishing any semblance of therapeutic alliance was challenging. "You are toiling under the most stressful clinical time in your professional career. You have a headache, the mask hurts, you're sweating, and it's impossible to establish any of the usual nonverbal clues with patients.".


While many of us are self-isolating, this is not viable for key workers who are putting themselves at risk for the common good. Like a soldier on the front line, they feel they are sacrificing their personal well-being for society’s needs.


As for soldiers, no amount of groundwork can truly brace them for what may be coming. The public are recognizing this, with the scenes of applause in the street reminiscent of WWII preparations.


Like soldiers, these brave individuals will require support afterwards. Indeed, as one study of social workers by the University of Georgia showed, social workers may suffer PTSD indirectly. The study of 300 people found that “repeatedly hearing the stories of trauma victims doubles the risk of social workers themselves experiencing post-traumatic stress disorder”.


15% of social workers in the study met the diagnostic criteria for PTSD compared to 7.8% of the general population. This phenomenon, often referred to as “secondary post traumatic stress disorder” was first discovered nearly a decade ago. In addition they found that:


• 40 percent thought about their work with traumatized clients without intending to • 22 percent reported feeling detached from others • 26 percent felt emotionally numb • 28 percent had a sense of foreshortened future • 27 percent reported irritability • 28 percent reported concentration difficulties


The article stressed that while the incidence of secondary post traumatic stress disorder was high, awareness about the issue was low.


Any highly stressful events, such as Covid-19, can only exacerbate these statistics. Social workers need to be recognized by the government not only as ‘essential’ staff but also ‘at risk’.


As the study states, “Social workers may hear about burnout and they may hear about self care, but they’re not hearing about secondary post traumatic stress disorder”.


While we cannot specify the consequences of Covid-19 before the outbreak is over, we must be ready to put stressed workers and their subsequent support at the top of the agenda when the time is right.

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