Phases of psychological response in COVID-19: A preliminary heuristic

Authors

DOI:

https://doi.org/10.5055/ajdm.2021.0381

Keywords:

COVID-19, pandemic, psychological impact, phases, mental health response

Abstract

Objective: To explore the putative phases of the psychological response to disaster: preimpact, impact, heroic, honeymoon, disillusionment, and recovery, and make recommendations for corresponding interventions.

Conclusions: Disasters such as the COVID-19 pandemic are often characterized by chaos and uncertainty. As a result, public health disaster planning and response represent formidable challenges. Although disasters can result from a wide array of hazards, regardless of the agent at work, they may follow a rather predictable trajectory of psychological phases. A heuristic of those phases can provide an opportunity for a more organized disaster mental health response and more efficient utilization of scarce resources.

Author Biographies

George S. Everly Jr, PhD

Adjunct Professor, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland

Albert W. Wu, MD, MPH

Professor, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland

James B. Potash, MD, MPH

Professor and Director, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland

References

Raphael B: When Disaster Strikes: A Handbook for the Caring Professions. New York: Basic Books, 1986.

United Nations: COVID-19 and the Need for Action on Mental Health. Geneva: United Nations, 2020.

Jameton A: Nursing Practice: The Ethical Issues. Englewood Cliffs, NJ: Prentice-Hall, 1984.

Dean W, Jacobs B, Manfredi RA: Moral injury: The invisible epidemic in COVID health care workers. Ann Emerg Med. 2020; 76(4): 385-386.

Williams RD, Brundage JA, Williams EB: Moral injury in times of COVID-19. J Health Serv Psychol. 2020; 46: 65-69.

Myers D, Wee D: Disaster Mental Health. New York: Brunner- Routledge, 2005.

Quanrantelli EL: The need for clarification in definition and conceptualization in research. In Sowder BJ, Lystad M (eds.): Disasters and Mental Health. Washington, DC: American Psychiatric Association, 1986.

Box GEP, Draper NR: Empirical Model-Building and Response Surfaces. New York: John Wiley & Sons, 1987.

Johns Hopkins University and Medicine Corona Virus Resource Center: New cases of COVID-19 in world countries. Available at https://coronavirus.jhu.edu/data/new-cases. Accessed October 28, 2020.

Terpstra T: Emotions, trust, and perceived risk: Affective and cognitive routes to flood preparedness behavior. Risk Anal. 2011; 31(10): 1658-1675. DOI: 10.1111/j.1539-6924.2011.01616.x.

Busch IM, Moretti F, Mazzi M, et al.: What we have learned from two decades of epidemics and pandemics: A systematic review and meta-analysis of the psychological burden of frontline healthcare workers. Psychother Psychosom. 2021; 1: 1-13.

Lai J, Ma S, Wang Y, et al.: Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020; 3(3): e203976. DOI: 10.1001/jamanetworkopen.2020.3976.

Green BL, Solomon SD: The mental health impact of natural and technological disasters. In Freedy JR, Hofoll SE (eds.): Traumatic Stress: From Theory to Practice. New York: Plenum Press, 1995.

Norris FH, Friedman MJ, Watson PJ, et al.: 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry. 2020; 65(3): 207-239.

Flynn BF: Psychological aspects of disasters. Renal Fail. 1997; 19(5): 611-620. DOI: 10.3109/08860229709109027.

Vlahov D, Galea S, Resnick H, et al.: Increased consumption of cigarettes, alcohol, and marijuana among Manhattan residents after the September 11th terrorist attacks. Am J Epidemiol. 2002; 555(11): 988-996.

Hall BJ, Tucker JD: Surviving in place: The coronavirus domestic violence syndemic. Asian J Psychiatr. 2020; 53: 102179. DOI: 10.1016/j.ajp.2020.102179. PMID: 32480357; PMCID: PMC7246009.

