Maintaining mental health among medical staff during the COVID-19 pandemic: Taiwan's experience

The COVID-19 pandemic is an unprecedented challenge for countries around the world. Medical professionals worldwide are facing the challenge of providing care for a large number of patients during this pandemic. At the same time, supporting the mental health of medical staff is also a critical part of the public health response. Negative psychological effects of the pandemic have been reported; they include burnout, compassion fatigue, anxiety, depression, post-traumatic stress disorder, and moral injury.^{1 , 2} How can hospitals address this issue? During the pandemic, Taiwan's Ministry of Health and Welfare established guidelines and directed health care organizations to maintain the mental health of medical staff. This paper describes the effective and useful strategies for supporting medical staff based on experiences from a medical center in southern Taiwan. We believe our model can help inform hospital administrators of strategies to better fight the COVID-19 pandemic, while also maintaining the mental health of medical staff. The viable approaches are described below (Fig. 1 ).

Fig. 1.

Steps of supporting mental health of medical staff.

Establish the task force and management algorithm³

• •Establish a team to support the mental health of medical staff as soon as national reports are made in order to ensure an early response. The task force should be led by an executive administrator in charge of coordination and communication between departments. The task force should be multidisciplinary and include physicians, nurses, psychiatrists, psychotherapists, social workers, etc.
• •The mission of the task force is to identify the needs of medical staff and provide the necessary support to reduce stress.³

Education and policy communication¹

Accurate, transparent and timely communication is very important to prevent wide-spread panic and increase compliance with pandemic response policies among both the public and medical staff.

• •Lectures should be held to provide the medical staff up-to-date knowledge and information about COVID-19. Training courses on proper use of personal protective equipment (PPE) should also be provided.
• •Clear messages, rationale and guidance for evolving standards of practice should be relayed, along with up-to-date, evolving recommendations for supporting staff. To manage the high volume of information, short videos can be made to communicate the policies of pandemic management, ensuring that the information is communicated in a way that is easily understandable and visually attractive.
• •Provide pandemic updates for all staff. Medical staff should be informed if there are any confirmed COVID-19 cases currently being treated at the hospital, while also protecting patient privacy, to prevent the spread of misinformation and subsequent panic.

Monitor Mental and physical health statuses¹

• •The mental and physical health of medical staff should be considered equally. An online reporting platform and screening algorithm could be established for staff to self-report their physical and mental statuses, on duty or at home. Further evaluation is used to assess the impact of stress, as well as psychological needs.
• •Medical staff need to report their body temperature and any COVID-19 symptoms daily using the online platform. Furthermore, their mental health status need to be reported weekly as well.
• •An effort should be made to recognize high-risk staff members. Staff members who may experience increased risk of poor mental health include those working at the emergency department, quarantine units, and dedicated epidemic clinics or janitors. If necessary, relaxation technique training can be provided to help staff members manage stress and improve sleep quality.^{1 , 3}

Provide Help1, 2, 3

• •Establish a hotline that allows medical staff rapid access to psychosocial assessment, counselling services, and psychiatric evaluation or treatment. Contingency plans for temporary time off work can be discussed and arranged.³
• •Provide unit managers the guidelines for debriefing and assessing the needs of staff members.
• •Medical staff who have a body temperature above 38 °C or show COVID-19 symptoms need to stop their duties. They will be quickly arranged to be assessed by a physician and receive a coronavirus test. Before resuming their work, the medical staff must have a negative coronavirus test result and display no fever related symptoms without any medication for at least 24 h.
• •Provide staff members with 24-h free access to food and beverages by partnering with 24-h businesses and rest facilities.
• •Provide formal and informal psychological support from psychologists to help medical staff deal with stress³
• •Support staff quarantined at home remotely to alleviate loneliness, keep in touch with the team, and provide up-to-date information on the situation at the hospital. There should be an emphasis on encouraging them to contact friends and family via the mobile phone or online.¹

Support from the executive hospital administrators

• •Ensuring a sufficient stockpile of PPE is one of the most critical tasks for hospital administrators to reassure medical staff on duty. The hospital administration has the responsibility to distribute the PPE reasonably.¹
• •The executive hospital administrators should personally visit the frontline staff to attend to their needs and show gratitude with a reward, as a way to honor their hard work.

Hospital administrators should strive to support their medical staff's mental health and wellbeing during the COVID-19 pandemic. Early intervention is key to preparing staff for a task associated with tremendous challenges. Effective leadership and managerial support for medical staff will be instrumental in the prevention of negative psychological outcomes. As the current pandemic continues to evolve, we believe that our model can help hospital administrators develop strategies that are feasible, effective, and sustainable in daily practice to maintain mental health among medical staff.

Declaration of competing interest

The authors have no conflicts of interest relevant to this article.