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Sim CSL, Asharani PV, Subramaniam M, Yi H. Roles and Dynamics within Community Mental Health Systems During the COVID-19 Pandemic: A Qualitative Systematic Review and Meta-Ethnography. Health Syst Reform 2024; 10:2314525. [PMID: 38598726 DOI: 10.1080/23288604.2024.2314525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 02/01/2024] [Indexed: 04/12/2024] Open
Abstract
Globally, COVID-19 had an immense impact on mental health systems, but research on how community mental health (CMH) systems and services contributed to the pandemic mental health response is limited. We conducted a systematic review and meta-ethnography to understand the roles of CMH services, determinants of the quality of CMH care, and dynamics within CMH systems during COVID-19. We searched and screened across five databases and appraised study quality using the CASP tool, which yielded 27 qualitative studies. Our meta-ethnographic process used Noblit and Hare's approach for synthesizing findings and applying interpretive analysis to original research. This identified several key themes. Firstly, CMH systems played the valuable pandemic role of safety nets and networks for the broader mental health ecosystem, while CMH service providers offered a continuous relationship of trust to service users amidst pandemic disruptions. Secondly, we found that the determinants of quality CMH care during COVID-19 included resourcing and capacity, connections across service providers, customized care options, ease of access, and human connection. Finally, we observed that power dynamics across the CMH landscape disproportionately excluded marginalized groups from mainstream CMH systems and services. Our findings suggest that while the pandemic role of CMH was clear, effectiveness was driven by the efforts of individual service providers to meet demand and service users' needs. To reprise its pandemic role in the future, a concerted effort is needed to make CMH systems a valuable part of countries' disaster mental health response and to invest in quality care, particularly for marginalized groups.
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Affiliation(s)
- Cheryl Su Ling Sim
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - P V Asharani
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Mythily Subramaniam
- Department of Research Division, Institute of Mental Health, Singapore, Singapore
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- National University Health System, Singapore, Singapore
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Osman S, Churruca K, Ellis LA, Luo D, Braithwaite J. The Unintended Consequences of Telehealth in Australia: Critical Interpretive Synthesis. J Med Internet Res 2024; 26:e57848. [PMID: 39190446 PMCID: PMC11387926 DOI: 10.2196/57848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 07/01/2024] [Accepted: 07/16/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Despite more than 2 decades of telehealth use in Australia and the rapid uptake during the COVID-19 pandemic, little is known about its unintended consequences beyond its planned and intended outcomes. OBJECTIVE The aim of this review was to synthesize evidence on the unintended consequences of telehealth use in Australia to clarify its impact beyond its planned and intended outcomes. METHODS We conducted a search of 4 electronic databases: Ovid MEDLINE, Ovid Embase, EBSCO CINAHL, and Scopus. A critical interpretive synthesis approach was adopted for its flexibility and interpretive nature. We extracted data about study characteristics and the types and models of telehealth services. The extracted unintended consequences were coded and mapped into the domains and dimensions of the Australian Health Performance Framework. RESULTS Of the 4241 records identified by the search, 94 (2.22%) studies were eligible for data extraction and analysis. Of these 94 studies, 23 (24%) reported largely positive unintended consequences of telehealth associated with health status, while 6 (6%) noted a potential negative impact of telehealth on socioeconomic status. The findings of 4 (4%) of the 94 studies highlighted societal and financial consequences of telehealth beyond the health system. Almost all studies (93/94, 99%) reported unintended consequences under the 5 dimensions of the Australian Health Performance Framework. CONCLUSIONS Our synthesis offers a framework for understanding the unintended consequences of the use of telehealth as an alternative to in-person care in Australia. While we have documented many unintended benefits of telehealth use, our findings also shed light on many challenges of delivering care via telehealth across different domains and dimensions. These findings hold significant practice and policy-making implications for ensuring safe and high-quality care delivery via telehealth.
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Affiliation(s)
- Sagda Osman
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia
| | - Kate Churruca
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia
| | - Louise A Ellis
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia
| | - Dan Luo
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia
- The Daffodil Centre, Sydney, Australia
| | - Jeffrey Braithwaite
- Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, North Ryde, Australia
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Stepanova E, Thompson A, Yu G, Fu Y. Changes in mental health services in response to the COVID-19 pandemic in high-income countries: a rapid review. BMC Psychiatry 2024; 24:103. [PMID: 38321403 PMCID: PMC10845680 DOI: 10.1186/s12888-024-05497-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Severe deterioration in mental health and disrupted care provision during the COVID-19 increased unmet needs for mental health. This review aimed to identify changes in mental health services for patients in response to the pandemic and understand the impact of the changes on patients and providers. METHODS Following the Cochrane guidance for rapid reviews, Cochrane CENTRAL, MEDLINE, Embase and PsycInfo were searched for empirical studies that investigated models of care, services, initiatives or programmes developed/evolved for patients receiving mental health care during COVID-19, published in English and undertaken in high-income countries. Thematic analysis was conducted to describe the changes and an effect direction plot was used to show impact on outcomes. RESULTS 33 of 6969 records identified were included reporting on patients' experiences (n = 24), care providers' experiences (n = 7) and mixed of both (n = 2). Changes reported included technology-based care delivery, accessibility, flexibility, remote diagnostics and evaluation, privacy, safety and operating hours of service provision. These changes had impacts on: (1) care access; (2) satisfaction with telehealth; (3) comparability of telehealth with face-to-face care; (4) treatment effectiveness; (5) continuity of care; (6) relationships between patients and care providers; (7) remote detection and diagnostics in patients; (8) privacy; (9) treatment length and (10) work-life balance. CONCLUSIONS A shift to telecommunication technologies had a significant impact on patients and care providers' experiences of mental health care. Improvements to care access, flexibility, remote forms of care delivery and lengths of operating service hours emerged as crucial changes, which supported accessibility to mental health services, increased attendance and reduced dropouts from care. The relationships between patients and care providers were influenced by service changes and were vastly depending on technological literacy and context of patients and availability and care access ranging from regular contact to a loss of in-person contact. The review also identified an increase in care inequality and a feeling of being disconnected among marginalised groups including homeless people, veterans and ethic minority groups. Telehealth in mental care could be a viable alternative to face-to-face service delivery with effective treatment outcomes. Further research is needed to better understand the impact of the changes identified particularly on underserved populations.
