Potential mental health consequences for workers in the Ebola regions of West Africa – a lesson for all challenging environments

Greenberg, Neil; Wessely, Simon; Wykes, Til

doi:10.3109/09638237.2014.1000676

Cited by 67 publications

(79 citation statements)

References 10 publications

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“…As expected (Greenberg et al, 2015; Hall et al, 2008; Hewlett & Hewlett, 2005), concerns about contagion and difficulties dealing with death and suffering were common. Preparatory training, especially for inexperienced staff, should cover mechanisms for coping with these issues.…”

Section: Discussionsupporting

confidence: 76%

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How to support staff deploying on overseas humanitarian work: a qualitative analysis of responder views about the 2014/15 West African Ebola outbreak

Rubin

Harper

Williams

et al. 2016

European Journal of Psychotraumatology

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BackgroundResponding to health crises overseas can be both rewarding and distressing for staff involved.ObjectiveWe interviewed UK staff involved in the 2014/15 Ebola response to identify experiences that positively or negatively affected them.MethodWe conducted qualitative telephone interviews with 30 Public Health England (PHE) staff and 21 non-governmental organisation (NGO) staff who had deployed to West Africa.ResultsThe main motivations for deploying were for moral reasons and personal development. Families were largely supportive of deployment, although family tension was apparent. Pre-deployment training was largely viewed positively. Common stressors included dealing with death and suffering as well as concerns about contagion, while uplifting aspects included seeing patients improve and receiving thanks from community members. Communications with home were largely satisfactory, although participants commonly self-censored their communication. Inter-organisational tensions caused stress, particularly for PHE staff hosted by NGOs. After deployment, loss of motivation and being avoided by friends and family were common.ConclusionHighlighting the personal benefits arising from deployments, as well as their moral value, may help to increase volunteering. Efforts to improve the support given to responders should focus on identifying how to better support families, preparing all staff members for dealing with death and the risk of contagion, providing opportunities for staff to more frequently experience the uplifting aspects of deployment, resolving inter-organisational difficulties, and educating others about the low risk posed by responders on their return.Highlights of the articleWe interviewed 51 medical and laboratory staff sent to West Africa during the 2014 Ebola outbreak, to understand what factors were stressful or uplifting.Common stressors included dealing with death and suffering as well as concerns about contagion. Uplifting aspects included seeing patients improve and receiving thanks from community members. After deployment, loss of motivation and being avoided by friends and family were common.Preparation and support for staff should consider these issues.

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Section: Discussionsupporting

confidence: 76%

“…As overseas deployments for health crises become more common, it is important to understand what factors contribute to positive and negative outcomes for the staff involved (Greenberg, Wessely, & Wykes, 2015). A recent review identified several factors that affect the wellbeing of humanitarian workers (Brooks et al, 2015).…”

mentioning

confidence: 99%

How to support staff deploying on overseas humanitarian work: a qualitative analysis of responder views about the 2014/15 West African Ebola outbreak

Rubin

Harper

Williams

et al. 2016

European Journal of Psychotraumatology

Self Cite

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“…community or family carers, traditional healers and health workers) can also experience psychological effects. Witnessing the traumatic course of the infection and their patients’ death puts carers at risk of poor psychological outcomes, including anxiety, depression and post-traumatic stress disorder 2 , 3 , 9 . Often, those assuming carer responsibilities are family members, particularly young people, who can experience increased anxiety, frustration and grief because of their relationship with the patient.…”

Section: Individual Levelmentioning

confidence: 99%

“…Carers have been reported to experience psychosomatic Ebola symptoms 2 , 3 , 8 , 9 . Carers can also experience isolation from their families or community because of the infection transmission risk (e.g.…”

Section: Individual Levelmentioning

confidence: 99%

Psychosocial effects of an Ebola outbreak at individual, community and international levels

Bortel

Basnayake

Wurie³

et al. 2016

Bull. World Health Organ.

402

329

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The 2013–2016 Ebola outbreak in Guinea, Liberia and Sierra Leone was the worst in history with over 28 000 cases and 11 000 deaths. Here we examine the psychosocial consequences of the epidemic. Ebola is a traumatic illness both in terms of symptom severity and mortality rates. Those affected are likely to experience psychological effects due to the traumatic course of the infection, fear of death and experience of witnessing others dying. Survivors can also experience psychosocial consequences due to feelings of shame or guilt (e.g. from transmitting infection to others) and stigmatization or blame from their communities. At the community level, a cyclical pattern of fear occurs, with a loss of trust in health services and stigma, resulting in disruptions of community interactions and community break down. Health systems in affected countries were severely disrupted and overstretched by the outbreak and their capacities were significantly reduced as almost 900 health-care workers were infected with Ebola and more than 500 died. The outbreak resulted in an increased need for health services, reduced quality of life and economic productivity and social system break down. It is essential that the global response to the outbreak considers both acute and long-term psychosocial needs of individuals and communities. Response efforts should involve communities to address psychosocial need, to rebuild health systems and trust and to limit stigma. The severity of this epidemic and its long-lasting repercussions should spur investment in and development of health systems.

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“…There is now a sizable body of scholarship which examines in depth the impact of, international response to, and the movement of Ebola in, West Africa (Greenberg et al, 2015;Pruyt et al, 2015). The literature on these subjects seems bottomless, offering insight on everything from new knowledge on potential transmission routes, courtesy of animal testing (e.g.…”

Section: Introductionmentioning

confidence: 98%

Ebola and alluvial diamond mining in West Africa: Initial reflections and priority areas for research

Maconachie

Hilson

2015

The Extractive Industries and Society

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Potential mental health consequences for workers in the Ebola regions of West Africa – a lesson for all challenging environments

Cited by 67 publications

References 10 publications

How to support staff deploying on overseas humanitarian work: a qualitative analysis of responder views about the 2014/15 West African Ebola outbreak

How to support staff deploying on overseas humanitarian work: a qualitative analysis of responder views about the 2014/15 West African Ebola outbreak

Psychosocial effects of an Ebola outbreak at individual, community and international levels

Ebola and alluvial diamond mining in West Africa: Initial reflections and priority areas for research

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