Photo Credit: Sarah Stacke/IRC
The information in this post was adapted from materials by the World Health Organization, Centers for Disease Control and Prevention, Psychology Today, Psychological First Aid, and the IRC’s Program Quality and Innovation unit and Duty of Care team.
This blog post offers tips on how to help your clients cope during the COVID-19 crisis, including suggestions for sharing information in a trauma-informed way and supporting clients’ mental health and wellbeing. For special considerations for families, see: Helping Refugee Children and Parents Cope During the COVID-19 Crisis.
All staff working to support clients should also be aware of their own stress and needs. Utilize resources for your own self-care, including seeking support from friends, family, and colleagues. To learn more, see Switchboard’s blog series Wellbeing for Service Providers During COVID-19.
Trauma-Informed Approaches to Sharing Information
Talk about the situation as directly and simply as possible. Explain that there is a virus in the community that can make people sick. Main symptoms include fever, cough, and shortness of breath. Stress the importance of prevention by staying home as much as possible, washing hands with soap for 20 seconds, using hand sanitizer, and cleaning surfaces in the home that family members touch frequently. Explain that older people and people who already have medical conditions are more likely to have complications. Check if clients know the name and phone number of their primary care clinic and let them know that if someone in the household exhibits symptoms, they should call their doctor for advice before going in person. If they don’t speak English, they should practice saying “I speak [language]; I need an interpreter” and know to stay on the line until they are connected.
Share information in appropriate languages and formats. Switchboard’s Round-Up of Multilingual Resources on COVID-19 includes materials in many languages and formats about the virus and what to do if you suspect you are ill with it. If relevant, accessible information is not available in the client’s language, encourage them to contact you or find someone they trust who can access this information and explain it to them.
Speak calmly, slowly, and patiently. Give clients opportunities to ask questions and share concerns. Practice active listening: tune in to what the client is trying to convey not just through their words but also through their emotions. If the client has a question and you don’t know the answer, it is okay to tell them that you will find out and call them back.
Recognize that outbreaks of communicable disease create tremendous stress for everyone. This may be especially true for clients who have been through trauma and deprivation or may already have significant burdens. Be prepared that some clients may exhibit significant distress. Many of the public implications of COVID-19, such as empty grocery store shelves, may be triggering for clients who have experienced war and disaster. Remind clients that many empty store shelves are temporary, and they will be restocked. Most of the empty shelves are a result of people buying more food than normal, not of a food shortage.
Supporting Clients’ Mental Health and Wellbeing
Validate to clients that it is normal to feel a wide range of emotions, including feeling sad, stressed, confused, scared, or angry during this time. Share resources to help normalize what they may be feeling:
- The Refugee Response, Managing Stress and Anxiety During COVID-19 – These videos, produced by The Refugee Response in partnership with Catholic Charities, Diocese of Cleveland Migration and Refugee Service and the Ohio Department of Health, are available in Arabic (Middle Eastern dialect), Arabic (Sudanese dialect), Arkanese, Burmese, Dari, English, French, Kachin, Karen, Karenni, Kinyarwanda, Kirundi, Kiswahili, Kurdish-Kurmanji, Sorani Kurdish, Nepali, Pashto, Rohingya, Russian, Somali, Spanish, Swahili, Tigrinya, Ukranian, and Vietnamese.
- World Health Organization (WHO), Coping with Stress During the 2019-nCoV Outbreak – This short document uses images and text to convey tips about coping with stress. Also available in Arabic, Chinese, French, Spanish, and Russian.
- American Red Cross, Coping with Sheltering at Home During COVID-19 – This guidance document includes suggestions for coping with stress and supporting others during the COVID-19 emergency. Available in Simplified Chinese, Traditional Chinese, Haitian Creole, English, French, Korean, Spanish, Tagalog, and Vietnamese.
- Emergency Community Health Outreach (ECHO), Mental Health Care During Crises – These videos, developed in 2010, are available in Hmong, Khmer, Lao, Somali, Spanish, and Vietnamese (all captioned in English).
- Haifa University, Finding Moments of Refuge in the COVID-19 Crisis: Mindfulness-SOS for Refugees – This online mindfulness-based program is designed for refugees and asylum seekers. These tools are part of a project called Moments of Refuge.
Help clients pro-actively identify coping strategies. People are resilient. Former refugees have many skills that have enabled them to survive through difficult situations in the past. Some questions you can ask include:
- What are things that you have done in the past that have helped you cope or feel safe?
- Who can you talk to that you trust to help?
- What are things that you can do that help distract you or keep you from worrying, even if it is just for a little while?
Encourage clients to stay in close contact with people who are important to them, including avoiding social isolation by talking often with family and friends. This can be done via phone, text, email, or social media apps.
Promote routines in daily life, even if clients cannot leave their homes. This includes regular sleeping, waking, and eating times. Encourage healthy practices including exercise that is safe and appropriate to their health and situation (for instance, stretching at home or taking a walk with appropriate social distancing).
Remind clients that limiting media exposure can reduce worry and agitation. Additionally, when consuming information about COVID-19, remind clients to only seek out and follow advice and information from reputable sources.
Discourage unhealthy behavior including smoking; alcohol and substance use; sleeping all day, etc. This can include having conversations with clients who already have alcohol or other substance dependency issues to practice harm reduction.
- Substance Abuse and Mental Health Services Administration (SAMSHA)
- Disaster Distress Helpline – This helpline provides 24/7, 365-day-a-year crisis counseling and support to people experiencing emotional distress related to natural or human-caused disasters. Services available for English speakers, Spanish speakers, and Deaf/Hard of Hearing.
- Taking Care of Your Behavioral Health During an Infectious Disease Outbreak – This fact sheet explains social distancing, quarantine, and isolation in the event of an infectious disease outbreak. It discusses feelings and thoughts that may arise during this time and suggests ways to cope and support oneself during such an experience. Also available in Spanish.
- Tips For Social Distancing, Quarantine, And Isolation During An Infectious Disease Outbreak – This tip sheet describes feelings and thoughts you may have during and after social distancing, quarantine, and isolation. It also suggests ways to care for your behavioral health during these experiences and provides resources for more help.
- Whole Health Action Management (WHAM) – Whole Health Action Management (WHAM) is a training program and peer support group model developed by SAMHSA’s Center for Integrated Health Solutions to encourage increased resiliency, wellness, and self-management of health and behavioral health among people with mental illnesses and substance use disorders.
- The Inter-Agency Standing Committee (IASC), Briefing Note about Mental Health and Psychosocial Support (MHPSS) aspects of COVID-19 – This guidance document contains information on how to: help older adults cope with stress; support the needs of people with disabilities; design messages and activities to help children deal with stress; set up MHPSS activities for adults in isolation/quarantine; provide support to response workers; and circulate community MHPSS message. Available in English, Chinese, Simplified Chinese, and Arabic.
- The Centers for Disease Control and Prevention (CDC), Coronavirus Disease 2019 (COVID-19): Stress and Coping – This page includes suggestions for reducing stress in yourself and others, information for parents, information for responders, and information for people released from quarantine. Also available in Spanish.
- National Network to End Domestic Violence, Using Technology to Communicate with Survivors During a Public Health Crisis – This page provides information and tools that programs can consider for communicating with clients remotely while maintaining privacy and confidentiality. Includes a Digital Services Toolkit available in English and Spanish.