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Affiliation(s)
- Evgenia Stepanova
- Population Health Sciences Institute, Newcastle University, Newcastle, UK.
| | - Alex Thompson
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Ge Yu
- Health Services and Population Research Department, Institute of Psychiatry, King's Health Economics, King's College London, Psychology & Neuroscience, London, UK
| | - Yu Fu
- Department of Primary Care and Mental Health, Institute of Population Health, University of Liverpool, Liverpool, UK
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Nazari Orakani S, Officer TN, Good G, McBride-Henry K. Systems Are Overstretched from the COVID-19 Pandemic: An Interpretive Description of Disabled People's Access to Healthcare and Disability Support in New Zealand. Healthcare (Basel) 2024; 12:387. [PMID: 38338272 PMCID: PMC10855788 DOI: 10.3390/healthcare12030387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/20/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
The COVID-19 pandemic disrupted healthcare and support services, creating challenges for disabled people. New Zealand implemented a range of policies to prevent and limit viral transmission of COVID-19. This study investigates disabled people's experiences accessing healthcare and disability support services during the COVID-19 pandemic, and based on this analysis, the implications of public health policy decisions on disabled people's experiences during the pandemic in New Zealand are explicated. A qualitative design underpinned by interpretive description methodology guided this study. A total of 64 disabled people or parents of disabled children participated in semi-structured interviews. The team of health services and disability researchers then engaged in an iterative thematic approach to analysis, which led to three key themes: (1) protective personal factors, which assisted disabled people to access healthcare and support services, (2) immediate pandemic policy impacts, including policy and legislative changes, which created additional access barriers for disabled people, and (3) exacerbating factors, including compounding vulnerabilities, overstretched systems, and the impact of the vaccine mandate, which worsened the already limited access to healthcare and disability services for disabled people. The pandemic overwhelmed an already stretched healthcare and disability support system, resulting in service disruptions with negative consequences for disabled people's health and wellbeing. Future policy development needs to be disability-centred in its inclusion of people with lived experience and consideration of the support needs of disabled populations. A first step in this process could include pandemic planning and policy co-design to ensure a continuum of healthcare services and support availability for individuals when services are disrupted. In addition, access to formal and informal support for disabled people should be recognised as a fundamental human right when accessing healthcare and disability support services.
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Affiliation(s)
- Solmaz Nazari Orakani
- School of Nursing, Midwifery and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington 6012, New Zealand; (T.N.O.); (K.M.-H.)
| | - Tara N. Officer
- School of Nursing, Midwifery and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington 6012, New Zealand; (T.N.O.); (K.M.-H.)
| | - Gretchen Good
- School of Health Sciences, Massey University, Palmerston North 4442, New Zealand;
| | - Karen McBride-Henry
- School of Nursing, Midwifery and Health Practice, Wellington Faculty of Health, Victoria University of Wellington, Wellington 6012, New Zealand; (T.N.O.); (K.M.-H.)
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Smith AH, Touchett H, Chen P, Fletcher T, Arney J, Hogan J, Wassef M, Cloitre M, Lindsay JA. Patient Satisfaction With a Coach-Guided, Technology-Based Mental Health Treatment: Qualitative Interview Study and Theme Analysis. JMIR Ment Health 2024; 11:e50977. [PMID: 38306167 PMCID: PMC10873794 DOI: 10.2196/50977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 10/20/2023] [Accepted: 10/21/2023] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Technology-based mental health interventions address barriers rural veterans face in accessing care, including provider scarcity and distance from the hospital or clinic. webSTAIR is a 10-module, web-based treatment based on Skills Training in Affective and Interpersonal Regulation, designed to treat posttraumatic stress disorder and depression in individuals exposed to trauma. Previous work has demonstrated that webSTAIR is acceptable to participants and effective at reducing symptoms of posttraumatic stress disorder and depression when delivered synchronously or asynchronously (over 5 or 10 sessions). OBJECTIVE This study explored factors that lead to greater patient satisfaction with webSTAIR, a web-based, coach-guided intervention. METHODS We analyzed qualitative interview data to identify themes related to patient satisfaction with webSTAIR delivered with synchronous video-based coaching. RESULTS Four themes emerged from the data: (1) coaching provides accountability and support, (2) self-pacing offers value that meets individual needs, (3) participants like the comfort and convenience of the web-based format, and (4) technical issues were common but not insurmountable. CONCLUSIONS We conclude that participants valued the accountability, flexibility, and convenience of tech-based interventions with video-delivered coaching.
