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Ching BCF, Badaoui A, Abou Seif N, Al Hallal R, Bundies GL, Campbell A, Rafie A, Song-Chase A, Hahn JS, Billings J. 'The phoenix that always rises from the ashes': an exploratory qualitative study of the experiences of an initiative informed by principles of psychological first aid following the Beirut blast. Eur J Psychotraumatol 2023; 14:2263146. [PMID: 37796664 PMCID: PMC10557531 DOI: 10.1080/20008066.2023.2263146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/11/2023] [Indexed: 10/07/2023] Open
Abstract
Background: On 4 August 2020, an explosion occurred in Beirut, Lebanon. Hundreds of people were killed, thousands injured and displaced. An initiative was rapidly initiated to provide remote support informed by psychological first aid for the mental health of Lebanese young adults affected by the blast. However, little is known about recipients' experiences of such initiatives.Objective: This study aimed to qualitatively explore the experiences of supporters and recipients in the community-led initiative following the blast.Method: We recruited a diverse sample of four supporters and four Lebanese recipients who took part in the Beirut initiative. Semi-structured interviews were conducted with participants. Reflexive thematic analysis was used to analyse the qualitative data.Results: We developed five themes from the qualitative interviews, which highlighted ideas around accessibility, alienation, the relationship, elements of the safe space created by the initiative, and unmet needs and areas for improvement. Recipients described the detrimental impact of the blast on their mental health within the Lebanese context and beyond. Recipients and supporters elucidated complex experiences of the support and its impact.Conclusions: Our findings suggest remote support has the potential to be acceptable for young adults in Lebanon. Further research into support informed by psychological first aid after similar crisis events is warranted.
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Affiliation(s)
- Brian Chi Fung Ching
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | - Alexandra Badaoui
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | - Nada Abou Seif
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | | | - Gabriel Luiz Bundies
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | - Amy Campbell
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | | | - Angela Song-Chase
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | - Jane Sungmin Hahn
- Division of Psychiatry, University College London, London, UK
- Beirut Initiative, London, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
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Abou Seif N, John-Baptiste Bastien R, Wang B, Davies J, Isaken M, Ball E, Pitman A, Rowe S. Effectiveness, acceptability and potential harms of peer support for self-harm in non-clinical settings: systematic review. BJPsych Open 2022; 8:e28. [PMID: 35034666 PMCID: PMC8811789 DOI: 10.1192/bjo.2021.1081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many people who have self-harmed prefer informal sources of support or support from those with lived experience. However, little is known about whether peer support improves outcomes for people who have self-harmed or about the risks of peer support interventions in non-clinical settings. AIMS The aims of this review were to examine the effectiveness, acceptability and potential risks of peer support for self-harm, and how these risks might be mitigated. METHOD We searched bibliographic databases and grey literature for papers published since 2000. We included peer support for self-harm that occurred in voluntary-sector organisations providing one-to-one or group support, or via moderated online peer support forums. RESULTS Eight of the ten papers included focused on peer support that was delivered through online media. No study compared peer support with other treatments or a control group, so limited conclusions could be made about its effectiveness. Peer support for self-harm was found to be acceptable and was viewed as having a range of benefits including a sense of community, empowerment, and access to information and support. The most commonly perceived risk associated with peer support was the potential for triggering self-harm. CONCLUSIONS Our findings highlighted a range of benefits of being part of a group with very specific shared experiences. Mitigations for potential risks include organisations using professional facilitators for groups, trigger warnings for online forums, and providing regular supervision and training so that peers are prepared and feel confident to support vulnerable people while maintaining their own emotional health.
