Cole Charles L, Barry Charlotte, Saunders Rob, Billings Jo, Stott Joshua, Buckman Joshua E J, Greene Talya, Cirkovik Mirko, Pilling Stephen, Wheatley Jon
Research Department of Clinical, Educational, and Health Psychology, University College London, UK; CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, UK; and Talk Changes (City & Hackney IAPT), Homerton Healthcare Foundation Trust, UK.
Research Department of Clinical, Educational, and Health Psychology, University College London, UK; and CORE Data Lab, Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational and Health Psychology, University College London, UK.
BJPsych Open. 2023 May 25;9(3):e95. doi: 10.1192/bjo.2023.66.
The COVID-19 pandemic has disproportionally affected the mental health of health and social care workers (HSCWs), with many experiencing symptoms of depression, anxiety and post-traumatic stress disorder. Psychological interventions have been offered via mental health services and in-house psychology teams, but their effectiveness in this context is not well documented.
To evaluate a stepped-care psychological support pathway for HSCWs from Homerton Healthcare Foundation Trust in London, which offered psychological first aid, evidence-based psychological therapies and group-based well-being workshops.
The service evaluation used a pre-post approach to assess depression, anxiety, functional impairment and post-traumatic stress disorder symptom change for those who attended sessions of psychological first aid, low- or high-intensity cognitive-behavioural therapy or a combination of these. In addition, the acceptability of the psychological first aid sessions and well-being workshops was explored via feedback data.
Across all interventions, statistically significant reductions of depression ( = 1.33), anxiety ( = 1.37) and functional impairment ( = 0.93) were observed, and these reductions were equivalent between the interventions, as well as the demographic and occupational differences between the HSCWs (ethnicity, staff group and redeployment status). HSCWs were highly satisfied with the psychological first aid and well-being workshops.
The evaluation supports the utility of evidence-based interventions delivered as part of a stepped-care pathway for HSCWs with common mental health problems in the context of the COVID-19 pandemic. Given the novel integration of psychological first aid within the stepped-care model as a step one intervention, replication and further testing in larger-scale studies is warranted.
新冠疫情对卫生和社会护理工作者(HSCWs)的心理健康产生了不成比例的影响,许多人出现了抑郁、焦虑和创伤后应激障碍症状。心理健康服务机构和内部心理团队已提供心理干预措施,但在这种情况下其有效性尚无充分记录。
评估伦敦霍默顿医疗保健基金会信托为HSCWs提供的逐步护理心理支持途径,该途径提供心理急救、循证心理治疗和基于群体的幸福工作坊。
该服务评估采用前后对比方法,评估参加心理急救、低强度或高强度认知行为治疗或这些治疗组合课程的人员在抑郁、焦虑、功能损害和创伤后应激障碍症状方面的变化。此外,通过反馈数据探讨了心理急救课程和幸福工作坊的可接受性。
在所有干预措施中,观察到抑郁(=1.33)、焦虑(=1.37)和功能损害(=0.93)有统计学意义的降低,这些降低在各干预措施之间以及HSCWs的人口统计学和职业差异(种族、工作人员群体和重新部署状态)之间是相当的。HSCWs对心理急救和幸福工作坊非常满意。
该评估支持在新冠疫情背景下,将循证干预措施作为逐步护理途径的一部分,为有常见心理健康问题的HSCWs提供服务的效用。鉴于心理急救在逐步护理模式中作为第一步干预措施的新颖整合,有必要在更大规模的研究中进行复制和进一步测试。