Behavioral health workers from a major labor union made a plea Friday for additional protections against COVID-19 for themselves and their patients.

The call echoes that of other health care unions, who have clamored in recent weeks for protections from the Occupational Safety and Health Administration against infectious diseases. But the AFL-CIO and affiliated unions also warned during a call with reporters that psychiatric facility and Veterans Affairs employees have to endure especially dangerous conditions that may be overlooked as the nation focuses on other hospitals overcrowded with sick patients.

Behavioral health workers in the field expressed numerous concerns about contracting the virus while caring for workers. Mental health workers often need to work in close proximity to patients, and not all types of care can be conducted through telemedicine. Since patients may not show COVID-19 symptoms, the risks may be less obvious than with emergency room or hospital personnel helping patients who are clearly sick.

“We’re still trying to maintain a positive therapeutic environment for our clients who believe that they might be in crisis or might be in crisis, which means we still need to be face-to-face with them and provide that nurturing environment, which is hard when you’re standing 6 feet away from someone, which you cannot do in all cases,” said Natalie Rogers, a part-time employee for Sonoma County Behavioral Health in California.

PPE in short supply

Rogers said her county provided personal protective equipment such as masks, but resources are scarce for many other behavioral health workers.

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Mike Yestramski, a psychiatric social worker at Western State Hospital in Washington state and the president of the Washington Federation of State Employees, said that despite a number of COVID-19 cases at his workplace, PPE is in short supply.

“We have been told that people can bring their own masks from home, but that is at the employee’s own risk. But even that came after incredible, intensive sessions with management before they conceded to let us bring our own personal protective equipment,” he said. “Originally, they wanted us to work with none.”

Yestramski said his psychiatric hospital has confirmed five COVID-19 cases in patients, including two that were fatal, as well as 15 cases among staff members as of Friday morning. His work requires very close contact with clients, including aiding in basic day-to-day tasks. Patients generally share a room, and the facility has narrow hallways and no air filtration system.

“Given how contagious this virus is, I am very, very concerned we will have an even bigger spike in infection,” he said, adding that he believes the true number of cases is higher than shown through the limited amount of testing available.

Ira Kedson, a licensed clinical psychologist and president of the American Federation of Government Employees Local 310, said he worries about the lack of uniform telework options for Veterans Affairs workers.

Kedson, who works for the Coatesville VA Medical Center in Pennsylvania, said he has been working to help several employees who are in medically at-risk groups to be able to telework.

“One employee, for example, has been using up her own leave because management has been reluctant to grant her the ability to telework,” he said. “The majority of employees are still going up to the VA to sit in their offices and do this, so they are at risk for whatever contaminants that might be between their cars and their offices as they grip the same doorknobs as everybody else.”

Protective equipment at his center is practically nonexistent.

“I couldn’t tell you what the PPE situation is at the VA where I work because I have not seen anyone wearing PPE since this began,” said Kedson. “I assume that they are doing that in urgent care but no one else has been given any protective equipment even if they have been sitting in small rooms seeing veterans a few feet away.”

Push for policy changes

Unions are pushing hard for changes to make work safer for behavioral health workers and their patients.

“The CDC guidelines aren’t the OSHA kind of enforceable standard that we would get with an infectious disease standard,” said AFL-CIO Secretary-Treasurer Liz Shuler, who wants Congress to require OSHA to develop standards for health care facilities that would protect medical workers.

She said her organization also will be pushing for anti-retaliation measures so that workers can speak out about harsh front-line working conditions without fear of penalty.

Kedson would like the VA to provide protective gear for all types of workers. He described an example of car screeners who, according to VA guidance, do not receive protective gear. Screeners inspect employee vehicles before they come onto the station and are often in close proximity to drivers during conversations.

“The people that are working in the hospitals with people who may potentially expose them to the virus need to have protective gear,” he said. “We need a uniform and more robust guidance on what is appropriate to protect people on the front lines caring for veterans, and other folks, who are potentially infected with this virus so they can keep doing that.”

Yestramski said what would be most helpful for them would be for hospitals and agencies to follow the stricter version of the CDC recommendations, such as preventing non-emergency patient transport. He also said funding was necessary to ensure workers aren’t overworked and therefore put at greater risk.

“We are aware that there are some inherent dangers in our work, but none of us signed up for a suicide mission,” said Yestramski.