Purpose of review Mental health (MH) problems among healthcare workers (HCWs) have the potential to impact negatively on the capacity of health systems to respond effectively to COVID-19. A thorough understanding of the factors that degrade or promote the MH of HCWs is needed to design and implement suitable intervention strategies to support the wellbeing of this population. Recent findings MH problems among HCWs were elevated prior to the COVID-19 pandemic. Accumulating evidence indicates that this public health crisis has had a disproportionately negative impact on the MH of specialised populations, including HCWs. Literature from prior health pandemics suggests that the adverse effects of the COVID-19 pandemic on the MH of HCWs are likely to persist in the aftermath of the public health crisis. Primary and secondary risk factors for adverse MH outcomes have been identified and should be considered when implementing interventions to protect the MH of HCWs. Summary The MH of HCWs has been negatively impacted by the COVID-19 pandemic, which is having a detrimental influence on the public health response to COVID-19. Protecting the MH of HCWs both during and beyond this public health crisis should remain a top priority, with particular emphasis on multifaceted interventions that aim to balance the psychological needs of individual HCWs with organisational-level strategies that could be targeted to promote their wellbeing.

The mental health of healthcare workers during the COVID-19 pandemic: a narrative review

ABSTRACT COVID-19 restrictions drove rapid adaptations to service delivery and new ways of working within Scotland’s mental health sector. This study explores mental health workers’ (MHWs’) experiences of delivering their services remotely. Twenty participants, who had worked in mental health professions in the National Health Service (NHS) in Scotland throughout the COVID-19 pandemic, took part in online semi-structured interviews. Data was transcribed then analysed using an inductive thematic analysis. Two major themes are reported: (1) ‘Improved Flexibility for both MHWs and Service Users’ and (2) ‘Teletherapies Challenge Therapeutic Boundaries’. In relation to (1) virtual platforms were seen as vital in maintaining patient care throughout the COVID-19 pandemic and a valuable resource for service users (SUs) who had previously struggled with mobility or social anxieties when accessing face-to-face services. Some MHWs’ also noted benefits for their productivity and comfort. Regarding (2) MHWs highlighted that whilst conducting teletherapies from home, work-life boundaries became blurred and, in some instances, typically comforting spaces became associated with the traumatic content discussed by SUs. These stressors seemed to be compounded by MHWs’ isolation, as they were less able to draw upon their colleagues for support. Further, confidentiality could not be assured, as MHWs and SUs alike had to accommodate their family members. These findings highlight important insights from MHWs in adapting to rapid changes in mental health working practices, particularly in relation to the challenges of delivering quality, safe and equitable services and the increased use of teletherapies. Such insights are vital in informing service developments and supporting future pandemic preparedness across a range of healthcare contexts and countries seeking to adopt hybrid models of mental health service delivery.

Frontline experiences of delivering remote mental health supports during the COVID-19 pandemic in Scotland: innovations, insights and lessons learned from mental health workers

The COVID-19 pandemic has become the greatest burden of disease worldwide and in Mexico, affecting more vulnerable groups in society, such as people with mental disorders (MD). This research aims to analyze the governance processes in the formulation of healthcare policies for people with MD in the face of the COVID-19 pandemic. An analytical qualitative study, based on semi-structured interviews with key informants in the healthcare system was conducted in 2020. The study followed the theoretical-methodological principles of the Governance Analytical Framework (GAF). The software ATLAS.ti-V.9 was used for inductive thematic analysis, classifying themes and their categories. To ensure the proper interpretation of the data, a process of triangulation among the researchers was carried out. The findings revealed that in Mexico, the federal Secretary of Health issued guidelines for mental healthcare, but there is no defined national policy. Decision-making involved multiple actors, with different strategies and scopes, depending on the type of key-actor and their level of influence. Majority of informants described a problem of implementation in which infection control policies in the psychiatric population were the same as in the general populations which decreased the percentage of access to healthcare during the pandemic, without specific measures to address this vulnerable population. The results suggest that there is a lack of specific policies and measures to address the needs of people with mental disorders during the COVID-19 pandemic in Mexico. It also highlights the importance of considering the role of different actors and their level of influence in the decision-making process.

