Connecting Audiologists and Speech-Language Pathologists With Mental Health Resources

Updated August 26, 2021

The COVID-19 pandemic has altered life in many ways. The isolation experienced during quarantines and physical distancing in addition to the economic crisis has profoundly impacted our personal and professional lives. In key respects, this public health crisis has disproportionately affected Black and Latinx Americans. This is a challenging time to manage feelings and deal with uncertainty. We want to help audiologists and speech-language pathologists (SLPs) by connecting you with a range of resources.

Warning Signs

• Bodily Sensations and Physical Effects: Rapid heart rate, muscle tension, headaches, gastrointestinal distress, nausea, inability to relax, trouble sleeping, nightmares, high adrenaline
• Strong Negative Feelings: Difficulty maintaining emotional balance, irritability, deep sadness, fear, anger, frustration
• Difficulty Thinking Clearly: Difficulty problem-solving and making decisions, disorientation and confusion, misinterpretation of situations and comments, memory issues
• Problematic or Risky Behaviors: Unnecessary risk-taking, failure to use universal precautions and PPE, refusal to follow directives, increased use or misuse of prescription drugs or alcohol
• Social Conflicts: Reduced ability to support others, conflicts with clients, peers, and family, withdrawal and isolation, blaming others, hostility, argumentativeness

The handout about strengthening resilience [PDF] shows warning signs and ways to deal with stress.

Concerns and Information

Feeling Overwhelmed

You may feel overpowered by your thoughts, emotions, and intense feelings. You are managing multiple roles and relationships, like serving as teacher and parent for children out of school or being with a spouse at home all the time, with everyone sharing the same space. 

You are juggling personal and professional responsibilities without a sense of autopilot or routine. Guidance to help navigate decision-making is varied, diverse, and occasionally conflicting. Uncertainty, changes in home and work life, screen fatigue, information overload, and compassion fatigue may all be contributing to exhaustion and feeling overwhelmed.

• American Counseling Association Self Care Resources in Trauma or Disaster
• Substance Abuse Mental Health Services Association (SAMHSA) Coping Tips for Traumatic Events and Disasters
• National Association of School Psychologists (NASP) Care for Caregivers: Tips for Families and Educators
• Shine: Care for Your Coronavirus Anxiety

Financial Stress 

The COVID-19 crisis has had a dramatic impact on the global economy. The resulting economic downturn has had far reaching effects. These changes have had disproportionate effects on well-being depending on socioeconomic and educational status.

You may have lost your job, have fewer clients, or may have totally shifted the way you provide services. You may have incurred costs for personal protective equipment (PPE) or to make changes in private clinics. Financial hardships can lead to mental health challenges (e.g., anxiety, depression, panic, substance use, worry).

Certified Financial Planner Board of Standards: Managing Your Finances During the COVID-19 Crisis

Historical Trauma

Historical trauma is multi-generational trauma experienced by a specific cultural, racial, or ethnic group. Historical trauma can result in distress and there are ways to strengthen resilience.

You and those you serve may have experienced, or continue to experience, historical trauma and/or racial battle fatigue. You should be mindful of the intersection and impact of these experiences to gain understanding of present-day reactions to events in the context of individual trauma narratives, to provide trauma-informed care, and to identify appropriate support. 

• University of Minnesota: Historical Trauma and Cultural Healing Resources
• Mental Health America: BIPOC Mental Health Resources
• NAMI: Identity and Cultural Dimensions Resources

Loneliness and Isolation

Social connections have been dramatically changed as a result of the COVID-19 pandemic. Unfortunately, the lack of social connections can lead to feelings of loneliness and isolation (see Dr. Vivek Murthy’s 2020 book, Together:The Healing Power of Connection in a Sometimes Lonely World).

You may be feeling disconnected from friends and family as well as missing the in-person connections with their clients/patients/students. As communication professionals, we know well the value and need for social connections for our mental health and well-being. Technology has helped, but sometimes Zoom meetings create more fatigue than connection.

• WHO #healthyathome
• COVID-19 Is Making America's Loneliness Epidemic Even Worse
• The Costs of Social Isolation: Loneliness and COVID-19

Loss and Grief

Grief is a natural reaction to loss. The COVID-19 pandemic has resulted in numerous losses. Grief reactions may include disbelief, anxiety, distress, depression, anger, sorrow, and changes in sleep and eating patterns. 

Audiologists and SLPs have experienced personal and professional losses since COVID-19, including loss of routines, financial security, ways of doing work, in-person interactions, with friends, family, co-workers, and clients/patients/students, in addition to witnessing illness and loss of lives due to COVID-19. Although a natural reaction to loss, grief may be exacerbated by the multiple losses and uncertainty during this time.

• Centers for Disease Control and Prevention (CDC): Grief and loss
• National Association of Independent Schools (NAIS): Coronavirus (COVID-19 Resources): Coping with Loss and Grief
• Grief Speaks: Cultures and Grief
• Understanding Grief in the Age of the COVID-19 Pandemic

Moral Distress/Ethical Dilemmas

Changes in the landscape of work during COVID-19, often urgent and immediate, have led to some ethical challenges and moral distress (or moral injury) when beliefs and values about professional practices have been compromised. Self-criticism, shame, and guilt may be signs of moral distress.

You may be confronting moral distress at work during the COVID-19 pandemic. It may be triggered by lacking PPE; providing care that falls short of “best practice;” working in fear of infection; being directed to perform procedures with little training; or being told to provide services only to “emergency” patients. You are attempting to navigate these ethical dilemmas at the same time when little to no time or space exists to grieve as a community the loss of clients/patients/students and colleagues (in addition to friends, neighbors and family).

