SAE Issue Brief: Stabilization Strategies to Gain Control during COVID-19

The coronavirus outbreak and its quick spread throughout our communities, nation and world, has caught everyone by surprise. Quick thinking and on-the-ground responses have been imperative to insure behavioral health clients are cared for, albeit in ways that may not be familiar to either practitioner or client.  We have all been receiving guidance from a variety of entities – local, city, state, and federal. The challenge becomes how to implement these new (and quickly changing) guidelines and maintain a high standard of care while mitigating liability and risk. Your first step as an agency is to define the issues and problems that are interfering with routine business operations and service delivery, as well as the assets that you have available to mitigate these concerns. Consider the following:

  • What are the issues you are facing related to administrative and fiscal operations, and clinical and staffing needs?
  • What are the knowledge dissemination gaps?
  • What assets/resources can you bring to address them?
  • What needs to change now?
  • What help do you need NOW?
  • How do you prepare for the future?

Knowing this allows everyone involved to immediately begin to develop a plan that addresses your immediate needs.  By clearly defining and understanding the problems while recognizing your agency’s strengths and how, as well as where, to apply them, you will identify the work needed, prioritized and done more efficiently and effectively. Additionally, this approach helps calm anxiety and reduce stress for administration, staff, and clients. To implement this effective and sustainable change, organizations need to develop and evaluate proposed stabilization strategies and what it will take to move to maintenance where appropriate.

Clearly, the new demands of the health crisis are destabilizing, confusing, and maybe even frightening.  You are concerned about continuing to provide quality care to clients, particularly high-risk clients, in new ways such as telemedicine services – an approach that for the most part is new to both clients, providers, regulators, and insurance companies.  You also have to pay attention to supporting, managing, and helping staff, both technically and clinically, while maintaining operations, billing, quality control, and more in this fast changing, unpredictable health environment.

We know from previous crises – Hurricane Katrina, Super Storm Sandy, 9/11, and others – that these catastrophic events increase stress, and when stress increases, people cope in ways that can be detrimental to self and others. Unfortunately, based on previous experience, we can expect to see increases in domestic violence, child abuse, substance abuse, depression, and suicidality, to mention just a few potential outcomes. Therefore, immediately identifying clients at greatest risk and developing safety plans is the first step.

But remember, crisis not only brings about danger; it also offers opportunities. It is at these times, when we may be feeling most disoriented and in uncharted waters, that structure, developing a plan, and establishing routines are most needed. This cannot be emphasized enough. Routines help us stay in control in the present, as well as plan for and manage the future. You know that there are things you can’t control – the virus, government responses, etc. – but there are things you can control, and that’s what you must focus on.

Some quick examples:
  • Supervision. This may be your most important tool. Set a schedule. Try to make it the same time and day that existed before this event.
  • How about staff meetings? The technology is there. Create a sense of community among your staff with group meetings.
  • If you haven’t already, bring together a leadership team to jointly decide next steps and responses. Encourage collaboration by getting your leadership team and staff to assess your agency’s issues with you and come up with ideas and plans. Engaging your staff will encourage their innovation and creativity. There are some people who really shine in a crisis. Who knows what you will learn about your staff and their hidden abilities.

Not only will this approach help during the current crisis, it will also help to establish and maintain beneficial changes in the future and build on lessons learned from the coronavirus pandemic.