By Dr Mark Xuereb, Visiting Lecturer, and Crisis Psychiatrist

With the general perception being that all front-liners should carry on and soldier through with their indispensable work during the COVID-19 pandemic, crisis psychiatrist and UM Visiting Lecturer Dr Mark Xuereb has expressed his growing concern of the significant mental toll this extraordinary situation is taking on this faction of the Maltese society.  

Referring to not just medical and healthcare staff, but to the police force and those providing ancillary services, who are spending long hours at work and away from their families, he said that these are particularly vulnerable to a major aggregate of psycho-social stressors, such as lack of sleep, stress, isolation, and loneliness, among others, and that COVID-19 has not just increased but accelerated the consequence of these stressors. It is also understood, Dr Xuereb said, that if they confess to this mental toll, the front-liners might be perceived as weak or might fear being let go from the job. 

“The toughness of spirit and firmness of purpose among these front-liners is incredible, and it is nice to clap hands, ring bells and blow whistles, but we need to remind ourselves they are human too. I would go as far as saying it might be counterproductive because if shells start to crack, productivity levels go down and judgement gets poorer”, he told Newspoint. 

The psycho-social dimension of COVID-19 has given rise to a number of challenges not just for those who are mentally healthy, but even more so for those with a predisposition to mental health disorders, which Dr Xuereb thinks are already silently causing a “psychological pandemic to be brewing”.  

“Parallel to the physical virus, which I fully trust the health authorities to be doing the best they can to minimise the effect of, there is another dimension to this crisis which can have more wide-reaching and permanent consequences; the psychological battle”, Dr Xuereb reiterated. 

This “parallel, invisible pandemic” needs immediate addressing through the formulation of a national strategy to prevent as much as possible the expected increase in mental health crises even once the physical challenges ebb away. 

He referred to a study published on the Lancet Psychiatry Journal, which shows an increase in psychological distress among healthcare workers. 

Back in September of 2019, Dr Xuereb launched Sokkors Fil-Pront (SFP), an NGO aiming to provide immediate care to those in crisis. The NGO is currently liaising with its counterparts abroad to come up with a set of easy-to-implement guidelines to minimise the incidences of mental health conditions. 

And whilst Dr Xuereb commends the mental health helpline set up purposely for COVID-19-related support, as well as the Employee Support Programme which provides a ‘wide range of free and confidential support services to public employees designed to assist them in managing their work and life difficulties’, he also said the support of independent services such as Crisis Resolution Malta is integral as they provide an alternative means of reaching out. 

For front-liners and all individuals to be able to keep strong in such times, he echoed the National Health Authorities’ advice to stick to a routine as much as possible, eat well, sleep well and keeping social contact, even if virtually. After all, the flip-side of vulnerability is resilience, “our innate and acquired toolkit to face any crisis, much like an athlete training for a race by building resilience”. 

“When you don’t need help, don’t get it, but when you need it, get it as soon as you can to avoid the increasing workload on the system”, Dr Xuereb concluded on the necessity of reaching out in times of distress.