We can no longer fully see the faces of people we meet. Important layers of human connection have been removed, adding a sense of distance between us.
Dr. Linda Uyeda, a family physician at the Forensic Psychiatric Hospital, realized this while meeting colleagues last summer, shortly after the initial COVID-19 restrictions were eased in B.C. She couldn’t see the full faces or expressions of people she met because of their masks and face shields, which made her feel a strange sense of discomfort and a lack of connection with them.
Shortly after this, while visiting BC Children’s Hospital with her son, Dr. Uyeda noticed that staff there had taken a novel approach to helping patients see and know their health care professionals’ faces.
“I saw several nurses and physicians at BC Children’s Hospital wearing buttons with their faces on them to help patients see who was behind the mask. I thought it was a great idea to be able to get to know who was treating and talking to us. I immediately thought of my patients at the Forensic Psychiatric Hospital and how much it could help them.
“Our patients are often struggling with mental and physical health problems when they enter our services. They may be frightened and uneasy, and we’re trying to use whatever we can to connect with them and help them feel safe. When we add masks, goggles, gowns and gloves, this can be even more difficult and confusing for them. Essentially, by adding these layers of PPE, we remove layers of human connection, which is essential to the care we provide.”
BCMHSUS staff members Barb Langlois, Connie Coniglio,
Gavin Wallace and Trevor Aarbo.
Dr. Uyeda highlighted one patient who was admitted during the pandemic and who had never seen the full faces of her physicians, nurses or social workers. “She felt wary of some staff and commented that by not seeing who we were, this caused her to feel more suspicious of us. I asked if she would like to see what I looked like and she did. I stepped back to keep a safe distance, pulled down my mask and goggles for several seconds and her reaction was touching. Her face lit up and she giggled, saying she never realized what I looked like. The barriers melted away, and it was a really meaningful moment.”
Dr. Uyeda brought the idea of showing the faces behind the mask to the Patient Experience and Community Engagement team at BC Mental Health and Substance Use Services to see if it could help patients and clients.
Kathryn Proudfoot, director of the Patient Experience and Community Engagement team, liked the idea and her team quickly mobilized to roll it out, starting at the Forensic Psychiatric Hospital.
“We wanted this to be quick, easy and low-barrier for staff, so we evolved the concept, providing staff with Polaroid pictures of themselves that they could fasten to their name tags. We’re seeing great success at the Forensic Psychiatric Hospital and are expanding the initiative to the Burnaby Centre for Mental Health and Addiction and the Heartwood Centre for Women this December.”
All of the patients at the Forensic Psychiatric Hospital are living with complex mental health and substance use disorders, and many have experienced trauma. BC Mental Health and Substance Use Services focuses on trauma-informed practice to help these patients, and an important part of a trauma-informed approach is two-way communication between staff and patients, which this initiative helps facilitate.
“We can see patients, but recently, they haven’t been able to see us. For effective care, it has to be a two-way, reciprocal relationship, and this Behind the Mask initiative supports that. It’s a simple yet very powerful concept.”
Barb Langlois, the director of inter-professional practice at the Forensic Psychiatric Hospital and an expert on trauma-informed practice, is an advocate for the initiative. “It’s about respecting the patient and where they are at, the patient being able to see who they are talking to and who is administering care, and to trust the staff. We can see patients, but recently, they haven’t been able to see us. For effective care, it has to be a two-way, reciprocal relationship, and this Behind the Mask initiative supports that. It’s a simple yet very powerful concept.”
Though patients are at the heart of the idea, it has also had positive effects for staff, particularly new team members getting to know their colleagues and casual staff who move between units and may not know the patients as well.
The Patient Experience and Community Engagement team is working to roll it out across the hospital and other BC Mental Health and Substance Use Services facilities.