COVID-19: Addressing the Urgent Mental Health Needs of Frontline Workers

COVID-19: Addressing the Urgent Mental Health Needs of Frontline Workers
Jorge E. Palacios, MD, Ph.D. – Senior Digital Health Scientist at SilverCloud Health

It is no secret that one by-product of the ongoing pandemic is an exacerbation of the country’s mental health crisis. According to research from Johns Hopkins, one in four Americans experience a mental health disorder in a typical year. Yet among adults in the U.S. rates of depression have steadily climbed from 8.5% before the pandemic to an alarming 32.8% in October of 2021, according to research published in The Lancet Regional Health—Americas.  

While it is vital that health systems rush to meet this increased demand for patients, it is equally as important that these same providers protect the well-being of their own workforce.

One meta-analysis on the global impact of the pandemic on the mental health of healthcare professionals found nurses and frontline workers to have significant risk factors. Anxiety, depression, and stress/PTSD were found to be the most common mental health issues facing healthcare professionals. And as evidenced by the Great Resignation, a survey by KLAS Research of 59,000 clinicians found burnout to be the number one reason a clinician would want to leave his or her job.

Armed with this awareness, there are concrete steps that health systems can take to address these issues and better serve frontline workers. OSF HealthCare, an integrated health system owned and operated by The Sisters of the Third Order of St. Francis, was able to implement changes to better support the mental and behavioral health needs of its employees through four simple tactics. 

Identify Needs & Establish Program Goals

At the onset of the pandemic, OSF HealthCare recognized the need to expand its existing patient-focused mental health care program to include its frontline employees. Challenges they identified included lack of access to mental health providers, transportation issues and stigma around seeking mental health help. In implementing their program, OSF laid out the following goals: 

1. Increase the number of employees utilizing mental health services

2. Obtain clinically significant improvement for employees in baseline severity for both anxiety and depression

3. Reduce the stigma of mental health services amongst employees and determine participant satisfaction with the program

Offer an Accessible Mental Health Solution to Employees

In addition to the surging demand for mental health services, other challenges associated with providing mental health care include barriers such as a lack of privacy, stigma surrounding needing mental health support, and long wait times. Selecting a digital platform enables providers to forgo each of these barriers, giving employees on-demand access to resources in the privacy of an app on their mobile, tablet, or computer. 

OSF HealthCare partnered with a digital mental health platform and made its programs available to employees. In addition to providing employees with immediate access to resources for sleep, resilience, and stress, they also developed a clinically validated Space from COVID-19 program, a positive mental health program designed for people impacted by COVID-19.  Space from COVID-19 includes a “Challenging Times” module to support mental health in response to issues directly related to the pandemic. 

Increase Awareness Among Employees

To increase awareness of the resources available to employees and reduce the stigma around seeking help for mental health issues, OSF developed a digital campaign that included targeted ads on Facebook. The messages included in the ads reassured individuals that they are not alone in their struggles and that support is available to them.

Measure Results & Impact

The success of an employee mental health program should be grounded in measurable goals to assess return on investment. OSF observed the following results: 

– Increase in the number of employees utilizing mental health services – From March through May 2020, when lockdowns related to the pandemic’s first wave were in full effect, OSF Healthcare saw a 300% increase in enrollments on the digital health platform, designed to address mental health challenges related to the pandemic.  

– Obtained clinically significant improvement for employees in each category of baseline severity – Using the digital mental health platform, OSF employees saw clinically significant improvements: 64% of users with moderate depression symptoms saw clinically significant reductions of three points or more on the Patient Health Questionnaire (PHQ9) or the Generalized Anxiety Disorder Assessment (GAD7); 59% of users experiencing moderate anxiety symptoms saw clinically significant reductions of three points or more on PHQ9 or GAD7; 55% of users experiencing severe anxiety symptoms saw clinically significant reductions of three points or more on PHQ9 or GAD7. 

– Reduced the stigma of mental health support amongst employees and determine participant satisfaction with the program: individuals across all levels of symptom severity typically spent between one and three hours interacting with the platform’s content, and participants reported an overall satisfaction rate of 97%. 

An important way to frame the success of an employee mental health program is by measuring overall engagement and clinical outcomes. Health systems should ask questions like: Do your employees feel better after using the platform? Did your employees learn new coping skills? Do your employees understand the tools available to them for self-management?  In the case of OSF’s campaign, they measured successful engagement in terms of both time spent and overall participant satisfaction while also observing clinically improved outcomes in employees. 

As the pandemic has highlighted, frontline workers are the backbone of a country in crisis. Looking ahead it will be imperative that health systems and providers take proactive measures to protect, support and promote the mental well-being of their employees. Digital mental health platforms offer one such solution to prevent burnout, reduce stigma and support the mental and behavioral health needs of those whose job it is to care for others. 


About Jorge Palacios, MD, PhD

Jorge Palacios, MD, Ph.D. is a Senior Digital Health Scientist at SilverCloud Health, a global provider of evidence-based wellbeing and behavioral health solutions, delivered digitally and at scale.