Predictors of Post-Traumatic Growth in a Sample of United Kingdom Mental and Community Healthcare Workers during the COVID-19 Pandemic.

Experiences of adversity can generate positive psychological effects alongside negative impacts. Little research to date has evaluated predictors of post-traumatic growth in mental or community healthcare workers during the COVID-19 pandemic. Following a survey of 854 community and mental healthcare staff in the United Kingdom in July to September 2020, multiple linear regression was used to determine the association between hypothesised risk and protective factors (personal, organisational and environmental variables) and total scores on the Post-traumatic Growth Inventory-Short Version. Positive self-reflection activities, black and minority ethnic status, developing new healthcare knowledge and skills, connecting with friends and family, feeling supported by senior management, feeling supported by the UK people, and anxiety about the personal and work-related consequences of COVID-19 each significantly independently predicted greater post-traumatic growth. Working in a clinical role and in mental healthcare or community physical healthcare predicted lower post-traumatic growth. Our research supports the value of taking an organisational growth-focused approach to occupational health during times of adversity, by supporting staff to embrace opportunities for personal growth. Valuing staff's cultural and religious identity and encouraging self-reflective activities, such as mindfulness and meditation, may help to promote post-traumatic growth.

Differences in Remote Mental Healthcare: Minority Ethnic Service User Experiences and Perceptions During COVID-19

AimsCOVID-19 has resurfaced health inequalities but also provides new opportunities for remote healthcare. Minority ethnic service users (SUs) are substantially under-represented in secondary mental health services due to gaps in understanding needs of this priority group. We aimed to assess and identify any differences in characteristics and acceptability, with a focus on minority ethnic mental health SUs.MethodsA prospective, online feedback questionnaire was developed with the help of SUs. This was built into video consultations (VCs), using the secure Attend Anywhere platform through a survey link. We present results between July 2020 and January 2022, during which, a total of 2,565 SUs completed the online questionnaire after VCs. SPSS (version 27) was used for descriptive statistical analysis. Chi-squared test, using 5% level of significance, was conducted to test differences between the two (minority Vs majority ethnic) SU groups.ResultsOf 2,565 SUs, 119 (4.6%) were from minority ethnic groups (Asian British, Mixed/multiple, Black British, and Other), 2,398 (93.5%) were White British, and 48 (1.9%) preferred not to disclose. A higher percentage of SUs were females from both minority (55.6%) and White British (66.1%) ethnic groups (ϰ2=5.476, p < 0.05). By age group, almost half (48.7%) of minority ethnic SUs were less than 25 years old, compared with those from White British ethnicity (29.2%). In contrast, only 2.5% minority ethnic SUs were aged ≥65 years with none ≥80 years old (ϰ2 Likelihood Ratio = 27.11, p < 0.001).No significant differences were found for video technical quality, such as waiting area, joining the video call, sound, and video quality. Similar findings were observed for video care delivery aspects with no significant differences between (minority ethnic and White British) SUs. Overall, both groups felt comfortable during the video call (ϰ2=0.137, p > 0.05), their needs were met (ϰ2=0.384, p > 0.05) and felt supported (ϰ2=0.164, p > 0.05). However, according to care team, a significantly higher percentage of minority ethnic SUs (43%) had remotely consulted Specialist (Eating disorders, Well-being/IAPT) services compared with those of majority ethnicity (29%) (ϰ2 Likelihood Ratio = 21.936, p < 0.05).ConclusionBoth minority ethnic and White British SUs found video care to be acceptable, with positive experiences. A significantly high proportion of minority ethnic SUs was younger and had remotely consulted Specialist services, with none in the 80-plus age group. These findings highlight priority areas to address among this massively underrepresented group in mental healthcare services.

Remotely connected: patient and clinician video care experiences in secondary mental health services during COVID-19, including future preferences

Aims Video-delivered care is a rapidly emerging area with potential to transform assessment and treatment strategies. The coronavirus (COVID-19) pandemic has accelerated these changes. Limited evidence exists for experiences of video care in secondary mental health services. We aimed to assess the acceptability of video care in mental health clinical practice during COVID-19. Method Structured questionnaires were developed with the help of patients and clinicians. The patient experience questionnaire was built into video sessions and completed online, using the Attend Anywhere (AA) platform from July 2020 to March 2021. A Trust-wide clinician views and experiences survey was conducted from July 2020 to October 2020. Descriptive analysis was performed using SPSS (version 27.0). Result Of 1,296 patients who completed the online feedback, the majority provided positive feedback for all aspects of video care. Most patients felt their needs were met (90%) and were supported (93%) during the video call. Positive experiences were informed by clinicians’ communication skills. For future appointments, just over half (51.7%) of patients preferred using video calls, followed by face-to-face (33%). Future video preference was informed by reasons reducing social anxiety and practical aspects such as child/carer needs, physical disability and travel. Of 252 clinicians completing the survey, 161 (64.7%) had used video for remote care delivery. Clinicians also provided positive feedback, with Microsoft-teams as the preferred platform. Most clinicians felt the therapeutic relationship (76.4%) and privacy (78.7%) were maintained using video. While 73% felt there were no safeguarding issues that impacted adversely, 30% felt that care quality was affected, and (69.9%) reported limited visual cues for video calls. Most clinicians (73%) felt confident about clinical decision-making remotely, though there were areas where clinicians felt less confident, such as assessing patients’ appearance and behaviour. Additionally, compared with face-to-face, video consultations seemed to be effective for social anxiety, but less so for Autism spectrum disorders, and with no perceived difference for depression or self harm. For future, more clinicians preferred face-to-face (40.1%) than video care (36.1%). Conclusion Mental health care delivered remotely via video is experienced positively by patients and clinicians alike. However, clinicians felt that quality of care is impacted, and additional remote clinical skills training may be beneficial. Going forward, there is acceptability for the use of video care in routine mental health practice for certain mental health presentations.

Foregrounding the perspectives of mental health services users during the COVID-19 pandemic

PurposeThis paper aims to highlight the critical importance of the perspectives of mental health service-users during the COVID-19 pandemic.Design/methodology/approachThis viewpoint is based on a review of recent research and literature and draws on consultations with experts by experience, including the lead author.FindingsThe authors argue that expertise-by-experience is critical to policy, service development and research;but there is a risk it will be neglected at a time of rapid and reactive clinical development.Research limitations/implicationsUnderstanding and responding to the nuances of individual need can only be achieved through coproducing service strategy design, delivery and research with mental health service users. The consultation outlined in this viewpoint gives some indication of the type of valuable insights that can be gained through seeking and listening to the perspectives of experts by experience.Originality/valueThe discussions revealed that experience of managing severe and complex mental health conditions can actually be advantageous when facing a crisis such as COVID-19.