Kaila Yeager
Kaila Yeager, regional emergency response advisor for the Florida Department of Health, trains shelter staff on operations during the COVID-19 pandemic. ©Elizabeth Dunn, 2020.

By Kelsey Merlo, Katrina Conen, Wie Yusuf, Jennifer Marshall, Joshua G. Behr, and Elizabeth Dunn

Implications for Public Health

Mental health interventions at both the organizational and individual level can help shelter staff manage the acute and chronic stress caused by co-occurring disasters.

When disaster strikes, employees and volunteers mobilize to provide shelter for those affected. In 2020, those involved in mass care planning and sheltering dealt with a historic hurricane season characterized by a record number of named storms. Simultaneously, the ongoing COVID-19 pandemic jeopardized the psychological well-being of the emergency management workforce, including those who work at emergency or special medical needs shelters.

Because these personnel are fundamental to shelter functioning and the protection of the populations they serve, action to mitigate potential turnover, absenteeism, and staffing shortages—all of which diminish our nation’s hurricane response capabilities—is critical. One way to decrease these issues is by addressing the psychological needs of shelter workers. With this in mind, we formed a CONVERGE COVID-19 Working Group with the goal of identifying psychological health concerns of hurricane shelter workers and well-being strategies that might support them.

Acute Stress Among Shelter Workers

An impending hurricane can cause collective anxiety as people assess storm risk, plan for potential damage, and determine how to best weather the storm. During the 2020 hurricane season, however, shelter staff and volunteers also faced the possibility of contracting COVID-19, either in shelters or in their community.

As with any other season, we always have those concerns about our families. Are they safe? Then with this COVID-19 issue, we have the concern about ‘If I serve like I’m supposed to, am I going to get sick? Am I going to take the illness back to my family?’ And that just adds to all the normal concerns. —Working group participant

Good communication about shelter practices, such as those put in place to protect physical health, can help lessen such concerns. Information should be delivered in an honest, specific, and consistent manner and provide insight into an organization’s plan to mitigate risks in the shelter environment.

Shelter staff can also practice techniques to limit negative emotional experiences. In particular, we suggest individual strategies that help workers reduce adverse feelings before they escalate. This could include reaching out to others for support or engaging in calming activities. Shelter staff and volunteers might choose to bring small items—such as a books, writing journals, playing cards, or headphones—to help proactively regulate emotions in stressful shelter environments. Taking time to recharge during or after a sheltering event is also a good idea. Simple techniques for recovery can include:

  • Catching up on sleep
  • Exercising
  • Journaling
  • Taking a “time out” when things are particularly stressful
  • Practicing mindfulness
  • Joining a support group
  • Seeing a mental health counselor or therapist

Chronic Stress

Emergency management and public health workers have been responding to the pandemic for nearly a year now, often working overtime because of the complexities of managing and planning for such an uncertain threat.

Our staff have been going through this COVID thing now for months. They’ve been working extra duty. They’ve been working under the anxiety of perhaps taking home COVID to their families. I think for this particular season, there is going to be a heightened level of fatigue [that] starts before we even get into hurricane season and have a storm. —Working Group participant

As job demands increase and individuals are disconnected from social support networks by the pandemic, stressors can manifest in higher levels of burnout, emotional exhaustion, and compassion fatigue. Chronic stress and burnout can lead to a host of psychological and physiological health issues, including depressive and anxiety disorders, headaches, dysregulated sleep, and respiratory infections.

Reducing burnout doesn’t happen overnight and often requires managing these chronic stressors. Individual strategies to reduce stressors include establishing adaptive time management techniques, developing strong social connections, and taking steps to rediscover personal meaning in life and work.

Employers can also help reduce staff and volunteer burnout by assuring workforce resources match demands, developing disaster behavioral health plans, and adapting staffing patterns that reduce stress and support recovery. Just-in-time trainings—including those focused on stress management and disaster behavioral health—can help workers prepare for increased stress, as can relevant resources delivered through virtual incident management systems. Using a job hazards assessment approach in planing and mitigating physical and emotional hazards is also effective.

Conclusion

Serving shelter clients while experiencing anxiety heightened by COVID-19 will exacerbate both short- and longer-term emotional stresses and other challenges for shelter workers. A broad strategy that recognizes the cumulative impacts of compounding disasters is needed. Interventions such as reflective supervision, employee assistance programs, or cognitive behavior therapy can be implemented at both organizational and individual levels. Making these resources available to staff and volunteers can assure that those who run the nation’s shelters are cared for to the same degree as those who stay there.

Suggested Tools


Emergency Evacuation and Sheltering During the COVID-19 Pandemic
National Academies of Sciences, Engineering, and Medicine

This rapid expert consultation aims to help emergency planners and other decision makers identify strategies for updating evacuation plans, sheltering operations, and risk communication practices to prepare for hazards and disasters that may occur during the COVID-19 pandemic and during future large-scale public health threats.

Tips for Disaster Responders: Understanding Compassion Fatigue
Substance Abuse and Mental Health Services Administration

Tip sheet for disaster responders that describes the causes and signs of burnout and secondary traumatic stress and provides tips for how to reduce these occurrences.

Navigating the Emotional Demands of Work
University of South Florida

A webinar providing guidance on how to navigate the emotional demands of work during a sheltering event.

A QuickGuide to Disaster Workforce Planning during the 2020 Hurricane-Coronavirus Pandemic Season and Beyond
University of South Florida

A guide to assist emergency planners in recruiting and developing a disaster response workforce during compounding disasters.

Job Hazard Analysis of Shelter Operations Tool
University of South Florida

A job hazard analysis of shelter operations worksheet to inventory job processes, identify their associated hazards, implement controls, and evaluate level of risk associated with each job.

For a list of all the tools included in this special collection, visit the Mass Sheltering Tool Index. A list of further readings are also available.