Person:

Stelson, Elisabeth

The relationship between Long COVID (LC) and psychiatric outcomes, as well as factors associated with presence and absence of these, has to date been insufficiently studied. To explore this, we evaluated psychiatric symptoms and coping among LC and recovered COVID-19 patients who participated in a large international survey. Given increased rates of psychiatric illness with chronic medical conditions and known immune-inflammatory contributors to psychiatric disease, we hypothesized that a subset, but not entirety, of LC respondents may have comorbid psychopathology. A significant minority of both groups experienced suicidality, depression, and anxiety symptoms with these symptoms being more common in the LC group. LC respondents used more adaptive coping styles. Psychiatric outcomes in LC were associated with younger age, greater reductions in overall health, higher symptom severity, limitations to physical capability, lower income, financial hardship, psychiatric history, employment impact, male sex, men and nonbinary gender, and negative experiences with medical professionals, family, friends, partners, and employers.

Our workplaces shape our health, whether through the stress of our workloads, pay and benefits we receive, interacting with physical surroundings, or obtaining support from colleagues and supervisors. This is as true for addiction treatment organizations as it is for any other workplace. However, the implications of working conditions in these settings are wider since how these workplaces shape worker health also impacts the health of clients seeking addiction treatment. Creating working conditions that support the health and wellbeing of the addiction treatment workforce is therefore central to providing consistent and effective addiction treatment for clients.

The considerable rise in substance use disorders has strained addiction treatment services across the United States, and this strain can be noticeably felt in organizations operating across Massachusetts—a state with one of the highest rates of overdose deaths in the country. The addiction treatment workforce has long been characterized by high rates of turnover and attrition, but with the rising rates of addiction, workforce shortages have greater implications for people seeking addiction care. This may be particularly true for residential addiction treatment facilities, which provide 24/7 care for individuals as they move into recovery.

The Substance Use Provider Occupational Wellbeing (SUPOW) Study aimed to understand how working conditions and larger socio-political influences impact the health and wellbeing of Massachusetts residential addiction providers working in state-funded facilities. This study also sought to identify how the health and wellbeing of providers impacted the organizations at which they worked and client care. As part of this community-initiated study, frontline providers, supervisors, and executive leaders participated in interviews and focus groups to share their perspectives and observations working in residential treatment across Massachusetts regions. As such, all analyses presented in this report are from the perspective of providers and leaders with first-hand experience working in residential addiction treatment.

Many professionals who work with people who have trauma histories experience vicarious trauma. Vicarious trauma is “second hand” trauma that is passed on to workers when they interact with individuals who experienced trauma “firsthand” or encounter information about the trauma. A worker may not directly experience the trauma, but because they work with people or communities that have, the worker may experience these traumas indirectly. Vicarious trauma can negatively affect the mental and physical health of professionals through psychological and physiological stress-response pathways. The Vicarious Occupational Trauma Exposure (VOTE) Index is a tool designed to identify parts of a worker’s job that expose them to vicarious trauma, how often they are exposed to vicarious trauma, and how strong the vicarious trauma exposure is. The VOTE Index assesses 16 common occupational sources of vicarious trauma across four domains: 1) clients/patients sharing about trauma; 2) receiving and reviewing evidence of trauma; 3) documenting and reporting trauma; and 4) other staff members sharing about trauma.