• Physicians Aren’t Burning Out; They are Suffering from Moral Distress
• U.S. Health and Human Services: Preventing and Addressing Moral Injury Affecting Health Care Workers During the COVID-19 Crisis
• AMN Healthcare: 10 Best Practices for Addressing Ethical Issues and Moral Distress

Coping Strategies

Self-Awareness

For audiologists and SLPs to carry out their ethical obligation to take care of their patients/clients/students--specifically “to hold paramount the welfare of persons they serve professionally”--under Principle I of the ASHA Code of Ethics, they must take care of themselves.

• Monitor warning signs of extreme stress and seek help from a mental health specialist when needed.
• Recognize this is a time of collective loss, grief, and uncertainty. We need to be aware of and take care of our own physical and mental health needs in order to help others.
• Have self-compassion and reduce negative self-talk.
• Limit comparisons and judgements about your own and co-worker's workload and coping mechanisms. Avoid comparative suffering.
• Use available resources related to mental health and well-being to manage stress, cope with grief and loss, and strengthen resilience.

Activate Your Parasympathetic Nervous System to Manage Stress

The Parasympathetic Nervous System is a technical way of thinking about the “brakes” of the body. Also known as the rest and digest nervous system, the parasympathetic nervous system helps the body conserve energy and protect itself. Like the brakes of a car, if the parasympathetic nervous system is working all the time to slow down a racing mind and body it will get worn down. Over the past few months, and likely in the months to come, our bodies are constantly faced with external stressors which may be unavoidable. Luckily, there are ways we can help our body activate our “brakes” to stay healthier, happier, and better prepared to combat stress and disease. 

There are many ways you can help activate your parasympathetic nervous system, such as: spending time in nature, reading, journaling, mindfulness, movement, art, music, and having a meditation, prayer, or gratitude practice.

The resources below can help strengthen your own parasympathetic nervous system and deepen your understanding of the stress response.

Activate Your Relaxation Response

• Progressive Muscular Relaxation
  • Script
  • Video
• Deep Breathing – 10 Breathing Techniques
• Qi Gong Yoga – What is Qi Gong? (And How You Can Start Practicing Today)
• Mindfulness – Practicing Mindfulness: 75 Essential Meditations to Reduce Stress, Improve Mental Health, and Find Peace in the Everyday
• Meditation
  • Aura – three-minute sessions and 30-second anxiety busters
  • Calm – daily meditations, body scans, master classes, and sleep stories    
  • Headspace.com – meditations and articles; free for anyone who is unemployed
  • Shine – inclusive meditations
• Mental Health Apps

Movement

Participating in activities and movement opportunities that you enjoy can relieve anxiety and stress by increasing your endorphins, allowing your mind and body a break from stressors, and improving your mood. Consider these tips as you plan a joyful movement routine.

• Exercise for Stress and Anxiety

Sleep

The role of sleep for your body is varied: immune function, metabolism, memory, learning, and a variety of vital functions. However, when you are stressed or anxious, your sleep can be negatively affected, especially if stress and anxiety are chronic conditions you experience.

• Stress and Sleep – How To Master Stress And Enjoy Restful Sleep Instantly
• Learn to Leave Stress Behind at Bedtime

Nourish Yourself

• Foods that help reduce anxiety

Social Support

Social support is strongly linked with increased health and wellbeing. You may find that during the pandemic and beyond you desire social support in different forms ranging from emotional, informational, tangible, or a sense of belonging. Take a social inventory and make the most of your social circle.

Find ways to connect with others even during times of physical distancing. Service to others through your work and in other ways brings meaning and purpose to your life.

Participate in professional communities, such as ASHA’s Special Interest Groups, multicultural constituency groups, state associations, and other interactive online communities.

Seeking Help

If you are experiencing an emergency, or you know someone who is, call 911.

Immediate Help

Call or text one of these hotlines for immediate help:

• National Suicide Prevention Lifeline
  1-800-273-TALK (8255)

• Crisis Text Line
  Text HOME to 741741

• SAMHSA Disaster Distress Hotline
  1-800-985-5990

• National Domestic Violence Hotline 
  800-799-7233 or TTY 800-787-3224

• The Trevor Project provides crisis intervention and suicide prevention services to LGBTQIA+ youth.

Ongoing Help

To find a behavioral health provider in your area call/visit one of these resources:

• SAMHSA National Helpline
  1-800-662 HELP (4357)

• If your employer uses an Employee Assistance Program (EAP), the EAP can also provide references for behavioral health providers in your area.

Find a culturally responsive behavioral health provider:  

• The National Alliance on Mental Illness provides helpful tips on selecting a culturally competent provider.
• The Black Mental Health Alliance offers confidential referrals for those seeking mental health services.
• GLMA maintains a provider directory of LGBTQIA+ professionals, including behavioral health providers.

References

• American Psychiatric Nursing Association: Managing Stress and Self-Care During COVID-19 
• Benefits of Sleep 
• Coping with Stress Due to a Pandemic
• Overactive Sympathetic Nervous System
• Social Support for Stress Relief 
• Taking Care of Yourself

These resources are shared for information purposes only and do not constitute mental health advice. The lists are not exhaustive, and inclusion does not imply endorsement by ASHA. We welcome your feedback and suggestions for additional resources. For more information or comments, contact Diane Paul at dpaul@asha.org.