/pdf/governance-in-mental-healthcare-policies-during-the-covid-19-3iwk784z.pdf

Governance in mental healthcare policies during the COVID-19 pandemic in Mexico

Impact of the COVID-19 pandemic on mental health among women: An editorial

First responders (FRs) are at high risk of being exposed to traumatic events in their occupational roles. Limited evidence-based support has been offered to FRs who have experienced occupational trauma using digital interventions (DIs). OBJECTIVE: To gain evidence from FRs relating to the impact of exposure to occupational trauma and describe the development of and planned protocol for testing an evidence-based, co-created DI called Sentinel to help manage and prevent trauma among FRs. METHODS: In phase 1, we conducted 52 interviews with FRs from fire and emergency, police, and emergency healthcare to explore the needs, views and experiences on using DI to support mental health. During phase 2, we developed the DI (Sentinel) content in consultation with current evidence, policy, theory and FRs experience. In phase 3, we plan to conduct a series of codesign workshops and development sprints to test and refine the DI (Sentinel). In phase 4, we will conduct a mixed methods non-randomized study to determine the feasibility, acceptability, usability and safety of the DI (Sentinel). RESULTS: We expect data to be collected from up to 50 FRs for feasibility testing. We expect to conduct approximately 30 qualitative interviews with FRs who engaged in the Sentinel trial and 20 health and social care professionals who referred FRs to the study. CONCLUSIONS: This study will provide preliminary evidence on the feasibility, acceptability, safety, usability and implementation potential of the DI (Sentinel). The findings will inform the decision to proceed with a powered efficacy trial. 

The development and protocol for testing a co-created digital intervention (Sentinel) to improve mental wellbeing and help manage and prevent trauma in first responders

Abstract Efforts have been made to adapt the delivery of mental health care and support services to the demands of COVID-19. Here we detail the perspectives and experiences of mental health workers (MHWs), in relation to what they found helpful when adapting mental health services during the COVID-19 pandemic and responding to its demands. Individual interviews were conducted with MHWs (n = 30) during the third COVID-19 lockdown. Interviews were audio-recorded, transcribed and managed using NVIVO. Qualitative data was analyzed using an inductive thematic approach. Three themes emphasized the importance of: (1) ‘self-care and peer support (checking in with each other)’, (2) ‘team cohesion and collaboration’ and (3) ‘visible and supportive management and leadership (new ways of working)’. Our findings emphasize the importance of individual, team and systems-based support in helping MHWs maintain their own wellbeing, whilst adapting and responding to the challenges in providing mental health care and support during this pandemic. Guidance and direction from management, with adaptive leadership in providing sustained, efficient, and equitable delivery of mental healthcare, is essential. Our findings support future policy, research and mental health practice developments through sharing important salutogenic lessons learned and transferable insights which may help with preparedness for future pandemics.

/pdf/what-have-we-learned-about-what-works-in-sustaining-mental-3e9aiqs2.pdf

What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response within the NHS Scottish context

This qualitative study explored how financial instability and insecure employment contribute to suicidal thoughts and behaviors among adults living in Scotland. Semi-structured interviews were conducted with 24 individuals who had experienced financial hardship, insecure employment, and suicidality. Reflexive thematic analysis identified key themes, highlighting how financial stressors create a cycle of unmet basic needs, powerlessness, and social isolation, which exacerbates suicidal distress. Workplace conditions including job precarity and lack of support, further intensified these experiences, while protective factors included supportive relationships and proactive help-seeking. A co-creation workshop with participants and stakeholders informed the study's recommendations, emphasizing the urgent need for strengthened employment protections, fair pay, and improved access to mental health services. The findings support emerging research on the role of employment quality in shaping mental health and suicide risk, demonstrating the need for integrated policy responses that address both workplace conditions and broader socio-economic determinants of mental health.

"It feels like the world is falling on your head": Exploring the link between financial instability, employment insecurity, and suicidality.

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What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response within the NHS Scottish context

Frontline experiences of delivering remote mental health supports during the COVID-19 pandemic in Scotland: innovations, insights and lessons learned from mental health workers

"It feels like the world is falling on your head": Exploring the link between financial instability, employment insecurity, and suicidality.