CHICAGO — It’s not unusual for people to cry on the phone when they talk with contact tracers.
Often, people vent to them about their fears, such as missing work because of a COVID-19 quarantine or infecting family members.
Occasionally, contact tracers have to call ambulances for the people on the other end of the line.
Since the early months of the pandemic, contact tracers have worked to try to slow the spread of COVID-19 by identifying close contacts of people with COVID-19 and often advising them to quarantine.
But the job is far more complex, and stressful, than just that. Contact tracers also ask those who test positive for COVID-19 about their well-being, so they can connect them with resources to help them successfully quarantine. In many cases, contact tracers get an earful from fearful people looking for comfort.
Those challenges and others led the Cook County Department of Public Health and the National Alliance on Mental Illness Metro Suburban to partner earlier this year to offer mental health training to contact tracers.
“This job takes an emotional and psychological toll on our staff daily because they’re dealing with people experiencing the trauma of having or potentially having COVID,” said Marla Blanton, a senior training specialist for the Cook County Department of Public Health. “It was imperative for us to provide mental health support for our staff.”
The training, which took place in June, helped teach the contact tracers how to listen with empathy, and how to recognize signs of burnout and stress in themselves, said Cherie Hunter, a Cook County health department contact tracer and investigator.
Hunter may speak with 20 people over the phone in one day. Some of her calls last 15 minutes and others go on for more than an hour.
Sometimes, one phone call leads to five more, to people who may have been exposed to COVID-19.
As a trained minister and former Air Force master sergeant, Hunter enjoys helping people and talking with them. But sometimes, when she calls a person, she reaches the person’s grieving family — or encounters other situations she couldn’t have anticipated.
Recently, Hunter called the home of a man with COVID-19, who had apparently been cheating on his spouse. As she spoke with the man, Hunter could hear his wife hollering in the background, suspicious of the phone call. Eventually, his wife got on the phone and called Hunter a profane name before she knew who she was.
“I said, ‘First of all, I’m not (an expletive), and secondly, we need to talk because I’m from the department of public health, and I’m talking to your husband because he contracted COVID,’” Hunter said. “She calmed down and apologized to me and was amenable.”
Another time, Hunter called a man in his 30s who lived alone and had tested positive for COVID-19. He told her the virus was a hoax, and he would be fine. When she called him back the next day to check in, he was so ill that she had to call an ambulance to take him to the hospital, and call his mother, to meet him there.
This past week, Hunter said her team called the homes of three people who had already died of COVID-19. In those situations, contact tracers must decide whether the time is right to ask questions. Contact tracers must also sometimes gently try to get people who test positive to think about how they will keep their communities safe, rather than just how to get through COVID-19 themselves, she said.
The training reinforced, for Hunter, that it’s important to set your own feelings aside when dealing with such high-stress situations.
“If you can understand what are your stressors at the moment and are you able to set it aside while you do the work ... it teaches you how to put everything in a different square, so you know that you’re there to help the other person,” Hunter said.
It’s also important, she said, to know when to take a step back, and take some time for yourself.
“I think as a contact tracer or investigator you have to know when life is about to come in on you and you may not say the right thing,” Hunter said. Members of Hunter’s contact tracing team also lean on one another for support and help one another succeed, she said.
The virtual training held by NAMI in June aimed to teach about 250 contact tracers, case investigators and supervisors how to identify signs and symptoms of mental health issues and cope with stress in themselves through self-care, said Kimberly Knake, executive director of the National Alliance on Mental Illness Metro Suburban, which operates in the west suburbs.
They learned how to be active, empathetic listeners, such as by responding to a person crying over the phone by asking if they could help the person breathe for a bit. And they learned mindfulness techniques to help keep themselves calm.
They also broke into virtual support groups, where they could talk about the pressures facing them as contact tracers.
“A lot of the contact tracers felt they were the only ones going through this,” Knake said. NAMI is rolling out a similar program to other Cook County Department of Public Health employees, she said.
Not all of the health department’s contact tracers had experience working in health care before joining the contact tracing program, which was conceived as a way to both help slow the spread of COVID-19 and put people back to work as contact tracers, if they were out of work. The health department realized that additional mental health training would be helpful after hearing about the stresses of contact tracing during a different training session, Blanton said.
Gina Chapman, a case investigator supervisor with the health department, said she encourages those who work under her to take time for themselves as needed — days off, a few minutes away to drink a cup of tea or to take a walk around the block.
If they’re shaken by a call, sometimes they’ll call her just to talk about it, she said.
“I personally am one who tells my team all the time: ‘Don’t burn yourself out. Don’t keep going,’” Chapman said. “You can’t be there for people if you can’t be there for yourself.”