Periodic Reporting for period 3 - RESPOND (Improving the Preparedness of Health Systems to Reduce Mental Health and Psychosocial Concerns resulting from the COVID-19 Pandemic)
Berichtszeitraum: 2022-12-01 bis 2024-05-31
The COVID-19 pandemic has importantly affected mental health and wellbeing of European citizens during the past four years. The mission of RESPOND was: 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 was 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 were:
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.
RESPOND was 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 were:
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.
In sum, after conducting scientific research across seven work packages in the period between December 2020 to June 2024, RESPOND has generated results across a variety of domains that address the objectives above.
Across studies and meta-analyses focused on the mental health consequences of the pandemic by RESPOND partners, a small but significant increase in self-reported mental health problems since the pandemic started have been reported. In addition to the known risk group of women, other risk groups for adverse mental health consequences during the pandemic were younger people, and people with a refugee or migrant background. People with pre-existing mental disorders did not present an increased risk, and suicide rates in Sweden did not increase. However, they were at a higher risk for COVID-19 related mortality in Spain. Men with mental health difficulties, particularly those with lower educational levels reported lower levels of adherence to the COVID-19 public health measures.
RESPOND partners implemented a two-step intervention based on World Health Organization (WHO)-developed strategies adapted for remote delivery to health and care workers and refugee and migrant populations with increased levels of distress: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+).
Results among healthcare workers with increased levels of distress in Spain, showed significant reductions in symptoms of anxiety, depression, and posttraumatic stress disorder. Further, results in people with a refugee or migrant background from Italy showed that the stepped-care DWM/PM+ program effectively reduced anxiety and depression symptoms in participants compared to the control group. Preliminary positive findings for the stepped-care DWM/PM+ program were also found for people with unstable housing in France, and Polish labour migrants in the Netherlands. In Belgium, a qualitative study among health workers in nursing homes for older people showed that participants in the DWM/ PM+ reported positive implementation outcomes in terms of appropriateness of the intervention. However, several organisational barriers that were identified, highlighted the need for strategies to improve program accessibility, acceptability, and feasibility for healthcare workers in crisis contexts.
This demonstrates the effectiveness of brief stepped-care psychological interventions in mitigating psychological distress during periods of crisis such as the COVID-19 pandemic, including health care workers and refugee and migrant populations.
Across studies and meta-analyses focused on the mental health consequences of the pandemic by RESPOND partners, a small but significant increase in self-reported mental health problems since the pandemic started have been reported. In addition to the known risk group of women, other risk groups for adverse mental health consequences during the pandemic were younger people, and people with a refugee or migrant background. People with pre-existing mental disorders did not present an increased risk, and suicide rates in Sweden did not increase. However, they were at a higher risk for COVID-19 related mortality in Spain. Men with mental health difficulties, particularly those with lower educational levels reported lower levels of adherence to the COVID-19 public health measures.
RESPOND partners implemented a two-step intervention based on World Health Organization (WHO)-developed strategies adapted for remote delivery to health and care workers and refugee and migrant populations with increased levels of distress: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+).
Results among healthcare workers with increased levels of distress in Spain, showed significant reductions in symptoms of anxiety, depression, and posttraumatic stress disorder. Further, results in people with a refugee or migrant background from Italy showed that the stepped-care DWM/PM+ program effectively reduced anxiety and depression symptoms in participants compared to the control group. Preliminary positive findings for the stepped-care DWM/PM+ program were also found for people with unstable housing in France, and Polish labour migrants in the Netherlands. In Belgium, a qualitative study among health workers in nursing homes for older people showed that participants in the DWM/ PM+ reported positive implementation outcomes in terms of appropriateness of the intervention. However, several organisational barriers that were identified, highlighted the need for strategies to improve program accessibility, acceptability, and feasibility for healthcare workers in crisis contexts.
This demonstrates the effectiveness of brief stepped-care psychological interventions in mitigating psychological distress during periods of crisis such as the COVID-19 pandemic, including health care workers and refugee and migrant populations.
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 (and have already led 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.
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.