What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency?

Sarah E Neil-Sztramko; Emily Belita; Stephanie Hopkins; Diana Sherifali; Laura Anderson; Emma Apatu; Lydia Kapiriri; Jean Eric Tarride; Olivier Bellefleur; Sharon Kaasalainen; Sharon Marr; Maureen Dobbins

doi:10.3389/fpubh.2023.1282296

What are effective strategies to respond to the psychological impacts of working on the frontlines of a public health emergency?

Front Public Health. 2023 Nov 7:11:1282296. doi: 10.3389/fpubh.2023.1282296. eCollection 2023.

Authors

Sarah E Neil-Sztramko^{1

2}, Emily Belita³, Stephanie Hopkins², Diana Sherifali³, Laura Anderson¹, Emma Apatu¹, Lydia Kapiriri⁴, Jean Eric Tarride^{1

5

6}, Olivier Bellefleur⁷, Sharon Kaasalainen³, Sharon Marr⁸, Maureen Dobbins^{2

3}

Affiliations

¹ Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, ON, Canada.
² National Collaborating Centre for Methods and Tools, Hamilton, ON, Canada.
³ School of Nursing, McMaster University, Hamilton, ON, Canada.
⁴ Health, Aging & Society, McMaster University, Hamilton, ON, Canada.
⁵ Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
⁶ Programs for Assessment of Technology in Health, Research Institute of St. Joe's Hamilton, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada.
⁷ National Collaborating Centre for Healthy Public Policy, Montreal, QC, Canada.
⁸ Unity Health, Toronto, ON, Canada.

Abstract

Background: The COVID-19 pandemic has disrupted the healthcare and public health sectors. The impact of working on the frontlines as a healthcare or public health professional has been well documented. Healthcare organizations must support the psychological and mental health of those responding to future public health emergencies.

Objective: This systematic review aims to identify effective interventions to support healthcare workers' mental health and wellbeing during and following a public health emergency.

Methods: Eight scientific databases were searched from inception to 1 November 2022. Studies that described strategies to address the psychological impacts experienced by those responding to a public health emergency (i.e., a pandemic, epidemic, natural disaster, or mass casualty event) were eligible for inclusion. No limitations were placed based on study design, language, publication status, or publication date. Two reviewers independently screened studies, extracted data, and assessed methodological quality using the Joanna Briggs Institute critical appraisal tools. Discrepancies were resolved through discussion and a third reviewer when needed. Results were synthesized narratively due to the heterogeneity of populations and interventions. Outcomes were displayed graphically using harvest plots.

Results: A total of 20,018 records were screened, with 36 unique studies included in the review, 15 randomized controlled trials, and 21 quasi-experimental studies. Results indicate that psychotherapy, psychoeducation, and mind-body interventions may reduce symptoms of anxiety, burnout, depression, and Post Traumatic Stress Disorder, with the lowest risk of bias found among psychotherapy interventions. Psychoeducation appears most promising to increase resilience, with mind-body interventions having the most substantial evidence for increases in quality of life. Few organizational interventions were identified, with highly heterogeneous components.

Conclusion: Promoting healthcare workers' mental health is essential at an individual and health system level. This review identifies several promising practices that could be used to support healthcare workers at risk of adverse mental health outcomes as they respond to future public health emergencies.Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=203810, identifier #CRD42020203810 (PROSPERO).

Keywords: COVID-19; education/awareness and skill development/training; healthcare workers; mental health; prevention; public health emergency.

Publication types

Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Emergencies
Health Personnel / psychology
Humans
Pandemics
Public Health*
Quality of Life*

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This scoping review was funded by the Public Health Agency of Canada, as part of the work of the National Collaborating Centre for Method and Tools (NCCMT). The views expressed herein do not necessarily represent the views of the Public Health Agency of Canada.