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Improving the Preparedness of Health Systems to Reduce Mental Health and Psychosocial Concerns resulting from the COVID-19 Pandemic

Periodic Reporting for period 2 - RESPOND (Improving the Preparedness of Health Systems to Reduce Mental Health and Psychosocial Concerns resulting from the COVID-19 Pandemic)

Reporting period: 2021-12-01 to 2022-11-30

The COVID-19 pandemic has importantly affected mental health and wellbeing of European citizens during the past two years. The mission of RESPOND is: 1) to identify critical resilience factors and specific vulnerable groups at risk of immediate and long-term adverse mental health impact of the COVID-19 pandemic; 2) To improve the resilience, wellbeing and mental health of frontline health and care workers and other vulnerable groups by implementing scalable World Health Organization (WHO) programmes, and 3) to steer future policy decisions by understanding and disentangling the effects of the COVID-19 pandemic and different public health containment and subsequently relaxation strategies on mental health and wellbeing in vulnerable groups across Europe’s different health systems.
RESPOND is centred around core questions regarding the short and long-term impacts of the pandemic on mental health and health inequalities on vulnerable groups within the general population, including frontline workers.
The objectives of RESPOND are:
1) Identifying groups that are at risk of poor mental health and wellbeing related to the COVID-19 pandemic and epidemic control decisions and identifying factors that influence resilience.
2) Examining and comparing individuals’ use of long-term health and mental health services across different European countries, such as Sweden, Italy, and Spain, which all have different approaches to controlling the pandemic.
3) Performing rapid and recurring holistic assessments of COVID-19 related policies and measures across Europe with the goal of protecting health workers and other groups at high risk for pandemic-related distress.
4) Examining the necessary conditions for successful implementation and expansion of remote-delivered stepped care using existing, scalable WHO programmes to benefit health workers and other groups at high risk for pandemic-related distress.
5) Providing regional and national health care authorities with transferable evidence-based practices, methodologies, and guidance in order to expand support measures for health workers and other groups at high risk for pandemic-related distress.
During the current reporting period, RESPOND has made significant progress. Partners in WP2 have continued to conduct data analyses on European and international longitudinal datasets and health registries. Risk and resilience factors for COVID-19-related mental health problems and wellbeing have been identified, leading to policy recommendations. Further, a large individual patient dataset combining longitudinal surveys of mental health and associated problems during the pandemic has been constructed with joint effort from RESPOND partners. In addition, the studies using health register data in Sweden, Italy and Spain have been initiated, with the first analyses being done.
Partners in WP3 continued with doing rapid, ongoing analyses of the response of mental health systems to the COVID-19 pandemic across all partner countries. Interviews have investigated the salience of mental health issues, the beliefs held by stakeholders, and describe how and when their interactions have affected the way mental health and wellbeing issues were considered during the COVID pandemic. They have also developed a survey tool to be administered to the general public and among specific stakeholders, using discrete choice options to investigate how decisions are balanced between population mental health and controlling the pandemic. Finally, WP3 has developed a mental health impact assessment framework to examine the impacts of COVID-19 in terms of mental health, either in exacerbating existing risks to the determinants of mental health, as well as documenting impacts that have arisen solely to conditions seen in the pandemic.
WP4 has finalized the inclusion of the randomized clinical trial (RCT) on implementation of the WHO stepped-care scalable programmes (Doing What Matters in Times of Stress and Problem Management Plus) for health workers in Spain. A total number of 232 health workers from Madrid and Barcelona were recruited and randomized across the stepped-care programme + care-as-usual (n=115) or care-as-usual only (n=117). The findings have been submitted for publication. The qualitative research project in Belgium, among workers in long-term care facilities, is ongoing.
In WP5, recruitment of refugees, migrants and labour migrants in Italy, the Netherlands, and France has successfully commenced during the current reporting period, and will be finalized during the next reporting period. Some delay is expected, due to new peaks of the pandemic, and associated lockdown measures.
In WP6, two policy briefs have been published during the current reporting period. These were disseminated widely to policymakers, as well as the general public, along with the third version of the rapid appraisal report and the report on strategies that stakeholders are prioritising from WP3. Multiple scientific articles were also published and disseminated. The End-User Group and Project Advisory Board have provided advice on the policy briefs and the other RESPOND deliverables. Further, partners have disseminated the results of RESPOND to policymakers, and scientific audiences, in order to inform policy and future research on the mental health effects of the pandemic.
The findings from RESPOND are expected to help policymakers to make informed decisions regarding the impact of emergency responses on population wellbeing, mental health, and the economy. The multi-country comparisons on how outbreak responses have impacted the health system and resilience in vulnerable groups will lead to best practices that are transferable between EU countries.
Evidence generated from the implementation of the WHO stepped-care programmes (DWM and PM+) will help facilitate bringing these programmes to scale in future pandemics and other emergencies. The programmes are expected to have an effect on mental health service delivery and to improve access to effective mental healthcare for vulnerable groups.
At this stage, the work carried out in RESPOND has already contributed towards adapting DWM and PM+ to the context of the war in Ukraine. DWM is now available in Ukrainian in an easily accessible format.
In a broad sense, we expect RESPOND to help narrow the mental health treatment gap by providing effective solutions to improve levels of health and wellbeing in the general population and among vulnerable groups in particular.
RESPOND Implementation Across Europe