Brahmi N, Singh P, Sohal M, et al.: Psychological trauma among the healthcare professionals dealing with COVID-19. Asian J Psychiatr. 2020; 54: 102241. DOI: 10.1016/j.ajp.2020.102241. PMID: 32634708; PMCID: PMC7305901.

Solomon Z, Shklar R, Mikulincer M: Frontline treatment of combat stress reaction: A 20-year longitudinal evaluation study. Am J Psychiatry. 2005; 162: 309-314.

Flynn B: Mental Health All-Hazards Disaster Planning Guidance. DHHS Pub. No. SMA 3829. Rockville, MD: Center for Mental Health Services, SAMHSA, 2003.

Ruzek JI, Young BH, Cordova MJ, et al.: Integration of disaster mental health services with emergency medicine. Prehosp Disast Med. 2004; 19(1): 46-53.

Schoenbaum M, Butler B, Kataoka S, et al.: Promoting mental health recovery after Hurricanes Katrina and Rita: What can be done at what cost. Arch Gen Psychiatry. 2009; 66(8): 906-914.

McCabe OL, Everly GS Jr, Brown LM, et al.: Psychological first aid: A consensus-derived, empirically supported, competency-based training model. Am J Public Health. 2014; 104(4): 621-628.

Everly GS Jr, Beaton RD, Pfefferbaum B, et al.: Training for disaster response personnel: The development of proposed core competencies in disaster mental health. Public Health Rep. 2008; 123: 13-19.

Institute of Medicine: Ready and Resilient Workforce. Washington, DC: National Academies Press, 2014.

Wu AW, Connors C, Everly GS Jr: COVID-19: Peer support and crisis communication strategies to promote institutional resilience. Ann Intern Med. 2020; 172(12): 822-823. DOI: 10.7326/M20-1236. PMID: 32251512; PMCID: PMC7146593.

Everly GS, Wu AW, Cumpsty-Fowler CJ, et al.: Leadership principles to decrease psychological casualties in COVID-19 and other disasters of uncertainty. Disaster Med Public Health Prep. 2020: 1-10. DOI: 10.1017/dmp.2020.395. PMID: 33087209.

Watson C, Toner ES, Shearer MP, et al.: Clade X. A pandemic exercise. Health Secur. 2019; 17(5): 410-417. DOI: 10.1089/hs.2019.0097.

Everly GS Jr, Lating JM: The Johns Hopkins Guide to Psychological First Aid. Baltimore: Johns Hopkins Press, 2017.

Edrees H, Connors C, Paine L, et al.: Implementing the RISE second victim support programme at the Johns Hopkins Hospital: A case study. BMJ Open. 2016; 6(9): e011708. DOI: 10.1136/bmjopen-2016-011708.

Everly GS Jr, Mitchell JT: Critical Incident Stress Management. Baltimore, MD: Chevron, 1997.

Norris FN, Friedman MJ, Watson PJ: 60,000 disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry. 2003; 65(3): 240-260. DOI: 10.1521/psyc.65.3.240.20169.

Everly GS Jr, Mitchell JT: Critical Incident Stress Management: A Review. Ellicott City, MD: ICISF, 2017.

Moran D, Wu AW, Connors C, et al.: Cost-benefit analysis of a support program for nursing staff. J Patient Saf. 2020; 16(4): e250-e254.

Dzau VJ, Kirch D, Nasca T: Preventing a parallel pandemic—A national strategy to protect clinicians’ well-being. N Engl J Med. 2020. DOI: 10.1056/NEJMp2011027.

Published

01/01/2021

How to Cite

Everly Jr, PhD, G. S., A. W. Wu, MD, MPH, and J. B. Potash, MD, MPH. “Phases of Psychological Response in COVID-19: A Preliminary Heuristic”. American Journal of Disaster Medicine, vol. 16, no. 1, Jan. 2021, pp. 5-12, doi:10.5055/ajdm.2021.0381.

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Section

Articles