Plan A, Plan B, and Plan C-OVID-19: adaptations for fly-in and fly-out mental health providers during COVID-19.

Mental health providers have rapidly pivoted their in-person practices to teletherapy and telehealth interventions to address the increased demand for mental health services during the COVID-19 crisis. The change to service delivery has emphasised challenges for mental health service providers, particularly in regions that rely on fly-in and fly-out (FIFO) mental health service providers who are no longer able to travel to their places of work. In this qualitative study, we examined the impact of COVID-19 on the delivery of mental health services in Inuit Nunangat. Using a participatory action research methodology, we conducted semi-structured interviews with eight FIFO mental health service providers to understand their experiences and implement strategies to effectively deliver mental health services in a pandemic. We identified three themes through thematic analysis: 1) Service providers identify the challenges in adapting their practices to meet individual and community needs; 2) Service providers recognise the opportunities for enhancements to service delivery; 3) Service providers identify telemental health services as a potentially effective adjunct to in-person sessions. The findings support reconceptualising post-pandemic mental health service delivery to include both face-to-face and telemental health services.

Supporting survivors of campus dating and sexual violence during COVID-19: A social work perspective.

The issue of dating and sexual violence (DSV) on college campuses has received increased attention nationwide as a criminal justice and public health issue. College and university employed social workers play a critical role in preventing and responding to campus DSV through direct clinical services to students as well as prevention through educational programming and training. COVID-19 has negative implications for DSV student victims, as well as service delivery and accessibility. This paper examines the innovative methods used by university employed social work clinicians and educators to meet evolving mental health care needs and continue violence prevention services during COVID-19.

Communication and Cooperation Between the Medical Academy, Medical Association, and Local Government: Health Counseling Program After Recovery From Coronavirus Disease 2019 (COVID-19) in Daegu.

We are currently experiencing the disaster of the COVID-19 pandemic. Since the first case of Coronavirus disease 2019 (COVID-19) was confirmed in South Korea on January 20, the number of COVID-19 cases in South Korea has been rapidly increasing until early March due to a local spread in Daegu, which is one of the eight metropolitan cities in South Korea with a population of 2.5 million. As the medical academy has social accountability as professionals, Daegu-Gyeongbuk branch of the Korean Academy of Family Medicine (Daegu-Gyeongbuk branch) developed the health counseling program for discharged COVID-19 patients. The Daegu-Gyeongbuk branch communicated with Daegu Medical Association and Daegu city for this program and incorporated available resources and capabilities as a leader of this program. This newly developed counseling program consists of medical consultations, sending healthcare brochures and medical supplies, and the appraisal at the end of the program. Not only COVID-19 related symptoms but also other psychological problems are also dealt with during consultations. This program started on March 18, and over 1,700 recovered patients have been receiving counseling as of April 28. Communication and cooperation between the medical academy, medical association, and government are essential to overcome the COVID-19 pandemic. Besides, we expect to apply this health counseling program and our model of setting this program cooperating with medical association and government to different infectious pandemic crisis.

Rapid Scaling Up of Telehealth Treatment for Tobacco-Dependent Cancer Patients During the COVID-19 Outbreak in New York City.

Background: The (COVID-19) pandemic resulted in sudden disruption of routine clinical care necessitating rapid transformation to maintain clinical care while safely reducing virus contagion. Introduction: Memorial Sloan Kettering (MSK) experienced a rapid evolution from delivery of in-person cessation counseling services to virtual telehealth treatments for our tobacco-dependent cancer patients. Aim: To examine the effect of rapid scaling of tobacco treatment telehealth on patient engagement, as measured by attendance rates for in-person counseling visits versus remote telehealth counseling visits. We also describe the patient, clinician, and health care system challenges encountered in rapid expansion of individual and group tobacco telehealth services. Methods: Data collected from the electronic medical record during the first 4 months of the COVID-19 pandemic were examined for tobacco treatment counseling. Results: From January 1, 2020 to March 30, 2020, markedly improved patient engagement was observed in ambulatory tobacco treatment services with greater attendance at scheduled telehealth visits than in-person visits, 75% versus 60.3%, odds ratio 1.84 (confidence interval: 1.26-2.71; p < 0.001). In addition, bedside hospital counseling visits were transformed into inpatient telephone visits with high levels of sustained patient engagement. Lastly, group telehealth services were launched rapidly to increase capacity and provide greater psychosocial support for cancer patients struggling with tobacco dependence. Discussion: Clinical, Information Technology (IT), and hospital system barriers were successfully addressed for most cancer patients seeking individual telehealth treatment. Group telehealth services were found to be feasible and acceptable. Conclusions: MSK's rapid leap into virtual care delivery mitigated disruption of tobacco treatment services and demonstrated strong feasibility and acceptance for managing complex tobacco-dependent patients.

