The Schwartz Centre Rounds: Supporting mental health workers with the emotional impact of their work

The burden of the COVID-19 pandemic on health systems and the physical and mental health of healthcare workers (HCWs) has been substantial. This cross-sectional study aims to assess the effects of COVID-19 on the psychological wellbeing of mental health workers who provide care to a vulnerable patient population that have been particularly affected during this crisis. A total of 387 HCWs from across a large urban mental health service completed a self-administered questionnaire consisting of socio-demographic, lifestyle and work-based information and validated psychometric scales. Depression and anxiety were measured using the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7), respectively; sleep problems with the Athens Insomnia Scale (AIS); burnout with the Maslach Burnout Inventory (MBI); and resilience with the Resilience Scale-14 (RS-14). Multivariable logistic regression analysis was performed to determine potential mediating factors. Prevalence of burnout was notable, with 52% recording moderate/severe in Emotional Exhaustion, 19.5% moderate/severe in Depersonalisation, and 55.5% low/moderate Personal Accomplishment. Over half of all respondents (52%) experienced sleep problems; the presence of depressive symptoms was a significant predictor of insomnia. An increase in potentially harmful lifestyle changes, such as smoking, alcohol consumption and overeating was also observed. However, high Resilience was reported by 70% of the samples and the importance of this is highlighted. Female gender was associated with increased levels of depression and emotional exhaustion while those with a history of mental health conditions were most at risk of affective symptoms, insomnia, and burnout. Overall, our study revealed considerable levels of psychological distress and maladaptive coping strategies but also resilience and satisfaction with organizational support provided. Findings can inform tailored interventions in order to mitigate vulnerability and prevent long-term psychological sequelae.

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Clinical effectiveness and cost effectiveness of individual mental health workers colocated within primary care practices: a systematic literature review

BMJ Open ◽

10.1136/bmjopen-2020-042052 ◽

2020 ◽

Vol 10 (12) ◽

pp. e042052

Author(s):

Jean-Baptiste Woods ◽

Geva Greenfield ◽

Azeem Majeed ◽

Benedict Hayhoe

Keyword(s):

Mental Health ◽

Primary Care ◽

Cost Effectiveness ◽

Health Worker ◽

Health Workers ◽

Risk Of Bias ◽

Mental Health Workers ◽

Mental Health Worker ◽

Care Practices ◽

Primary Care Practices

ObjectivesMental health disorders contribute significantly to the global burden of disease and lead to extensive strain on health systems. The integration of mental health workers into primary care has been proposed as one possible solution, but evidence of clinical and cost effectiveness of this approach is unclear. We reviewed the clinical and cost effectiveness of mental health workers colocated within primary care practices.DesignSystematic literature review.Data sourcesWe searched the Medline, Embase, PsycINFO, Healthcare Management Information Consortium (HMIC) and Global Health databases.Eligibility criteriaAll quantitative studies published before July 2019 were eligible for the review; participants of any age and gender were included. Studies did not need to report a certain outcome measure or comparator in order to be eligible.Data extraction and synthesisData were extracted using a standardised table; however, pooled analysis proved unfeasible. Studies were assessed for risk of bias using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool and the Cochrane collaboration’s tool for assessing risk of bias in randomised trials.ResultsFifteen studies from four countries were included. Mental health worker integration was associated with mental health benefits to varied populations, including minority groups and those with comorbid chronic diseases. Furthermore, the interventions were correlated with high patient satisfaction and increases in specialist mental health referrals among minority populations. However, there was insufficient evidence to suggest clinical outcomes were significantly different from usual general practitioner care.ConclusionsWhile there appear to be some benefits associated with mental health worker integration in primary care practices, we found insufficient evidence to conclude that an onsite primary care mental health worker is significantly more clinically or cost effective when compared with usual general practitioner care. There should therefore be an increased emphasis on generating new evidence from clinical trials to better understand the benefits and effectiveness of mental health workers colocated within primary care practices.

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Measures and narratives of the nature, causes and consequences of violent assaults and risk perception of psychiatric hospitals in Ghana: Mental Health workers’ perspectives

International Journal of Mental Health Nursing ◽

10.1111/inm.12878 ◽

2021 ◽

Author(s):

Roger A. Atinga ◽

Lily Yarney ◽

Kingsley Saa‐Touh Mort ◽

Joshua A. Gariba ◽

Joana Salifu Yendork

Keyword(s):

Mental Health ◽

Risk Perception ◽

Health Workers ◽

Psychiatric Hospitals ◽

Mental Health Workers

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Mental health workers' experiences of support and help‐seeking following workplace violence: A qualitative study

Nursing and Health Sciences ◽

10.1111/nhs.12816 ◽

2021 ◽

Author(s):

Nicole C. Rodrigues ◽

Elke Ham ◽

Bonnie Kirsh ◽

Michael C. Seto ◽

N. Zoe Hilton

Keyword(s):

Mental Health ◽

Qualitative Study ◽

Workplace Violence ◽

Help Seeking ◽

Health Workers ◽

Mental Health Workers

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Vicarious trauma: Strategies for legal practice and law schools

Alternative Law Journal ◽

10.1177/1037969x21999850 ◽

2021 ◽

pp. 1037969X2199985

Author(s):

Kelley Burton ◽

Amanda Paton

Keyword(s):

Mental Health ◽

Vicarious Trauma ◽

Health Workers ◽

Mental Health Workers ◽

Future Research ◽

First Year ◽

Helping Professionals ◽

Legal Practice ◽

Law Schools ◽

Individual Level

We examine the effect of vicarious trauma on various stakeholders in the legal profession. Criminal lawyers are likely to experience higher levels of vicarious trauma than other lawyers. Additionally, lawyers are at a heightened risk of vicarious trauma compared to other helping professionals such as mental health workers. We identify a range of strategies that can be implemented at an organisational or individual level to address vicarious trauma. Future research should evaluate the effectiveness of vicarious trauma strategies and initiatives. Importantly, we argue that vicarious trauma initiatives should begin in first-year law courses and continue over a career.

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