Remote crisis intervention and suicide risk management in COVID-19 frontline healthcare workers

Frontiers in Psychology · 11 authors, 4 centres

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TL;DR

This prospective implementation study evaluated remote, manualized evidence-based crisis intervention and suicide risk management delivered to COVID-19 frontline healthcare workers in Mexico via a free 24-h helpline. Among 51 analyzed cases, 79.4% were rated as much or very much improved post-intervention and emotional distress was significantly reduced (p < 0.001).

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Post-intervention, 79.4% were rated much or very much improved on the CGI-Improvement scale, and emotional distress was significantly reduced (p < 0.001). All manualized techniques were employed in at least one case, with listening and containment used in 90% of cases. Three participants (5.9%) dropped out. Key limitations include the absence of a control group, improvement ratings provided by treating therapists rather than independent raters, and non-anonymous satisfaction measures.

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cohort

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psychiatry

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ORIGINAL PAPER

PMC10645097

Remote crisis intervention and suicide risk management in COVID-19 frontline healthcare workers

Frontiers in Psychology

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ABSTRACT

Introduction Despite the propagation of virtual mental health services for vulnerable groups during COVID-19 pandemic, the implementation and evaluation of remote evidence-based practices (EBP) to manage them in low- and middle-income countries remains scarce. In the current study, we describe and evaluate the implementation process and clinical impact of brief, remote, manualized EBP for crisis intervention and suicide risk management among healthcare workers attending patients with COVID-19 (COVID-19-HCWs) in Mexico. Methods The implementation process comprised community engagement of volunteer mental health specialists, creation of new clinical teams with different disciplines and skills, intervention systematization through manuals and education through 4-h remote training as main strategies. Mexican COVID-19-HCWs who had used a free 24-h helpline rated their pre- and post-intervention emotional distress. Therapists recorded patients’ pre-intervention diagnosis, severity, and suicide risk, the techniques used in each case, and their post-treatment perception of COVID-19-HCWs’ improvement at the end of the intervention. Results All techniques included in the intervention manual were employed at least in one case ( n = 51). At the beginning of the intervention, 65.9% of the COVID-19-HCWs were considered moderately ill or worse according to Clinical Global Impression-Severity (CGI-S) scores, whereas at the end, 79.4% of them were perceived as much or very much improved according to CGI-Improvement scores (CGI-I), and their emotional distress had been significantly reduced ( p < 0.001). Discussion This prospective study provides evidence that implementation of remote EBP is feasible and useful to reduce emotional distress and suicide risk among COVID-19-HCWs from a middle-income country. However, this study was limited by lack of a control group, improvement ratings provided by therapists and non-anonymous satisfaction ratings.

CITATION EXPORT

Rebeca Robles, Sara Infante, Miriam Feria et al.. Remote crisis intervention and suicide risk management in COVID-19 frontline healthcare workers. Frontiers in Psychology. (2023). https://doi.org/10.3389/fpsyg.2023.1253179

AUTHORS

11 · 4 CENTRES

Rebeca Robles, Sara Infante, Miriam Feria, Iván Arango, Elsa Tirado, Andrés Rodríguez-Delgado, Edgar Miranda, Ana Fresán, Claudia Becerra, Raul Escamilla, Eduardo Angel Madrigal de León

1Global Mental Health Research Center, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
2Directorate of Clinical Services, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
3Laboratory of Clinical Epidemiology, Subdirectorate of Clinical Research, Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico
4General Directorate Ramón de la Fuente Muñiz National Institute of Psychiatry, Mexico City, Mexico