Dealing with Community Mental Health post the Fukushima disaster: lessons learnt for the COVID-19 pandemic.

Under the COVID-19 pandemic, mitigation of psychological distress is required. At present, the demand for remote intervention for the numerous affected people is increasing, and telephonic support can be useful. Since the Fukushima nuclear disaster in 2011, we have been developing a large-scale telephonic support system and implementing brief interventions for the Fukushima people identified at risk of psychological problems such as depression and post-traumatic stress disorder. In this article, we report the lessons from the Fukushima disaster that can be applied to the COVID-19 pandemic and describe how the telephonic intervention facilitates easier access to psychological help for people with a broad range of psychological distress who are not able to visit treatment or care resources. In our telephonic intervention, we first sent a mental health and lifestyle survey to the people affected by the Fukushima disaster. The counselor team then provided telephonic intervention to high-risk persons as identified on the basis of the survey results. The individuals had expected to receive from the telephonic system help mainly in the form of stress-coping methods, social resource information such as schools, public offices or medical facilities, and lifestyle advice. Since we also experienced that psychological care for telephone counselors was necessary to mitigate the substantial emotional burden, we used the following three approaches: (i) regular supervision of the telephone counseling methods, (ii) seminars for improvement of counseling skills and (iii) individual psychological support. The positive loops between counselors and consulters will help advance a society affected by a disaster.

[Measures to contain gender-based violence during the COVID-19 pandemic]. / Medidas de contención de la violencia de género durante la pandemia de COVID-19.

Crises, emergencies and times of unrest have been linked to increased interpersonal violence, including violence against women. Following the declaration of alarm status and quarantine, different measures have been implemented to mitigate the possible effect of gender violence (Contingency Plan against Gender-Based Violence in Coronavirus Crisis or Royal Decree Law on Emergency Measures). This document reviews the measures adopted so far by the government of Spain, the autonomous governments and the initiatives formulated in different countries. In the absence of concrete economic measures to date, and the scenario of economic uncertainty, we conclude that it is not possible to prevent gender-based violence in a comprehensive way, without considering the increase in unemployment, temporary and instability employment, economic dependency or the overload of household chores and reproductive tasks, among other elements that facilitate it.

The Balanced Opioid Initiative: protocol for a clustered, sequential, multiple-assignment randomized trial to construct an adaptive implementation strategy to improve guideline-concordant opioid prescribing in primary care.

BACKGROUND: Rates of opioid prescribing tripled in the USA between 1999 and 2015 and were associated with significant increases in opioid misuse and overdose death. Roughly half of all opioids are prescribed in primary care. Although clinical guidelines describe recommended opioid prescribing practices, implementing these guidelines in a way that balances safety and effectiveness vs. risk remains a challenge. The literature offers little help about which implementation strategies work best in different clinical settings or how strategies could be tailored to optimize their effectiveness in different contexts. Systems consultation consists of (1) educational/engagement meetings with audit and feedback reports, (2) practice facilitation, and (3) prescriber peer consulting. The study is designed to discover the most cost-effective sequence and combination of strategies for improving opioid prescribing practices in diverse primary care clinics. METHODS/DESIGN: The study is a hybrid type 3 clustered, sequential, multiple-assignment randomized trial (SMART) that randomizes clinics from two health systems at two points, months 3 and 9, of a 21-month intervention. Clinics are provided one of four sequences of implementation strategies: a condition consisting of educational/engagement meetings and audit and feedback alone (EM/AF), EM/AF plus practice facilitation (PF), EM/AF + prescriber peer consulting (PPC), and EM/AF + PF + PPC. The study's primary outcome is morphine-milligram equivalent (MME) dose by prescribing clinicians within clinics. The study's primary aim is the comparison of EM/AF + PF + PPC versus EM/AF alone on change in MME from month 3 to month 21. The secondary aim is to derive cost estimates for each of the four sequences and compare them. The exploratory aim is to examine four tailoring variables that can be used to construct an adaptive implementation strategy to meet the needs of different primary care clinics. DISCUSSION: Systems consultation is a practical blend of implementation strategies used in this case to improve opioid prescribing practices in primary care. The blend offers a range of strategies in sequences from minimally to substantially intensive. The results of this study promise to help us understand how to cost effectively improve the implementation of evidence-based practices. TRIAL REGISTRATION: NCT04044521 (ClinicalTrials.gov). Registered 05 August 2019.