Tailored messages will defeat Ebola

The more we learn about Ebola, the more it is becoming apparent that overcoming the psychosocial reactions to this deadly virus comes down to one word: education.

Education that is tailored to the audience has been most successful, as has maintaining a focus on the psychosocial impact of the disease on patients (here and abroad), their families, and their health care workers. Take the case of Nigeria, which the World Health Organization (WHO) declared free of Ebola virus transmission on Oct. 20. Nigeria used contact tracing to physically monitor all identified contacts daily for 21 days. In addition to allocating government funds and disbursing that money quickly, the private sector reportedly contributed resources aimed at scaling up control measures.

Perhaps most importantly, according to the WHO, “house-to-house information campaigns and messages on local radio stations, in local dialects, were used to explain the level of risk, effective personal preventive measures, and the actions being taken for control. The full range of media opportunities was exploited – from social media to televised facts about the disease delivered by well-known ‘Nollywood’ movie stars.”

I cannot overemphasize the importance of tailoring our educational messages about the virus to specific audiences. The sort of information needed to help allay the anxiety of an administrative assistant who asks, “Why didn’t the vaccine those nurses took before treating the patient work?”) is different from the information required of a front-line nurse at a public sector hospital, who might ask “Will our gowns protect us if we have a patient?” or a hospitalist at a tertiary care pediatrics hospital who might wonder “Is our isolation unit appropriate for treating this disorder?”

Regarding the disease’s potential victims – patients, family, health care workers – we should be mindful of the psychosocial impact that even the possibility of contact with the virus has. Potential contacts with the virus face destruction of all of their belongings, an inability to work while bills mount, and even the stress of the unwelcome spotlight.

Indeed, while there is a dearth of information available on mental health aspects of Ebola, specifically, there are powerful stories out there (here and here, for example) on the persistent stigma associated with this terrible disease.

Several other community mental health perspectives need to be considered, as well:

• What if a potential victim is a transient homeless man known to the community mental health system who is not inclined to accept a voluntary quarantine?

• What if he slept the night before at a homeless shelter for 300 people, all of whom are required to leave the shelter each morning?

• What if the potential victim is an intravenous drug abuser not inclined to accept an offer of methadone as a substitute while in quarantine?

• What if the potential victim is actively psychotic, not committable under your particular state’s law, but refusing all assistance because of paranoia?

• What if a call comes from a school principal stating that an elementary student, the child of a health care worker involved in an Ebola case, is distraught over marginalization in class and in the cafeteria by fellow students?

• What if a community of first-generation immigrants, historically dependent upon the psychosocial support of a robust group of community volunteers, suddenly finds itself without those supports when one member of the community is diagnosed with the disease?

• What if some members of the community also have the challenge of a severe mental illness?

As physicians and mental health experts, we can take the lead in tamping down anxiety tied to Ebola. How do we do it? By fostering education and preparedness, advocating for minimizing the risk of more victims of this disease, and supporting efforts to end its spread in West Africa.

Here in the United States, we must help our communities maintain their empathy for the suffering of Ebola’s victims and their families, as well as the suffering of the health care workers (and their families, too) who bravely care for these unfortunate patients.

Dr. Baker is medical director for behavioral health in the Texas Department of State Health Services, Austin.

The more we learn about Ebola, the more it is becoming apparent that overcoming the psychosocial reactions to this deadly virus comes down to one word: education.

Education that is tailored to the audience has been most successful, as has maintaining a focus on the psychosocial impact of the disease on patients (here and abroad), their families, and their health care workers. Take the case of Nigeria, which the World Health Organization (WHO) declared free of Ebola virus transmission on Oct. 20. Nigeria used contact tracing to physically monitor all identified contacts daily for 21 days. In addition to allocating government funds and disbursing that money quickly, the private sector reportedly contributed resources aimed at scaling up control measures.

Perhaps most importantly, according to the WHO, “house-to-house information campaigns and messages on local radio stations, in local dialects, were used to explain the level of risk, effective personal preventive measures, and the actions being taken for control. The full range of media opportunities was exploited – from social media to televised facts about the disease delivered by well-known ‘Nollywood’ movie stars.”

I cannot overemphasize the importance of tailoring our educational messages about the virus to specific audiences. The sort of information needed to help allay the anxiety of an administrative assistant who asks, “Why didn’t the vaccine those nurses took before treating the patient work?”) is different from the information required of a front-line nurse at a public sector hospital, who might ask “Will our gowns protect us if we have a patient?” or a hospitalist at a tertiary care pediatrics hospital who might wonder “Is our isolation unit appropriate for treating this disorder?”

Regarding the disease’s potential victims – patients, family, health care workers – we should be mindful of the psychosocial impact that even the possibility of contact with the virus has. Potential contacts with the virus face destruction of all of their belongings, an inability to work while bills mount, and even the stress of the unwelcome spotlight.

