Mental Health Insights - Interview with Dr. Bill Mansbach February 22, 2021

Regulation | February 22, 2021 | by Jill Schumann

Dr. Bill Mansbach, Chief Executive Officer and President of Counterpoint Health Services, joined the LeadingAge Coronavirus Update Call on February 22, 2021.

Dr. Bill Mansbach, Chief Executive Officer and President of Counterpoint Health Services, joined the LeadingAge Coronavirus Update Call on February 22, 2021. He responded to questions from Ruth Katz and from callers.

Q: Please tell us about Counterpoint and the mental health work you have been doing in the past year.

A: Counterpoint provides behavioral health services with a significant focus on older adults. We work in nursing homes, assisted living and memory care communities, and in the broader community. We work with older adults, staff members and family members in a variety of settings. Our sister organization BCAT does research and has been working on issues related to COVID as well.

Q: BCAT has been conducting surveys. Please tell us about those.

A: BCAT did its first survey in May, the second data set was in October, and a current, even broader survey will collect data on more than 1,000 participants who are caregivers working in any setting. The survey will close on Wednesday so analysis will begin then. We are looking for respondents who work with older adults, especially in post-acute settings.

Q: What are you exploring with these surveys?

A: We are looking at the psychological burden on healthcare providers; how organizations are coping and supporting their staff; and attitudes toward the COVID-19 vaccine. We want to look at trends over time.

Q: What do you mean when you use the term “psychological burden”?

A: That refers to the collection of symptoms people are experiencing at the time – depression and anxiety, but also somatic and cognitive issues as well.

Q: What did you learn from the early surveys and what changes do you anticipate with this next set of data?

A: We anticipated that this pandemic would generate significant PTSD. In both May and October, we found that in both surveys 50% of staff members in nursing homes, assisted living and memory care met the threshold for psychological burden, which is about 30% higher than pre-pandemic. Fifty percent of family members met the threshold, as did 40% of residents. You can use a quick instrument (M5 is free and validated and available at enrichvisits.com) with your own organization.

Q: What do you anticipate you will see with this current survey?

A: We anticipate that we will experience a lessening of psychological burden. However, sometimes as the situation improves workers will fully experience how difficult the past year has been (which is consistent with PTSD), and that may mean some people make the decisions to leave the field.

Q: What else might you see?

A: Many organizations have gotten better at knowing how to support their staff, and we hope we see staff members who are supporting one another. Of course, we also hope to see good vaccine uptake and a resultant sense of hope.

Q: Might you share some practical tools with us?

A: In partnership with LeadingAge, we have developed The Art of the Supportive Check In which is included in the Pandemic Playbook. We also have a series of stress management tools, including one-minute stress management videos that can be found in our support center. We have tools that outline ways of creating meaningful engagement for residents and staff. And we are collecting data on various types and professions of staff members and their attitudes toward the COVID-19 vaccine. We will then create tools to encourage people to be vaccinated. It is important to get good information out. You can go to www.thebcat.com and sign up as an educator to see information as we post it. There are resources for managers, peers, and individuals.

Q: We know that isolation is causing concern – what are you seeing?

A: There is a fundamental balance between keeping people safe from COVID and finding ways to help people engage, since we know that isolation can be devastating. We must work at creating pathways for meaningful engagement, especially for people with dementia who have more difficulty with virtual forms of engagement.

Q: What do you think we will see next?

A: Organizations are learning how to support staff and residents and the vaccine will be important as we move forward. Yes, there will be variants of the virus, but there is light at the end of the tunnel.

Q: What can staff members do to alleviate the psychological burden of family members who take their emotions out on staff members?

A: We’ve seen that in the pandemic families complained more about caregiver staff and staff members complained more about families. We need to normalize that. When people are afraid, the fear is often translated to anger, so we should not take it personally nor be defensive. Focus on the ways we can be helpful and be agents of change to be part of the solution.

Q: What should supervisors do to intervene with stressed staff members?

A: What supervisors and peers are seeing is the tip of the iceberg. People are struggling even more than they appear to be. Take people aside routinely, validate their feelings and introduce resources that may help, including trained professionals. Normalize the feelings and encourage people to understand that things can get better.

Q: What can staff do to help residents?

A: It is important to start with screening – the BADS -Brief Anxiety and Depression Scale is a good tool. When appropriate make a referral to the right healthcare provider. It is about more than medication. And, emphasize for residents and families that engagement is the best medicine.