Research-led frontline mental wellbeing recommendations

An Australian research team has developed a set of recommendations to manage the mental health of frontline medical workers during viral outbreaks, such as the coronavirus (COVID-19) pandemic. Employers can use several practical steps to minimise mental health impacts, according to the researchers. The study analysed staff impacts during SARS, MERS, H1N1, H7N9, Ebola and COVID-19 in a range of countries, including China, Taiwan, Canada, Hong Kong, Saudi Arabia, Greece, Mexico, Germany and Liberia. The set of recommendations includes clear communication, providing training and education, enforcing infection control procedures, ensuring adequate supplies of protective equipment and providing access to psychological interventions.

“The recommendations should be supplemented with simple changes to medical practice,” one of the researchers, Associate Professor Dan Siskind, said. “Implementing screening stations to direct patients to relevant infection treatment clinics, redesigning high-risk procedures and reducing the number of patients in hospital wards will all help to protect the mental health of frontline workers.” The researchers developed the recommendations after analysing 59 international studies on the psychological effects of treating viral outbreaks. Findings revealed that clinicians who were younger, in a junior role, parents of dependent children or had an infected family member were at greater risk of psychological distress. Longer periods of quarantine, lack of practical support and stigma were also negative contributors.

“Although psychological distress is expected when staff are under pressure to look after large numbers of potentially infectious patients, employers can assist by making these recommended changes,” Associate Professor Siskind said. The study’s lead author, Professor Steve Kisely, said supervisors should consider staff needs when assigning duties — especially if staff had been redeployed to meet rising clinical demands — and where possible, make redeployment voluntary. “Staff need regular breaks and appropriate rosters, so they can access food and other daily living supplies, and make video contact with their families to alleviate concerns,” Professor Kisely said. “They may also need alternative accommodation to reduce the risks of infecting their families.”

The full study, titled ‘Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis’, was published open access in the British Medical Journal.

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