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Affiliation(s)
- Ashley Helm Smith
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
| | - Hilary Touchett
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Patricia Chen
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- Department of Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Terri Fletcher
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Jennifer Arney
- Department of Sociology, College of Human Sciences and Humanities, University of Houston Clear Lake, Houston, TX, United States
| | - Julianna Hogan
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Miryam Wassef
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Marylene Cloitre
- National Center for Post-Traumatic Stress Disorder Dissemination and Training Division, Veteran Affairs Palo Alto Health Care System, Palo Alto, CA, United States
| | - Jan A Lindsay
- Houston Veteran Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veteran Affairs Medical Center, Houston, TX, United States
- South Central Mental Illness Research, Education and Clinical Center, Houston, TX, United States
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
- Rice University's Baker Institute for Public Policy, Houston, TX, United States
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Murphy MM, Pemberton C, Wheeler E, Gulston LD, Kerr-Layne O, John A, Baksh B, Thomas G, Allen CF. Youth perspectives on mental health during COVID-19 lockdown in a Small Island Developing State: implications for emergency response. Front Psychiatry 2024; 14:1285399. [PMID: 38250264 PMCID: PMC10797114 DOI: 10.3389/fpsyt.2023.1285399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/07/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Evidence exploring the relationship between COVID-19 mitigation measures and mental health has primarily been from quantitative studies in large, developed countries. A qualitative study to explore the knowledge, attitudes and behaviors of young people living in Trinidad and Tobago was conducted to engage and collaborate with youth on matters affecting them during the pandemic. Methods Ten virtual focus groups were conducted with 64 participants aged 18 to 24 in 2021 when partial lockdown measures were in effect for COVID-19 prevention. Groups were stratified by geographic location and socioeconomic status. The recordings were transcribed and analyzed to explore themes of importance to youth. Results Negative impacts on mental health emerged as a strong theme. Lack of timelines for restrictions led to wide ranging mental health impacts, conflict and tension existed in home environments, longer restrictions led to erosion of the social culture, and young people experienced stress about the changing face of education and job security due to the pandemic. Discussion Measures taken to address one serious public health concern, COVID-19, led to the aggravation of another serious public health concern, mental ill-health. Mental health initiatives to help young people navigate issues specific to their generation must be developed. In low resourced Small Island Developing States settings. The increased need for mental health services during and because of the COVID-19 pandemic highlights the need for strengthening the capacity and resilience of these to respond to environmental and health emergencies. Building the resilience of educational and employment services is also needed.
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Affiliation(s)
- Madhuvanti M. Murphy
- The George Alleyne Chronic Disease Research Centre, The University of the West Indies, Bridgetown, Barbados
| | | | - Erica Wheeler
- The Pan American Health Organization/World Health Organization, Port of Spain, Trinidad and Tobago
| | | | | | - Ayana John
- The Ministry of Health, Port of Spain, Trinidad and Tobago
| | - Beverly Baksh
- The Ministry of Health, Port of Spain, Trinidad and Tobago
| | - Gail Thomas
- The Pan American Health Organization/World Health Organization, Port of Spain, Trinidad and Tobago
| | - Caroline F. Allen
- The Pan American Health Organization/World Health Organization, Port of Spain, Trinidad and Tobago
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Hagen MH, Hartvigsen G, Jaccheri L, Papavlasopoulou S. Digital Psychosocial Follow-up for Childhood Critical Illness Survivors: A Qualitative Interview Study on Health Professionals' Perspectives. Scand J Child Adolesc Psychiatr Psychol 2024; 12:50-62. [PMID: 39027413 PMCID: PMC11255782 DOI: 10.2478/sjcapp-2024-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024] Open
Abstract
Background Digital solutions have been reported to provide positive psychological and social outcomes to childhood critical illness survivors, a group with an increased risk for long-term adverse psychosocial effects. Objective To explore health professionals' perspectives on the potential of digital psychosocial follow-up for childhood critical illness survivors. Methods Using a qualitative approach, expert interviews with six health professionals working at a Norwegian hospital were conducted. Transcribed interviews were analyzed using Braun and Clarke's six-phase thematic analysis framework. Concurrent data collection and analysis using inductive coding was also employed, and a model of codes was constructed. Results The interview yielded thirteen unique codes regarding the health professionals' perspectives on the potential for digital psychosocial follow-up for childhood critical illness survivors, organized in a model comprising the two main themes: Affecting Factors and Digital Usage. Demographic factors (the child's medical condition, age, gender, and residence) and environmental factors (the child's family and health professionals) tended to affect the current psychosocial follow-up. Hospital limitations concerning a lack of digital solutions, worse relationship building with video communication, and children's already high screen time reflected the current state of digital usage. However, ongoing digitalization, existing successful digital solutions, children's good digital skills, and an ongoing process of creating an artifact are also seen as opportunities for digital usage in future psychosocial follow-up for childhood critical illness survivors. Conclusions Researchers can build further on these findings to investigate the potential of digital psychosocial follow-up for childhood critical illness survivors, and clinicians can use it as a starting point for improving psychosocial follow-up.
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Affiliation(s)
- Marte Hoff Hagen
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, University of Tromsø – The Arctic University of Norway, Tromsø, Norway
| | - Letizia Jaccheri
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Sofia Papavlasopoulou
- Department of Computer Science, Norwegian University of Science and Technology, Trondheim, Norway
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Hewa Koneputugodage E. COVID-19 medicare benefits schedule telehealth for private psychiatric outpatient care in Victoria, Australia. Australas Psychiatry 2023; 31:528-534. [PMID: 37227131 PMCID: PMC10225803 DOI: 10.1177/10398562231177822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVE We explore telehealth use by private psychiatrists in Victoria during the first 12 months of COVID-19, in the context of: COVID-19 case numbers and restrictions; telehealth use in Victoria compared to national use; telehealth and face-to-face consultations during the first 12 months of COVID-19 compared to face-to-face consultations in the 12 months pre-COVID-19. METHOD Outpatient psychiatric face-to-face and telehealth consultations, from March 2020 to February 2021 in Victoria, were analysed using face-to-face consultations from March 2019 to February 2020 as a comparison group, and compared to national telehealth use and trends in COVID-19 case rates. RESULTS Total psychiatric consultations increased by 16% from March 2020 to February 2021. Telehealth compromised 56% of total, peaking at 70% of consultations in August during the height of COVID-19 cases. Thirty-three percent of total consultations and 59% of telehealth consultations were via telephone. Telehealth consultations per capita in Victoria were consistently lower than the overall Australian level. CONCLUSION Telehealth usage during the first 12 months of COVID-19 in Victoria suggests it is a feasible alternative to face-to-face treatment. Telehealth-mediated increases in psychiatric consultations likely indicates an increased psychosocial need for support.
