Abstract

The COVID-19 pandemic is an unprecedented challenge to society. Mental health support for health care workers is a critical component of the public health response. There is an urgent need to provide mental health support for front-line caregivers at risk for mental injury and post-traumatic stress disorder. We describe the literature base for a multilevel model of care and the practical steps for its implementation. The goal is to know the frequency of these disorders and the appropriate model of care. We reviewed articles found on PubMed through March 20, 2021, using the following keywords : Moral injury : a particular type of trauma characterized by guilt, existential crisis, and loss of confidence that can develop as a result of a perceived moral violation ; Acute stress : a characteristic set of symptoms that may develop in response to exposure to a traumatic event(s). It usually involves an anxiety response that includes some form of reliving or reactivity to the traumatic event ; Post-traumatic stress disorder : a characteristic set of symptoms that develops following exposure to a traumatic event(s). A manual search of Google Scholar was performed to identify additional relevant studies. We included articles that met the following inclusion criteria : studies investigating possible risk and/or resilience factors for symptoms of moral injury, acute stress, post-traumatic stress disorder, and prevention steps among caregivers facing the COVID-19 pandemic. The initial search generated 122 articles and a total of 36 articles meeting our inclusion criteria. Symptoms of acute stress disorder, post-traumatic stress disorder in resuscitation providers and the risk of PTSD for front-line staff was approximately 10%.

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