Taking Social Support Into Account Regarding the Mental Health of Health Care Practitioners Involved in Treating Patients With COVID-19

To the Editor:

Health care practitioners tasked with treating COVID-19, an infectious disease of an unknown nature, face many stressors. These sources of stress include the pressure and difficulty of the work, as well as social stigma. Health care practitioners are likewise exercising vigilance day after day to prevent themselves from getting infected at work. The fear of infection, along with the pressures of work, cause great stress as they live their lives. What do health care staff in such situations need to do to protect their mental and physical health? While the WHO has already published its mental health and psychosocial considerations during the COVID-19 outbreak on the Web, there has been almost no discussion of the specific measures that health care institutions should take with regard to the mental health of health care practitioners. We would like to take this occasion to propose a perspective on this matter from research on social support.

“Social support is the perception and actuality that one is cared for and the provision of assistance or comfort to others, typically to help them cope with biological, psychological, and social stressors.”¹ This support can be classified in various ways such as informational, appraisal, instrumental, and emotional.² When battling an unknown virus such as this one, having correct informational support is necessary above all else. At the same time, care must be taken with how the information is transmitted because it can easily become confusing. Health care institutions' infection-control teams should thus ideally have a system to transmit accurate information regularly. It is also important to appropriately evaluate the contribution of practitioners in the institutions as appraisal support. Instrumental support, meanwhile, refers to guaranteeing a system where practitioners can get adequate rest and not excessively strain themselves, and emotional support is when practitioners are shown adequate understanding and appreciation by those around them. These practices must be thoroughly followed at health care sites.

There is another view that categorizes social support by how it is given and received: received support and perceived support. Received support is as its name suggests, while perceived support refers to the supported individual feeling that they have received or could receive support, regardless of whether they have. Individual differences in perceived support, along with social skills, personality, and self-esteem,³ are known to emerge as a result of family relationships in childhood. For this reason, it is important (1) to conduct more active interventions on those who find it hard to maintain good interpersonal relationships at work and receive perceived support and (2) for hospitals to make their response as an organization clearer in order for practitioners to acquire perceived support. The effect of received support on physical and mental health is not uniform, while perceived support is confirmed to have a positive effect.^{4 , 5}

For the sake of the physical and mental health of health care practitioners, it is important for health care sites and organizations to take social support into account and for health care institutions to adopt the perspective of social support in their day-to-day operations. Now is the time for health care institutions to build systems based on this perspective to maintain their practitioners' mental health. This is what must be done to prevent the breakdown of the health care system and overcome this unprecedented difficult situation.