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Affiliation(s)
- Evani Hewa Koneputugodage
- Mental Health, Justice Health, Alcohol and Drug Services, Canberra Health Services, Canberra, ACT, Australia
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Kaba D, Salwi SM, Daniel NR, Polenick CA. 'I feel like this will never end': mental health during the COVID-19 pandemic among older adults with chronic conditions. Aging Ment Health 2023; 27:1576-1583. [PMID: 37020428 PMCID: PMC10524161 DOI: 10.1080/13607863.2023.2193553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 03/15/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES The COVID-19 pandemic may have a negative impact on mental health, especially among older adults with chronic conditions who are more vulnerable to severe illness. In this qualitative study, we evaluated how the pandemic has impacted the ways that adults aged 50 and older with chronic conditions managed their mental health. METHODS A total of 492 adults (M = 64.95 years, SD = 8.91, range = 50-94) who lived in Michigan (82.1%) and 33 other U.S. states completed one anonymous online survey between 14 May 14 and 9 July 2020. Open-ended responses were coded to ascertain relevant concepts and were reduced to develop major themes. RESULTS We determined four main themes. The COVID-19 pandemic impacted how participants took care of their mental health through: (1) pandemic-related barriers to social interaction; (2) pandemic-related routine changes; (3) pandemic-related stress; and (4) pandemic-related changes to mental health service use. CONCLUSION This study indicates that older adults with chronic conditions experienced various challenges to managing their mental health in the early months of the COVID-19 pandemic, but also showed considerable resilience. The findings identify potential targets of personalized interventions to preserve their well-being during this pandemic and in future public health crises.
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Affiliation(s)
- Diarratou Kaba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Shreya M. Salwi
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Nikita R. Daniel
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Courtney A. Polenick
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
- Aging & Biopsychosocial Innovations Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI 48104
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Farrer LM, Clough B, Bekker MJ, Calear AL, Werner-Seidler A, Newby JM, Knott V, Gooding P, Reynolds J, Brennan L, Batterham PJ. Telehealth use by mental health professionals during COVID-19. Aust N Z J Psychiatry 2023; 57:230-240. [PMID: 35360958 PMCID: PMC10080222 DOI: 10.1177/00048674221089229] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To examine and describe telehealth use and attitudes among mental health professionals in Australia and New Zealand during the initial stages of the COVID-19 pandemic. METHODS Participants completed a brief online survey between May and July 2020. Participants were recruited via peak and professional organisations and through psychology-focused social media groups and networks. The survey examined frequency of telehealth use, reasons for non-use, telehealth modalities, prior use, attitudes towards use, plans for future use, and training, information or resource needs. RESULTS A total of 528 professionals (85.2% female) participated in the survey, of which 98.9% reported using telehealth and 32.2% reported using telehealth exclusively. Respondents were less likely to use telehealth if they worked with clients experiencing complex issues (e.g. trauma), had more hours of weekly client contact, had a choice about whether to use telehealth or felt less positive about using technology. Respondents were more likely to hold positive views towards telehealth if they were female, had used online programmes with clients previously, were frequent telehealth users and were comfortable using technology. Participants expressed mixed views on client safety and the impact of telehealth on therapeutic process and effectiveness. CONCLUSION Telehealth has a clear and ongoing role within mental healthcare and there is a need for strong guidance for professionals on how to manage client risk, privacy, security and adapt therapy for delivery via telehealth. In particular, there is a need for individual-, organisational-, professional- and policy-level responses to ensure that telehealth remains a viable and effective healthcare medium into the future.
