It has been over two months since our lives first began to change due to COVID-19. We may not be able to leave home as much as we like due to shelter-in-place orders, we have to be extra cautious in maintaining social distancing, and we have to wear protective personal equipment, if we can access it. When we are able to leave home, stressors — which didn’t exist before the pandemic — determine how safe we will be. These new stressors may include things like the availability of protective gear, or whether we must rely on public transportation to get to work, or whether social distancing is sufficient to prevent illness. For many of us, leaving home is a choice, but, for those we rely on the most — the essential workers — it may not be.

For essential workers, leaving home is not a choice, and lacking the necessary protective equipment they need adds anxiety to an already tense time. Each day workers juggle these pressures with the need to provide for their families, who they likely worry about endangering. This without mentioning the long hours with little sleep and sometimes being quarantined in isolation within their own home to protect those family members.

When we hear the term “essential worker,” many of us only imagine front-line health workers: first responders like paramedics and EMTs, or doctors and nurses. Because of their training and expertise we expect them to be resilient, responsible, and self-sacrificing. We see them as heroes — though it’s important not to let the language of battle avoidable risks or leadership failure — and respect them for their contribution to keeping us safe.

We may not, however, expect these workers to suffer from fear and anxiety or debilitating stress like the rest of us.

With the advent of COVID-19, we have had to expand our definition of “essential worker” to include those in food service, grocery store clerks, restaurant staff, bus drivers manufacturers, who are all essential — the full list of essential workers is extensive and surprising. The strength they show, though, may simply obscure natural and healthy feelings of fear.

Skyrocketing Levels of Anxiety

As a therapist, I work closely with many of these essential workers. I’ve learned to distinguish when they have expended their reserves, and are struggling to continue helping others in spite of their own exhaustion and fears. The sad truth is that, behind the mask of strength, some essential workers are struggling severely.

For many, their stress and anxiety levels are skyrocketing; they are not eating nor sleeping, and their anxiety and depression levels have spiked dangerously. They are worried, afraid, cry in silence when they can find a few seconds to be alone. The calamitous realities of the coronavirus outbreak are affecting not only bodies but also the mental health of our essential workers.

The biggest challenges, for all of us, may come next — mental health issues. While the need for personal protective equipment may be the obvious priority, mental health protection is equally necessary. Mental health help should be as prioritized as the use of masks and gloves.

Social isolation

It’s unclear how long the self-imposed physical isolation that some essential workers must endure will continue. The uncertainty of this reality is causing deeper loneliness but also depression and anxiety that will likely outlast the pandemic if proper help is not made available.

For most of us, knowing we should not go outside or socialize affects our psyche negatively, but there is some relief — short walks or jogs — if we are able to maintain safe social distancing and proper protective gear. For those quarantined, however, even that is a luxury they’re not able to enjoy. For many, the risks that they’re exposed to require them to self-isolate to a degree that most of us do not.

From the experience of smaller scale past epidemics, we know that a quarantine has severe effects on the mental and emotional health of essential workers. It can cause PTSD, severe anxiety, depression, and increase drug or alcohol abuse. Without the help of a mental health professional, these outcomes can be terribly detrimental, not just to the impacted workers, but to their families, friends, and community.

Disappointment

Another impact of the coronavirus outbreak on essential workers includes feelings of disappointment and objectification that many workers feel toward their workplace. This disappointment stems from the fact that many lack personal protective equipment and adequate support, both for their mental and physical health. Many have also voiced concerns that their health and safety are not their employer’s primary concern, rather employers are focused on the bottom line. While workers may be there to make a difference, pay bills, and provide for their family — the priorities of decision makers may be to shareholders and executives. Many essential workers have already walked off the job in protest and a general strike for more protections has been organized for May 1st.

Health risks

Essential workers are also concerned about their lives. For some of us, these thoughts may be irrational — we panic because there is obviously some serious risk from a lethal, highly transmissible disease — but to those on the front lines, infection is an overwhelming probability, especially for health care workers seeing death on a staggering scale and are exposed daily to gravely ill, infectious patients. Daily exposure to such stressors, as well as the virus, may cause feelings of doom or hopelessness. These feelings may not only create anxiety but, even severe panic attacks, which can result in unwanted visits to the ER.

How We Can Support the Mental Health of Essential Workers

In order to help those who work the front lines — to truly support them — employers, the government, and mental health experts need to collaborate to create targeted, sustainable, and timely mental health services available to all. This practice is common in other developed countries. Recently, Talkspace began offering free mental health services to first responders and creating free support groups available for everyone.

Understandably, large systemic changes cannot happen overnight. But, as we deliberate over new processes, we must remember that when essential workers were required on the front lines, they did not dither. They jumped into action. In the same way, we as a society must think about ways to protect their mental health.

Those who are risking their lives to save ours and keep essential goods and services available cannot wait. The best mental health assistance is that which prevents or anticipates a crisis before it develops.

Whether therapist or lay person, we will try to give back by sewing masks, donating gloves and hand sanitizer, and by staying home to protect the most vulnerable. But we can also give the gift of mental health services by donating paid sessions to frontline health workers, volunteering, creating awareness within our community, or lobbying government officials to increase the help available to those who need it.

Those of us who can stay home to avoid the risks of returning to work. Essential workers cannot avoid those risks. Let us help them by being proactive — we know now without a doubt, that they would do the same for us.

Originally published on Talkspace.

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