Indeed, while there is a dearth of information available on mental health aspects of Ebola, specifically, there are powerful stories out there (here and here, for example) on the persistent stigma associated with this terrible disease.

Several other community mental health perspectives need to be considered, as well:

• What if a potential victim is a transient homeless man known to the community mental health system who is not inclined to accept a voluntary quarantine?

• What if he slept the night before at a homeless shelter for 300 people, all of whom are required to leave the shelter each morning?

• What if the potential victim is an intravenous drug abuser not inclined to accept an offer of methadone as a substitute while in quarantine?

• What if the potential victim is actively psychotic, not committable under your particular state’s law, but refusing all assistance because of paranoia?

• What if a call comes from a school principal stating that an elementary student, the child of a health care worker involved in an Ebola case, is distraught over marginalization in class and in the cafeteria by fellow students?

• What if a community of first-generation immigrants, historically dependent upon the psychosocial support of a robust group of community volunteers, suddenly finds itself without those supports when one member of the community is diagnosed with the disease?

• What if some members of the community also have the challenge of a severe mental illness?

As physicians and mental health experts, we can take the lead in tamping down anxiety tied to Ebola. How do we do it? By fostering education and preparedness, advocating for minimizing the risk of more victims of this disease, and supporting efforts to end its spread in West Africa.

Here in the United States, we must help our communities maintain their empathy for the suffering of Ebola’s victims and their families, as well as the suffering of the health care workers (and their families, too) who bravely care for these unfortunate patients.

Dr. Baker is medical director for behavioral health in the Texas Department of State Health Services, Austin.

The more we learn about Ebola, the more it is becoming apparent that overcoming the psychosocial reactions to this deadly virus comes down to one word: education.

Education that is tailored to the audience has been most successful, as has maintaining a focus on the psychosocial impact of the disease on patients (here and abroad), their families, and their health care workers. Take the case of Nigeria, which the World Health Organization (WHO) declared free of Ebola virus transmission on Oct. 20. Nigeria used contact tracing to physically monitor all identified contacts daily for 21 days. In addition to allocating government funds and disbursing that money quickly, the private sector reportedly contributed resources aimed at scaling up control measures.

Perhaps most importantly, according to the WHO, “house-to-house information campaigns and messages on local radio stations, in local dialects, were used to explain the level of risk, effective personal preventive measures, and the actions being taken for control. The full range of media opportunities was exploited – from social media to televised facts about the disease delivered by well-known ‘Nollywood’ movie stars.”

I cannot overemphasize the importance of tailoring our educational messages about the virus to specific audiences. The sort of information needed to help allay the anxiety of an administrative assistant who asks, “Why didn’t the vaccine those nurses took before treating the patient work?”) is different from the information required of a front-line nurse at a public sector hospital, who might ask “Will our gowns protect us if we have a patient?” or a hospitalist at a tertiary care pediatrics hospital who might wonder “Is our isolation unit appropriate for treating this disorder?”

Regarding the disease’s potential victims – patients, family, health care workers – we should be mindful of the psychosocial impact that even the possibility of contact with the virus has. Potential contacts with the virus face destruction of all of their belongings, an inability to work while bills mount, and even the stress of the unwelcome spotlight.

Indeed, while there is a dearth of information available on mental health aspects of Ebola, specifically, there are powerful stories out there (here and here, for example) on the persistent stigma associated with this terrible disease.

Several other community mental health perspectives need to be considered, as well:

• What if a potential victim is a transient homeless man known to the community mental health system who is not inclined to accept a voluntary quarantine?

• What if he slept the night before at a homeless shelter for 300 people, all of whom are required to leave the shelter each morning?

• What if the potential victim is an intravenous drug abuser not inclined to accept an offer of methadone as a substitute while in quarantine?

• What if the potential victim is actively psychotic, not committable under your particular state’s law, but refusing all assistance because of paranoia?

• What if a call comes from a school principal stating that an elementary student, the child of a health care worker involved in an Ebola case, is distraught over marginalization in class and in the cafeteria by fellow students?

• What if a community of first-generation immigrants, historically dependent upon the psychosocial support of a robust group of community volunteers, suddenly finds itself without those supports when one member of the community is diagnosed with the disease?

• What if some members of the community also have the challenge of a severe mental illness?

As physicians and mental health experts, we can take the lead in tamping down anxiety tied to Ebola. How do we do it? By fostering education and preparedness, advocating for minimizing the risk of more victims of this disease, and supporting efforts to end its spread in West Africa.

Here in the United States, we must help our communities maintain their empathy for the suffering of Ebola’s victims and their families, as well as the suffering of the health care workers (and their families, too) who bravely care for these unfortunate patients.

Dr. Baker is medical director for behavioral health in the Texas Department of State Health Services, Austin.