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.