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Affiliation(s)
- Louise M Farrer
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
| | - Bonnie Clough
- School of Applied Psychology, Griffith University, Southport, QLD, Australia
| | | | - Alison L Calear
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
| | | | - Jill M Newby
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.,School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Vikki Knott
- Australian College of Applied Psychology, Brisbane, QLD, Australia
| | - Piers Gooding
- Melbourne Law School, The University of Melbourne, Carlton, VIC, Australia
| | - Julia Reynolds
- Research School of Psychology, The Australian National University, Canberra, ACT, Australia
| | - Leah Brennan
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, The Australian National University, Acton, ACT, Australia
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11
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Barwise A, Huschka T, Woo C, Egginton J, Huang L, Allen JS, Johnson M, Hamm K, Wolfersteig W, Phelan S, Allyse M. Perceptions and Use of Telehealth among diverse communities: A Multisite Community Engaged Mixed Methods Study. J Med Internet Res 2023; 25:e44242. [PMID: 36867682 PMCID: PMC10057900 DOI: 10.2196/44242] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Telehealth has been increasingly adopted by healthcare systems since the start of the COVID-19 pandemic. Although telehealth may provide convenience for patients and clinicians, there are several barriers to accessing it and using it effectively to provide high quality patient care. OBJECTIVE This study, was part of a larger multisite community engaged study conducted to understand the impact of COVID-19 on diverse communities. The work described here explored the perceptions of and experience with telehealth use among diverse and underserved community members during COVID-19. METHODS We used mixed methods across three regions in the US (Midwest, Arizona, and Florida) from January 2021-November 2021. We promoted our study through social media and community partnerships, disseminating flyers in English and Spanish. We developed a moderator guide and conducted focus groups in English and Spanish mostly using a videoconferencing platform. Participants were placed in focus groups with others who shared similar demographic attributes and geographic location. Focus groups were audio-recorded and transcribed. We analyzed our qualitative data using the framework analytic approach. We developed our broader survey using validated scales and with input from community and scientific leaders and distributed it through social media in English and Spanish. We included a previously published questionnaire which had been used to assess perceptions about telehealth among patients with HIV. We analyzed our quantitative data using SAS software and standard statistical approaches. We examined the effect of region, age, ethnicity/race and education on use and perceptions of telehealth. RESULTS We included data from 47 focus groups. Due to our mode of dissemination, we cannot calculate a response rate for the survey. However, we received 3447 English language and 146 Spanish language responses. Over 90% of participants had internet access and 94% had used telehealth. About half of all participants agreed or strongly agreed that telehealth would be beneficial in the future because it better fit their schedules and they would not need to travel. However, about half also agreed or strongly agreed they would not be able to express themselves well and could not be examined when using telehealth. Indigenous participants were especially concerned about these issues when compared to other racial groups. CONCLUSIONS This work describes findings from a mixed methods community engaged research study about telehealth including perceived benefits and concerns. Although participants enjoyed the benefits of telehealth (not having to travel and easier scheduling) they also had concerns (not being able to express themselves well and not having a physical exam) about telehealth.. These sentiments were especially notable among the Indigenous population. Our work highlights the importance of fully understanding the impact of these novel health delivery modalities on the patient experience and actual or perceived quality of care received. CLINICALTRIAL
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Affiliation(s)
- Amelia Barwise
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | - Todd Huschka
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | | | - Jason Egginton
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | - Lily Huang
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, US
| | | | | | - Kathryn Hamm
- Office of Evaluation and Partner Contracts, Southwest Interdisciplinary Research Center,, Arizona State University, Phoenix, US
| | - Wendy Wolfersteig
- Office of Evaluation and Partner Contracts, Southwest Interdisciplinary Research Center,, Arizona State University, Phoenix, US
| | - Sean Phelan
- Department of Family Medicine, Mayo Clinic, Rochester, US
| | - Megan Allyse
- Quantitative Health Sciences, Mayo Clinic, Jacksonville, US
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12
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Honey A, Hines M, Barton R, Berry B, Gilroy J, Glover H, Hancock N, Waks S, Wells K. Preferences for telehealth: A qualitative study with people accessing a new mental health service. Digit Health 2023; 9:20552076231211083. [PMID: 37928331 PMCID: PMC10621303 DOI: 10.1177/20552076231211083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/12/2023] [Indexed: 11/07/2023] Open
Abstract
Objectives To examine preferences for telehealth versus in-person services for people who sought mental health support from an unfamiliar service during the COVID-19 pandemic and to identify the factors that influenced these preferences. Methods Data are drawn from semi-structured interviews with 45 participants (32 people who accessed mental health services, 7 informal support people, and 6 people who accessed services themselves as well as identifying as informal supports). Data relating to experiences of telehealth, comparisons with in-person services and preferences were coded inductively and analysed using qualitative content analysis. Results Just over half of the participants in our sample preferred telehealth or at least regarded it as a suitable option. Those who preferred telehealth were more likely to have had direct experience, particularly via videoconferencing, as part of their access to this new mental health service. Reasons for preferring in-person services included belief in the superiority of interpersonal communication in these settings, compatibility with personal communication style and discomfort with technology. Those preferring telehealth cited its convenience, elimination of the need to travel for services, the comfort and safety afforded by accessing services at home and the ability to communicate more openly. Conclusions Hybrid models of care which harness the unique benefits of both in-person and remote service modalities appear to have a legitimate place in models of mental health care outside of pandemic situations. These results illuminate the potential of telehealth services when engaging with people seeking mental health help for the first time and in situations where existing relationships with service providers have not yet been established.
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Affiliation(s)
- Anne Honey
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Monique Hines
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Rebecca Barton
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Bridget Berry
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - John Gilroy
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Helen Glover
- Enlightened Consultants, Brisbane, Qld, Australia
| | - Nicola Hancock
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Shifra Waks
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen Wells
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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13
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Mavragani A, Torous J, Jacobs R. IT and the Quality and Efficiency of Mental Health Care in a Time of COVID-19: Case Study of Mental Health Providers in England. JMIR Form Res 2022; 6:e37533. [PMID: 36423321 PMCID: PMC9822565 DOI: 10.2196/37533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/26/2022] [Accepted: 11/24/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In England, COVID-19 has significantly affected mental health care and tested the resilience of health care providers. In many areas, the increased use of IT has enabled traditional modes of service delivery to be supported or even replaced by remote forms of provision. OBJECTIVE This study aimed to assess the use and impact of IT, in remote service provision, on the quality and efficiency of mental health care during the pandemic. We drew on sociotechnical systems theory as a conceptual framework to help structure the gathering, analysis, and interpretation of data. METHODS We conducted a national scoping survey that involved documentary analysis and semistructured interviews with 6 national stakeholders and case studies of 4 purposefully selected mental health providers in England involving interviews with 53 staff members. RESULTS Following the outbreak of COVID-19, mental health providers rapidly adjusted their traditional forms of service delivery, switching to digital and telephone consultations for most services. The informants provided nuanced perspectives on the impact on the quality and efficiency of remote service delivery during the pandemic. Notably, it has allowed providers to attend to as many patients as possible in the face of COVID-19 restrictions, to the convenience of both patients and staff. Among its negative effects are concerns about the unsuitability of remote consultation for some people with mental health conditions and the potential to widen the digital divide and exacerbate existing inequalities. Sociotechnical systems theory was found to be a suitable framework for understanding the range of systemic and sociotechnical factors that influence the use of technology in mental health care delivery in times of crisis and normalcy. CONCLUSIONS Although the use of IT has boosted mental health care delivery during the pandemic, it has had mixed effects on quality and efficiency. In general, patients have benefited from the convenience of remote consultation when face-to-face contact was impossible. In contrast, patient choice was often compromised, and patient experience and outcomes might have been affected for some people with mental health conditions for which remote consultation is less suitable. However, the full impact of IT on the quality and efficiency of mental health care provision along with the systemic and sociotechnical determinants requires more sustained and longitudinal research.
