TY - JOUR
T1 - Effectiveness of a mental health stepped-care programme for healthcare workers with psychological distress in crisis settings
T2 - a multicentre randomised controlled trial
AU - RESPOND Consortium
AU - Mediavilla, Roberto
AU - Felez-Nobrega, Mireia
AU - McGreevy, Kerry R.
AU - Monistrol-Mula, Anna
AU - Bravo-Ortiz, María Fe
AU - Bayón, Carmen
AU - Giné-Vázquez, Iago
AU - Villaescusa, Rut
AU - Muñoz-Sanjosé, Ainoa
AU - Aguilar-Ortiz, Salvatore
AU - Figueiredo, Natasha
AU - Nicaise, Pablo
AU - Park, A. La
AU - Petri-Romão, Papoula
AU - Purgato, Marianna
AU - Witteveen, Anke B.
AU - Underhill, James
AU - Barbui, Corrado
AU - Bryant, Richard
AU - Kalisch, Raffael
AU - Lorant, Vincent
AU - McDaid, David
AU - Melchior, Maria
AU - Sijbrandij, Marit
AU - Haro, Josep Maria
AU - Ayuso-Mateos, Jose Luis
N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - BACKGROUND: Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. OBJECTIVE: To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. METHODS: We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. FINDINGS: Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. CONCLUSIONS: Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS: Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER: NCT04980326.
AB - BACKGROUND: Evidence-based mental health interventions to support healthcare workers (HCWs) in crisis settings are scarce. OBJECTIVE: To evaluate the capacity of a mental health intervention in reducing anxiety and depression symptoms in HCWs, relative to enhanced care as usual (eCAU), amidst the COVID-19 pandemic. METHODS: We conducted an analyst-blind, parallel, multicentre, randomised controlled trial. We recruited HCWs with psychological distress from Madrid and Catalonia (Spain). The intervention arm received a stepped-care programme consisting of two WHO-developed interventions adapted for HCWs: Doing What Matters in Times of Stress (DWM) and Problem Management Plus (PM+). Each intervention lasted 5 weeks and was delivered remotely by non-specialist mental health providers. HCWs reporting psychological distress after DWM completion were invited to continue to PM+. The primary endpoint was self-reported anxiety/depression symptoms (Patient Health Questionnaire-Anxiety and Depression Scale) at week 21. FINDINGS: Between 3 November 2021 and 31 March 2022, 115 participants were randomised to stepped care and 117 to eCAU (86% women, mean age 37.5). The intervention showed a greater decrease in anxiety/depression symptoms compared with eCAU at the primary endpoint (baseline-adjusted difference 4.4, 95% CI 2.1 to 6.7; standardised effect size 0.8, 95% CI 0.4 to 1.2). No serious adverse events occurred. CONCLUSIONS: Brief stepped-care psychological interventions reduce anxiety and depression during a period of stress among HCWs. CLINICAL IMPLICATIONS: Our results can inform policies and actions to protect the mental health of HCWs during major health crises and are potentially rapidly replicable in other settings where workers are affected by global emergencies. TRIAL REGISTRATION NUMBER: NCT04980326.
KW - COVID-19
KW - adult psychiatry
KW - anxiety disorders
KW - depression & mood disorders
UR - http://www.scopus.com/inward/record.url?scp=85168614984&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85168614984&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/bmjment-2023-300697
DO - https://doi.org/10.1136/bmjment-2023-300697
M3 - Article
C2 - 37263708
SN - 2755-9734
VL - 26
SP - 1
EP - 8
JO - BMJ Mental Health
JF - BMJ Mental Health
IS - 1
M1 - e300697
ER -