From Baltimore to Vellore, India: Global Support for Nurses Struggling with COVID-Related Mental Health

“Infectious disease doesn’t have borders,” says Dr. Nancy Reynolds, Associate Dean of Global Affairs and Director, Johns Hopkins School of Nursing Center for Global Initiatives. “What really stands out is that nurses all over the world are struggling with their mental health.”

COVID-19 has reached incredible caseloads in India, particularly since April, with an official death toll of 419,000 and NPR, the New York Times, Wall Street Journal, and Bloomberg News accounting for an underreported death toll likely in the millions. “Indian nurses see death at work and death at home,” says Dr. Vinciya Pandian. Similar to the U.S., nurses have been the backbone of the pandemic response yet are under-resourced and overridden with fear of contracting the virus and passing it to their families.

The stress on nurses cannot be overlooked. “Nurses are experiencing unprecedented demands from their patients and enormous mental health pressure leading to serious psychological distress,” Howard Catton, CEO of the International Council of Nurses said in a statement in January. “The unique mass trauma is likely to have a significant, long-term impact manifesting in a wave of post-traumatic stress disorder (PTSD), depression, and anxiety, the scale of which we cannot yet determine.”

Rising to the mental health challenge

Nurse leaders at Johns Hopkins School of Nursing and College of Nursing, Christian Medical College (CMC), Vellore, India, rose to the challenge. Through a collaborative partnership, both institutions organized and presented the Leveraging Global Partnership in Addressing COVID-Related Mental Health Webinar Series, consisting of five different topics targeting all health care workers, nursing students, parents, and children. The series’ outstanding attendance—at four in the afternoon Indian Standard Time and eight in the morning Eastern Standard Time no less—is an indication of just how necessary this information is for nurses. There were 11,139 registrants, over 4,400 live attendees, and over 2,100 recording views from over 37 countries.

View the playlist of webinars

The series’ outstanding attendance included 11,139 registrants, over 4,400 live attendees, and over 2,100 recording views from over 37 countries.

Dr. Nancy Reynolds and Dr. Vinciya Pandian provided leadership from the Johns Hopkins’ side, working through the WHO Collaborating Center for Nursing and Midwifery and the Center for Global Initiatives (both housed in the Johns Hopkins School of Nursing) and the Johns Hopkins India Institute, an all-Johns Hopkins initiative launched shortly before the COVID-19 pandemic began. Their partners at CMC, Vellore are Dr. Vathsala Sadan, Professor, and Dr. Manoranjitham Sathiyaseen, Dean of the College of Nursing and Professor of Psychiatry Nursing.

What’s more, the school is Dr. Pandian’s alma mater; she graduated and came to the U.S. and Johns Hopkins 25 years ago. “It’s wonderful to be able to formally give back,” Dr. Pandian says. She truly appreciates Dr. Nancy Reynolds and the Johns Hopkins India Institute, “Without their support, I could not have contributed at this global level.”

Culturally relevant support

The Leveraging Global Partnership in Addressing COVID-Related Mental Health Webinar Series was developed specifically in response to requests for mental health support from Indian partner nurse leaders at CMC, Vellore, but in India, there is a greater stigma on mental health and there are different cultural and professional norms. Each webinar included a partner from India who was able to deliver mental health strategies in cultural context.

Take “time,” for example. Mental health advice is frequently “take a break” – to meditate, do yoga, even a few moments to decompress, eat or drink water during the workday. However, the nurse to patient ratio is different—with little time for breaks—and after work female nurses are expected to return home and care for their families.

“It really rests upon the shoulders of nurse leaders to care for staff and allocate adequate time for staff’s self-care,” says Dr. Vinciya Pandian. “Even giving them a bottle of water, a snack during their shift, is meaningful because nurses don’t have time to grab food.”

A sense of solidarity

As India prepares for a third wave, with a four percent vaccination rate in the country, nurse researchers at Johns Hopkins empathize and seek out additional avenues to offer support and work together.

“I hope to see more of this collaboration between nurses in different countries in the future,” says Dr. Nancy Reynolds. The Johns Hopkins School of Nursing, Johns Hopkins India Institute, and CMC, Vellore are working on a collaborative memorandum of understanding (MOU) to make that happen.

COVID-19 & India Mental Health Webinars

View the playlist of webinars

• Leveraging global partnerships in addressing COVID-Related Mental Health: A Webinar Series
• Acute and long-term impact of COVID-19 ON Mental Health
• Psychological Wellbeing of Students During COVID-19 Pandemic & Lockdown
• How Parents Can Help Their Children to Cope with Education
• Fear and Anxiety of Working in COVID-19 Wards
• Caregiver’s Burden and How to Help Caregivers During COVID-19 Pandemic

Acknowledgements

The organizers of Leveraging global partnerships in addressing COVID-Related Mental Health: A Webinar Series, would like to acknowledge Dr. Karan Kverno, Dr. Patty Wilson, Dr. Tamar Rodney, Dr. Katherine Rediger, Dr. Natalie Regier, Dr. Jason Farley, and Angela Chang Chiu from the Johns Hopkins University School of Nursing, and Dr. Manoranjitham Sathiyaseelan, Mrs. Alice Sony, Dr. Vinitha Ravindran, Mrs. Sheela Durai, Mrs. Helen Sujatha Charles, Dr. Bala Seetharaman, and Mrs. Ida Nirmal from the Christian Medical College Vellore, College of Nursing for their participation and expertise.

ABOUT THE AUTHOR: SYDNEE LOGAN

Sydnee Logan, MA is the Sr. Social Media and Digital Content Specialist for Johns Hopkins School of Nursing. She shares Hopkins Nurses with the world.