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Affiliation(s)
| | | | - Rowena Jacobs
- Centre for Health Economics, University of York, York, United Kingdom
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14
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Seidler ZE, Wilson MJ, Oliffe JL, Kealy D, Ogrodniczuk JS, Walther A, Rice SM. "I could hang up if the practitioner was a prat": Australian men's feedback on telemental healthcare during COVID-19. PLoS One 2022; 17:e0279127. [PMID: 36516184 PMCID: PMC9749969 DOI: 10.1371/journal.pone.0279127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic restrictions, uncertainties and management inconsistencies have been implicated in men's rising distress levels, which in turn have somewhat normed the uptake of telemental healthcare services (i.e., phone and/or video-conference-based therapy). Given past evidence of poor engagement with telemental health among men, this mixed-methods study examined Australian men's use of, and experiences with telemental health services relative to face-to-face care during the pandemic. A community sample of Australian-based men (N = 387; age M = 47.5 years, SD = 15.0 years) were recruited via Facebook advertising, and completed an online survey comprising quantitative items and open-response qualitative questions with the aim of better understanding men's experiences with telemental healthcare services. In total, 62.3% (n = 241) of participants reported experience with telemental health, and regression analyses revealed those who engaged with telemental health were on average younger, more likely to be gay and university educated. Men who had used telemental health were, on average, more satisfied with their therapy experience than those who had face-to-face therapy. Among those who had telemental healthcare, marginally lower satisfaction was observed among regional/rural based relative to urban men, and those who had to wait longer than 2 months to commence therapy. Qualitative findings highlighted positive aspects of telemental healthcare including comfort with accessing therapy from familiar home environments and the convenience and accessibility of telemental health alongside competing commitments and COVID-19 restrictions. Conversely, drawbacks included technical limitations such as crosstalk impeding therapeutic progress, disconnects and audio-visual lag-times and the 'impersonal' nature of telemental healthcare services. Findings broadly signal COVID-19 induced shifts norming of the use of virtual therapy services, with clear scope for improvement in the delivery of therapeutic practice using digital modalities, especially among help-seeking men.
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Affiliation(s)
- Zac E. Seidler
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Movember, Melbourne, Australia
- * E-mail:
| | - Michael J. Wilson
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - John L. Oliffe
- School of Nursing, University of British Columbia, Vancouver, Canada
- Department of Nursing, The University of Melbourne, Melbourne, Australia
| | - David Kealy
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | | | - Andreas Walther
- Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland
| | - Simon M. Rice
- Orygen, Parkville, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
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15
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Ogunseitan AB, Smith MM. Telehealth: An Avenue for Expanding Access to Specialist Palliative Care. Jt Comm J Qual Patient Saf 2022; 48:625-626. [PMID: 36184266 DOI: 10.1016/j.jcjq.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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16
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Leeming D, Lucock M, Shibazaki K, Pilkington N, Scott B. The Impact of the COVID-19 Pandemic on Those Supported in the Community with Long-Term Mental Health Problems: A Qualitative Analysis of Power, Threat, Meaning and Survival. Community Ment Health J 2022; 58:1297-1309. [PMID: 35032283 PMCID: PMC8760583 DOI: 10.1007/s10597-021-00932-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/13/2021] [Indexed: 01/01/2023]
Abstract
Research suggests that the COVID-19 pandemic has had a significant impact on those already living with mental health problems, though there is also evidence of resilience. However, to date there has been limited in-depth qualitative investigation. We interviewed 15 people living with long-term mental health problems who, before the pandemic, were being supported by third sector organisations, to explore how they experienced lockdowns and accessing services remotely. Template analysis was informed by the Power Threat Meaning Framework and suggested that participants experienced significant threats to their mental wellbeing and recovery which were exacerbated by current or previous powerlessness and inequality. Although participants described positive coping strategies, several described a return of unhelpful behaviours that had contributed to the original difficulties. The findings illustrate the wider contributions of social and economic context to mental health problems and the importance of ensuring that people do not feel abandoned and are proactively supported.