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Affiliation(s)
| | | | - Belinda Wang
- Division of Psychiatry, University College London, UK
| | | | | | | | - Alexandra Pitman
- Division of Psychiatry, University College London, and Camden and Islington NHS Foundation Trust, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, UK
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Berkhout SG, Billings J, Abou Seif N, Singleton D, Stein H, Hegarty S, Ondruskova T, Soulios E, Bloomfield MAP, Greene T, Seto A, Abbey S, Sheehan K. Shared sources and mechanisms of healthcare worker distress in COVID-19: a comparative qualitative study in Canada and the UK. Eur J Psychotraumatol 2022; 13:2107810. [PMID: 35979505 PMCID: PMC9377263 DOI: 10.1080/20008066.2022.2107810] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: COVID-19 has had a significant impact on the wellbeing of healthcare workers, with quantitative studies identifying increased stress, anxiety, depression, insomnia, and PTSD in a wide range of settings. Limited qualitative data so far has offered in-depth details concerning what underlies these challenges, but none provide comprehensive comparison across different healthcare systems. Objective: To explore qualitative findings relating to healthcare worker distress from two different countries to understand the nuanced similarities and differences with respect to the sources and impact of distress relating to COVID-19. Method: A comparative interpretive thematic analysis was carried out between two qualitative data sets examining healthcare workers' experiences of distress during the COVID-19 pandemic. Data from Canada and the UK were collected in parallel and analyzed in an iterative, collaborative process. Results: A number of sources of distress cut across both study settings including concerns about safety and patient care, challenges at home or in one's personal life, communication issues, work environment, media and public perception, and government responses to the pandemic. These sit on a spectrum from individual to institutional sources and were mutually reinforcing. Our analysis also suggested that common mechanisms such as exacerbations in uncertainty, hypervigilance, and moral injury underpinned these sources, which contributed to how they were experienced as distressing. Conclusion: This is the first international collaboration utilising qualitative data to examine this pressing issue. Despite differences in the political, social, health service, and pandemic-related context, the sources and mechanisms of distress experienced by healthcare workers in Canada and the UK were remarkably similar. HIGHLIGHTS This international comparative qualitative study explores how mechanisms that lead to distress are shared across different geographies and cultures, even as the local context shapes the sources of distress themselves.
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Affiliation(s)
- Suze G Berkhout
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
| | - Nada Abou Seif
- Division of Psychiatry, University College London, London, UK
| | - David Singleton
- Division of Psychiatry, University College London, London, UK
| | - Hilarie Stein
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Siobhan Hegarty
- Division of Psychiatry, University College London, London, UK
| | | | - Emilia Soulios
- Division of Psychiatry, University College London, London, UK
| | | | - Talya Greene
- Division of Psychiatry, University College London, London, UK.,Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Susan Abbey
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
| | - Kathleen Sheehan
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,University Health Network, Toronto, Canada
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Billings J, Abou Seif N, Hegarty S, Ondruskova T, Soulios E, Bloomfield M, Greene T. What support do frontline workers want? A qualitative study of health and social care workers' experiences and views of psychosocial support during the COVID-19 pandemic. PLoS One 2021; 16:e0256454. [PMID: 34473755 PMCID: PMC8412294 DOI: 10.1371/journal.pone.0256454] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has placed a significant burden on the mental health and wellbeing of frontline health and social care workers. The need to support frontline staff has been recognised. However, there is to date little research specifically on how best to support the mental health needs of frontline workers, and none on their own experiences and views about what might be most helpful. AIMS We set out to redress this research gap by qualitatively exploring UK frontline health and social care workers' own experiences and views of psychosocial support during the pandemic. METHOD Frontline health and social care workers were recruited purposively through social media and by snowball sampling via healthcare colleagues. Workers who volunteered to take part in the study were interviewed remotely following a semi-structured interview guide. Transcripts of the interviews were analysed by the research team following the principles of Reflexive Thematic Analysis. RESULTS We conducted 25 interviews with frontline workers from a variety of professional groups working in health and social care settings across the UK. Themes derived from our analysis showed that workers' experiences and views about psychosocial support were complex. Peer support was many workers' first line of support but could also be experienced as a burden. Workers were ambivalent about support shown by organisations, media and the public. Whilst workers valued psychological support services, there were many disparities in provision and barriers to access. CONCLUSIONS The results of this study show that frontline health and social care workers are likely to need a flexible system of support including peer, organisational and professional support. More research is needed to fully unpack the structural, systemic and individual barriers to accessing psychosocial support. Greater collaboration, consultation and co-production of support services and their evaluation is warranted.
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Affiliation(s)
- Jo Billings
- Division of Psychiatry, University College London, London, United Kingdom
| | - Nada Abou Seif
- Division of Psychiatry, University College London, London, United Kingdom
| | - Siobhan Hegarty
- Division of Psychiatry, University College London, London, United Kingdom
| | - Tamara Ondruskova
- Division of Psychiatry, University College London, London, United Kingdom
| | - Emilia Soulios
- Division of Psychiatry, University College London, London, United Kingdom
| | - Michael Bloomfield
- Division of Psychiatry, University College London, London, United Kingdom
- Traumatic Stress Clinic, Camden & Islington NHS Foundation Trust, London, United Kingdom
- National Institute for Health Research University College London Hospitals Biomedical Research Centre, London, United Kingdom
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Talya Greene
- Division of Psychiatry, University College London, London, United Kingdom
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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