Dr. Jess Calohan, DNP, PMHNP-BC
Associate Professor, Frontier Nursing University; Chair, Psychiatric-Mental Health Nurse Practitioner Department
Dr. Jess Calohan, a board-certified psychiatric-mental health nurse practitioner, is retired from the U.S. Army after 20 years of service. During his years in service, he contributed to the military’s mental health policy and helped reshape its approach to clinical care in treating combat-related sleep disturbances for those in the Veterans Affairs and military health systems.
He has over 18 years of experience in treating service members who were diagnosed with PTSD during their deployment and non-deployment settings.
Dr. Calohan says mental health is a big problem everywhere these days. He says that during the COVID-19 pandemic, there are more cases of mental health troubles, including from causes such as domestic violence and dealing with layoffs. He says handling this mental health issue is going to be “a marathon, not a sprint.”
Managing mental health
Dr. Calohan recently recorded some self-care strategy webinars and hopes to help fellow nurses, as well as members of the community, learn how to self-soothe and manage stress.
He says the first thing nurses need to do is manage their basic needs, such as caring for themselves and their family and eating nutritious food. Next, they should make sure they stay hydrated, get exercise, and find a quiet place to get rest, getting a minimum of 4-6 hours sleep at a time.
“This is almost akin to a traumatic situation, like a disaster response. And oftentimes what happens is that the first thing to go is people forget to meet their basic needs: eating, sleeping, and drinking water. That’s really one of the core messages that I wanted to get out to folks: you’ve got to meet your basic needs,” says Dr. Calohan. These days, we are all dealing with a fear of the unknown and a loss of control. Staying in a routine can help people better handle the situation.
Setting boundaries
Unfortunately, emotional components are not necessarily taught in nursing school. That means handling mental and emotional strain often happens on the job.
“We’re role models for our patients and we have to be able to set those boundaries. The problem is that folks, particularly medical folks, are often resistant to those things because of the associated stigma that we still have with mental health,” says Dr. Calohan. “I will tell you some of my most complicated patients that I have dealt with in my clinical career are doctors, nurses, and first responders. I reinforced to people that we all need some help at some point in time. It’s not a sign of weakness; it’s actually an opportunity for self-improvement.”
Telemedicine
Dr. Calohan offers telepsychiatry from his remote office in western Washington State. He says in a regular circumstance, mental health can be stigmatized, but that is exacerbated during a pandemic such as COVID-19. For example, in the past month, two of his patients have attempted suicide.
He says people are embracing telehealth as a new way to get mental healthcare. All you need is a quiet place and good internet. He can prescribe medications if necessary, but most patients benefit from talk therapy.
He says telemedicine can reduce no-show rates, provides better access to care for patients, and is convenient. For example, one of his patients who was experiencing anxiety said he felt a level eight of anxiety before the call and a level four after the call.
Typically, appointments last 20-30 minutes. Longer sessions can go 45-50 minutes. Insurance usually covers telemedicine. In some instances, patients can go to a local clinic and do a remote conference with the doctor. He says it’s a stigma-reducing opportunity since the patient goes into a traditional clinic and no one has to know the patient is receiving mental healthcare. Dr. Calohan can then document the patient’s mental health treatments in the medical file.
The road ahead
In the big picture, Dr. Calohan says hospitals and other clinic settings need to do a better job providing for their nurses. During coronavirus, nurses are complaining about a lack of protective equipment and feeling overworked; he says leaders need to do a better job helping those nurses feel appreciated.
He’s hopeful that after the pandemic, telemedicine will still be available and insurance-eligible for patients.
As Dr. Calohan says, “I hope that some of these things, these policy changes about people being able to be seen from their homes, is something that shifts. I also believe that there is going to be an uptick in folks that need mental health care after the crisis is over. This is basically equivalent to a traumatic situation, and there’s always going to be fallout from people that have experienced very difficult things during this time that’s going to lead to long-term mental health consequences.”