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Affiliation(s)
- Dawn Leeming
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK.
| | - Mike Lucock
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Kagari Shibazaki
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Nicki Pilkington
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
| | - Becky Scott
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK
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17
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McMahon G, Douglas A, Casey K, Ahern E. Disruption to well-being activities and depressive symptoms during the COVID-19 pandemic: The mediational role of social connectedness and rumination. J Affect Disord 2022; 309:274-281. [PMID: 35489558 PMCID: PMC9044653 DOI: 10.1016/j.jad.2022.04.142] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Disruption to everyday routine during the COVID-19 pandemic has resulted in considerable implications for global mental health. The inter- and intra-personal mechanisms by which disrupted routine can contribute to elevated depressive symptoms has not been well-explored. The present study aimed to examine how feelings of social (dis)connectedness and rumination, as a maladaptive coping strategy, could explain the association between disrupted well-being activities and depressive symptoms. METHODS Participants (N = 496) ranging in age from 18 to 73 years (M = 28.73, SD = 10.93) completed an online survey within the first 3 months of the COVID-19 pandemic, which included measures of disruption to usual psychological and physical well-being activities, social connectedness, rumination, and depressive symptoms. Social connectedness and rumination were investigated as serial mediators of the association between disrupted well-being activities and depression using Hayes' PROCESS macro. RESULTS 39.5% of the sample reported clinically significant levels of depression. Disruption to well-being activities predicted higher depressive symptoms, and this was partially explained by feelings of social disconnectedness and subsequent rumination. Rumination, alone, was not a significant mediator between disrupted routine and depressive symptoms. LIMITATIONS The cross-sectional survey design does not preclude the possibility of bidirectional effects. CONCLUSION The social distancing public health measures to combat COVID-19 have contributed to widespread disrupted routine, and in turn, elevated symptoms of depression. Social disconnectedness plays a particularly important role in this association. Intervention strategies should consider social factors as a 'social cure' for mass, positive mental health promotion during COVID-19.
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Affiliation(s)
- Grace McMahon
- Department of Psychology, University of Limerick, Limerick, Ireland.
| | | | - Kevin Casey
- Department of Psychology, University of Limerick, Limerick, Ireland
| | - Elayne Ahern
- Department of Psychology, University of Limerick, Limerick, Ireland
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18
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Rosen B, Preisman M, Read H, Chaukos D, Greenberg RA, Jeffs L, Maunder R, Wiesenfeld L. Providers' perspectives on implementing resilience coaching for healthcare workers during the COVID-19 pandemic. BMC Health Serv Res 2022; 22:780. [PMID: 35701756 PMCID: PMC9194890 DOI: 10.1186/s12913-022-08131-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/24/2022] [Indexed: 11/30/2022] Open
Abstract
Background The COVID-19 pandemic severely exacerbated workplace stress for healthcare workers (HCWs) worldwide. The pandemic also magnified the need for mechanisms to support the psychological wellbeing of HCWs. This study is a qualitative inquiry into the implementation of a HCW support program called Resilience Coaching at a general hospital. Resilience Coaching was delivered by an interdisciplinary team, including: psychiatrists, mental health nurses allied health and a senior bioethicist. The study focuses specifically on the experiences of those who provided the intervention. Methods Resilience Coaching was implemented at, an academic hospital in Toronto, Canada in April 2020 and is ongoing. As part of a larger qualitative evaluation, 13 Resilience Coaches were interviewed about their experiences providing psychosocial support to colleagues. Interviews were recorded, transcribed, and analyzed for themes by the research team. Interviews were conducted between February and June 2021. Results Coaches were motivated by opportunities to support colleagues and contribute to the overall health system response to COVID-19. Challenges included finding time within busy work schedules, balancing role tensions and working while experiencing burnout. Conclusions Hospital-based mental health professionals are well-positioned to support colleagues’ wellness during acute crises and can find this work meaningful, but note important challenges to the role. Paired-coaches and peer support among the coaching group may mitigate some of these challenges. Perspectives from those providing support to HCWs are an important consideration in developing support programs that leverage internal teams.
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Affiliation(s)
- Benjamin Rosen
- Sinai Health, Toronto, Canada. .,Department of Psychiatry, University of Toronto, Toronto, Canada.
| | - Mary Preisman
- Sinai Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Heather Read
- Sinai Health, Toronto, Canada. .,Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada.
| | - Deanna Chaukos
- Sinai Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Rebecca A Greenberg
- Sinai Health, Toronto, Canada.,Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Lianne Jeffs
- Sinai Health, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Robert Maunder
- Sinai Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Lesley Wiesenfeld
- Sinai Health, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada
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19
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McQueen M, Strauss P, Lin A, Freeman J, Hill N, Finlay-Jones A, Bebbington K, Perry Y. Mind the distance: experiences of non-face-to-face child and youth mental health services during COVID-19 social distancing restrictions in Western Australia. AUSTRALIAN PSYCHOLOGIST 2022. [DOI: 10.1080/00050067.2022.2078649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
| | - Penelope Strauss
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Ashleigh Lin
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | | | - Nicole Hill
- Telethon Kids Institute, Perth, Australia
- Centre for Child Health Research, The University of Western Australia, Perth, Australia
| | | | - Keely Bebbington
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Yael Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
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20
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Schneider SE, Ross AM, Boskey ER. 'We are essential:' Pediatric health care social workers' perspectives on being designated essential workers during the COVID-19 pandemic. SOCIAL WORK IN HEALTH CARE 2022; 61:36-51. [PMID: 35138996 DOI: 10.1080/00981389.2022.2028696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 12/29/2021] [Accepted: 01/09/2022] [Indexed: 06/14/2023]
Abstract
Continued provision of essential services is critical to maintaining society's functioning during a crisis. During COVID-19, lockdowns and restrictions designed to preserve the public's health forced an examination of what it means to be an essential worker. Drawing from thematic analyses of focus group data from 55 social workers employed in a large, urban, pediatric, quaternary hospital, this study examines the perspectives of hospital social workers on the meaning of the essential status designation of social work. Findings revealed themes pertaining the substance of social work, the ways in which essential status is carried out, and implications of the designation not only for the future of the profession but also for the populations who receive social work services. The discussion raised important questions about the essential role of social workers in broader health care settings. Our findings suggest that health care systems need to engage in ongoing discussions of how to maximize the efficacy of the social work workforce, both in terms of integration with medical teams and recognition of the important roles social workers play across the hospital system, and facilitate the performance of their essential functions.
