COVID-19 – Steep rise in staff needing mental health support

The COVID-19 pandemic has had a massive impact on mental health on campuses in the United States these past four months – massive not only in levels of fear, anxiety and stress, but also in the large numbers of people who have needed emotional support, says Jonathon Novello, a clinical social worker and counsellor at Michigan State University in the United States.

Very interestingly, during the first couple of weeks of the pandemic there was a sharp decline in the number of requests for individual counselling – but a “huge increase” in requests for departmental and unit-based services and larger support sessions, all delivered remotely.

Novello was a speaker for a webinar on universities and the COVID-19 pandemic hosted by the Alliance for African Partnership, a consortium of 11 universities in Africa and Michigan State University or MSU in the United States. University World News is the media partner.

“Dialogue #5 – Coping with Mental Health Impacts of COVID-19 in Higher Education: Responses and lessons learned” was the title of the fifth and penultimate webinar in the dialogue series, which is moderated by Professor Paul Zeleza, vice-chancellor of Kenya’s United States International University-Africa.

Prior to COVID-19, individual counselling comprised the great bulk of mental health support work at MSU, said Novello, a counsellor and clinical lead with the Employee Assistance Program or EAP and a consultant to Health4U, the health-promoting programme of the university, which is offered to all academics, staff, graduate assistants and retirees.

The EAP provides a range of health and wellness services, coaching services and departmental services including critical incident debriefings and support groups, management and employee consultations, and training for resiliency, parenting, relationships and so on.

Pandemic phases on campus

Regarding mental health, counsellors at MSU break pandemic developments and effects into three phases.

“The first phase was around uncertainty and instability and adjusting to the work. The world got very unsafe and uncertain and people struggled with that. And with uncertainty comes anxiety,” said Novello. Staff have been battling with sometimes intense anxiety as well as with working from home, dealing with loss and grief and many other issues.

Some people also struggled with the notion of ‘essential’ and ‘non-essential’ workers, Novello noticed – a kind of COVID-19 version of ‘haves’ and ‘have-nots’.

Large numbers of academics and staff had to leave campus and work at home, while other quite large numbers of staff had to keep working, for instance those staff who had to prepare food daily for the 3,000 of MSU’s 55,000 students who remained on campus.

Some academics and staff working at home were unhappy with the notion of being ‘non-essential’ or in other words ‘expendable’, while among ‘essential’ staff there were anxieties about getting infected and some resentment about having to work during the pandemic.

“The second phase was around fatigue. People just getting exhausted and tired of this.” Along with feelings that the difficult COVID-19 situation had gone on for a long time, came new realities and fears, said Novello.

“Financial realities started to creep in, a recognition that the university was going to have to respond by producing a budget and finding ways to pay for things. And so there started to be fears around furloughs, lay-offs, pay cuts, across the board. That continues to this day.”

Also, academics became “really anxious and frustrated” when they were unable to conduct research, and also worried about funding for their research in future.

Now MSU and many universities are thinking about reopening – the third phase. “That brings a whole new set of feelings of uncertainty and, again, chronic anxiety, fear and panic, and people worried about getting sick.” In Michigan it has looked like there will be a second wave of COVID-19.

Further: “Faculty are really unclear about how to teach and that creates a lot of angst and frustration. There is lack of clarity about how teaching is going to happen, and so you can see another set of anxieties starting to creep in.

“In addition, in the United States, and across the world, [we] are dealing with the reality of the killing of George Floyd and the impacts, as racial injustice and inequality have really risen to the surface of consciousness.”

Shift in mental health problems

The pandemic prompted a shift in the type of mental health problems that employees presented with.

A study of impacts on staff from March to June 2020 found that anxiety was the biggest problem (19% of people), followed by stress related to work concerns at 16%, general stress 13%, depression 10%, relationship concerns 10%, family concerns 9%, grief and loss 7%, health anxiety 6%, adjustment-transition 6% and work environment concerns 4%.

There have been some important shifts, highlighted by a comparison with March to June 2019, when stress related to work concerns was 18%, anxiety 16%, relationship concerns 15%, family concerns 12%, general stress 10%, depression 8%, work environment concerns 6%, grief and loss 6%, other 6%, and adjustment-transition was 3%.

Last year’s figures were similar to previous years. “But now anxiety has jumped to the forefront and that is the primary thing people are coming in for, followed by work concerns and stress, and depression has jumped from sixth to fourth.”

There has been a significant rise in depression and cases of anxiety in the past three months, Novello said, and a new category showed up – health anxiety, with people seeking support for anxieties around health related issues.

Responding to emotional needs

For the Employee Assistance Program, a first test in responding to the emotional needs of staff was shifting rapidly from in-person to remote counselling. “That is a challenge that all mental health providers have had to get around – and quickly,” Novello told the webinar.

Fortunately the EAP had already been dealing with Zoom, but still switching everything online immediately was a major task. “Generally that was pretty successful,” although some clients struggled for different reasons, for instance related to privacy.

During the first weeks of the pandemic there was a notable drop in the number of requests for individual counselling – but a “huge increase” in requests for departmental and unit-based services and larger support sessions, also done on Zoom. Previously, most of the programme’s work was individual counselling sessions.

The bump in departmental-level and support sessions was remarkable, and led counsellors to sit back and reflect on what other kinds of services they might begin to create.

“We began doing this by offering support groups and different kinds of remote learning opportunities to increase our staff and faculty’s resilience and tolerance and ability to weather difficult situations. That’s been really interesting,” commented Novello.

He put numbers to the work transformation. In the early days of COVID-19 there were around 50 calls and 100 emails a week for individual counselling. This quickly dropped to around 10 calls and 40 emails a week. “Since the pandemic [began], we have served over 3,000 employees.”

Colleagues at universities across the US, and some internationally, have told Novello that they have experienced similar changes. “In addition to their transition to online services they also saw, especially initially, a significant decrease in the number of clients seen for individual sessions and a significant increase in the number of requests for larger support sessions.”

Plans for moving forwards

Now is the time that Michigan State and other universities are creating protocols for returning to campus and counsellors are monitoring the recommendations of professional organisations like the National Association of Social Workers and the American Psychological Association.

“A big challenge is how in the world do we provide counselling services in person at this point? I honestly can’t imagine doing counselling with a mask on. Part of what we do in mental health work is look at people’s faces,” Novello pointed out.

“We will continue to offer larger supportive services and resiliency webinars because those have been really successful, and we’re reaching lots more people. It’s been really exciting. We will also continue to offer online services for people if they are anxious about coming in. We want to honour that.”