By ALICIA MORTON FARLESE

Not in our lifetimes has humanity experienced such a pervasive, profound, and prolonged retreat from “normal lives.” This. Will. Not. Be. Easy. 

While the conversation about the serious negative impact on our behavioral health has started, we also suffer from a scarcity of behavioral health professionals, and equitable access to these essential resources.  

More than ever, we all seem to “get it” and are reflexively more forgiving when we hear that some of us are struggling with the behavioral health consequences of Covid -19 — we’ve all been there to some extent over the past year.  

As a Veteran, I’m accustomed to reintroduction plans, designed with thoughtful consideration, anticipatory preparation, and behavioral health resources for military members (and their families) returning from deployment. As we approach normalcy, a similar reentry will soon begin, yet we’re not talking about what to expect and how our behavioral health needs will be addressed. Where are the post-pandemic re-entry plans? Yes – we want to get back – but just as the military members need level-setting guidance, support, and understanding as they return “home” so do all of us as we begin our reentry. 

Our battlefield has been the isolation, home-schooling, remote working, laid-off, caring-for (and saying goodbye to) loved ones for the last 11 months. It has been the tangled web of emotions: tragic, heartwarming, frustrating, endearing, exhausting and confusing. Emerging from this Nebel des krieges will not be the walk in the park that we hopeful humans imagine it to be.  Now is the time to plan for re-entry. 

We’re (barely) hangin in there… 

Most kids have not been physically in their schools since March 2020, parents are living a new and challenging reality of juggling parenting, supervising remote learning, and fulfilling their own work responsibilities – over the Internet. 

These are the fortunate families! Those with computers, adequate Internet service, and private-enough spaces for overlapping Zoom interactions.

Sadly, many families have had to find non-home settings for their remote-learning children and work commitments. Worse yet, many families have been faced with job losses and/ or had to decide which parent would quit work to stay home with the kids.  

We know that this has most often been the mother and folks are already sounding the alarm on the longer-term consequences of this workforce change and the inequity of the gender pay gap.  

Getting back to normal will NOT be like riding a bike. 

We are all grateful that the viral spread seems to be slowing and vaccinations are beginning to land in arms. We are on the cusp of returning to normal – as schools are beginning to open, parents are beginning to have “alone” time at home, and peace seems to be within reach.  

Yet, as we have learned from our Veterans, the blessing of our re-entry will bring unexpected challenges:

• The unexpected guilt and readjustment challenges when no longer having that 1:1 time you once complained about and felt you had way too much of while in your “safe Covid pod.” 
• A spectrum of emotion – from palpable anxiety to nagging worry about health safety and Covid-19 exposure with a return to school, work, sports, and travel.
• Disruption of these renewed freedoms and thus “return to normal” set-backs with localized/regional Covid-19 flare-ups
• Establishing new routines once school and work no longer happen remotely

Marshaling resources for the ride ahead.

I worry about not preparing folks for these feelings during this period of readjustment. We need to ensure all of us know that  these conflicting feelings are normal and expected after “coming home” from such a long (and often lonely) “deployment.” We all need to be kind to and support each other as we find ourselves struggling with post-Covid reintegration. Health care and public health leaders need to start discussing and planning for these additional post-pandemic behavioral health challenges and be prepared to proactively and adequately respond. The time, then – is now – that we think about re-entry and the hard work ahead. 

Preparing for this gradual re-entry will be an “all hands on deck” effort!  Awareness and discussion of the behavioral health effects of this pandemic cannot cease as we transition to a post-Covid world. Actually, the attention, open dialogue, patience, kindness, and dedicated interventions in place now need to be amplified and extended over a long period of time post-pandemic. 

• Medical and behavioral health providers, public health leaders, schools, clergy, and the media must NOW begin creating awareness and having discussions of these additional re-entry challenges into all current Covid-19 behavioral health initiatives. 
• Federal, state, and local governments should ensure funding for and execution of behavioral health interventions are continued well beyond the current crisis.
• Federal departments (e.g., DOD, DHS) and military-focused organizations should repurpose well-established reintegration best-practices for the general public reintegration efforts.
• Employers should prepare now for the physical and behavioral health needs and concerns of their employees returning to physical workplaces and (re)establishing a post-Covid workplace milieu.
• Schools must be vigilant in monitoring and intervening quickly when students have challenges during this time of transition from significant social and education disruption to reintegration. 

This will not be easy, but we can do this together! 

Alicia Morton Farlese DNP, RN-BC is a passionate leader in health IT, recently retired after 26 years in the USN & USPHS, spending the latter 2/3 of her career in senior health IT positions at CMS and ONC.