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Affiliation(s)
- Samantha E Schneider
- Winona State University, College of Nursing and Health Sciences, Rochester, Minnesota, USA
| | - Abigail M Ross
- Fordham University Graduate School of Social Service, New York, New York, USA
| | - Elizabeth R Boskey
- Boston Children's Hospital, Center for Gender Surgery, Boston, Minnesota, USA
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21
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Bäuerle A, Jahre L, Teufel M, Jansen C, Musche V, Schweda A, Fink M, Dinse H, Weismüller B, Dörrie N, Junne F, Graf J, Skoda EM. Evaluation of the E-Mental Health Mindfulness-Based and Skills-Based "CoPE It" Intervention to Reduce Psychological Distress in Times of COVID-19: Results of a Bicentre Longitudinal Study. Front Psychiatry 2021; 12:768132. [PMID: 34803775 PMCID: PMC8599585 DOI: 10.3389/fpsyt.2021.768132] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background: The SARS-CoV-2 pandemic poses immense challenges for health care systems and population-wide mental health. The e-mental health intervention "CoPE It" has been developed to offer standardized and manualized support to overcome psychological distress caused by the pandemic. The aim of this study was to assess the effectiveness of "CoPE It" in terms of reducing distress (primary outcome), depression and anxiety symptoms, and improving self-efficacy, and mindfulness (secondary outcomes). Furthermore, the intervention's usability, feasibility, and participants' satisfaction with "CoPE It" was evaluated (tertiary outcome). The study protocol has been published previously. Methods: A bicentre longitudinal study was conducted from April 27th 2020 to May 3rd 2021. N = 110 participants were included in the analyses. The intervention consisted of four modules featuring different media promoting evidence-based methods of cognitive behavioral therapy and mindfulness-based stress reduction. Difference in psychological distress between baseline (T0) and post-intervention (T1) were analyzed by repeated measure analysis of covariance. Mixed linear models were applied to assess moderating effects. Depressive symptoms, generalized anxiety symptoms, self-efficacy, and mindfulness were compared between baseline (T0) and post-intervention (T1) via t-tests. Usability of the "CoPE It" intervention and participants' satisfaction was evaluated by calculation means and frequencies. Results: Primary outcome: A significant effect of time on psychological distress at post-intervention (T1) after controlling for age, gender, education, mental illness and attitudes toward online interventions was found. Depressive and anxiety symptoms, and mindfulness were a significant moderators of the relationship between time and psychological distress for consistent wording. Secondary outcomes: There was a significant decrease in depressive symptoms and generalized anxiety, and a significant increase in self-efficacy and mindfulness between baseline (T0) and post-intervention (T1). Tertiary outcomes: 95.83% of the participants thought the "CoPE It" intervention was easy to use and 87.50% were satisfied with the "CoPE It" intervention in an overall, general sense. Conclusion: The e-mental health "CoPE It" intervention seems to be an effective approach in reducing psychological distress, anxiety and depressive symptoms, and in enhancing self-efficacy and mindfulness during the COVID-19 pandemic. Participants' satisfaction and the program's feasibility, and usability were proven to be high. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: DRKS00021301.
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Affiliation(s)
- Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lisa Jahre
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Venja Musche
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Madeleine Fink
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Hannah Dinse
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Benjamin Weismüller
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nora Dörrie
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Florian Junne
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany.,Department for Psychosomatic Medicine and Psychotherapy, Otto Von Guericke University Magdeburg, Magdeburg, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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22
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Kowalski E, Schneider A, Zipfel S, Stengel A, Graf J. SARS-CoV-2 Positive and Isolated at Home: Stress and Coping Depending on Psychological Burden. Front Psychiatry 2021; 12:748244. [PMID: 34880791 PMCID: PMC8645573 DOI: 10.3389/fpsyt.2021.748244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/01/2021] [Indexed: 12/28/2022] Open
Abstract
Objective: The SARS-CoV-2 pandemic has led to pronounced health changes, especially for those infected and psychologically burdened. This cross-sectional study examined the stress experience and coping strategies during home isolation of SARS-CoV-2 infected individuals and analyzed differences regarding psychological burden. Methods: SARS-CoV-2 infected respondents were recruited by telephone and completed an online survey during their home isolation. This questionnaire assessed sociodemographic aspects, somatic factors, psychological burden (depressive symptoms, anxiety, and somatic symptom disorder), perceived stress and coping behavior during the home isolation. Results: Out of 838 SARS-CoV-2 infected individuals during the study period, 648 were contacted and 224 home-isolated respondents were included in the study. Disgrace, social restrictions, job fear, health concerns, and infectiousness could be explored as stressors during the home isolation. Fifty-four percent experienced psychological burden. SARS-CoV-2 infected and home-isolated individuals with psychological burden perceived significant stressors more strongly (p < 0.001, r = 0.5) and coped significantly less (p < 0.001, r = 0.3) with their infection and home isolation compared to SARS-CoV-2 infected individuals without psychological burden. Conclusion: SARS-CoV-2 infected individuals with psychological burden experienced higher stressors and were unable to cope adaptively with home isolation. Therefore, a general and standardized screening procedure for psychological burden should be established. SARS-CoV-2 infected individuals with psychological burden should receive targeted support with professional help in the areas of stress experience and coping skills during their home isolation and beyond to avoid long-term consequences.
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Affiliation(s)
- Elias Kowalski
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Health Department Freudenstadt, Freudenstadt, Germany
| | | | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany.,Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
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