To cite: Rubinstein, T. B., Breslow, A. S., Zayde, A., Ding, O., Alpert, J. E., & Gabbay, V. (2023). Psychological impact of the COVID-19 pandemic on healthcare worker parents. Journal of Psychosomatic Research, 170, 111359. https://doi.org/10.1016/j.jpsychores.2023.111359

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Abstract

Context: During the COVID-19 pandemic, frontline workers have experienced high levels of stress and anxiety. Montefiore Medical Center recognized the urgent need for mental health support to mitigate and treat psychological distress among staff. Various mental health support services were implemented. This report provides an overview of the interventions implemented at Montefiore and provides preliminary insights on the utilization and value of these ongoing services.

Outcomes: The interventions instituted at Montefiore included psychoeducational resources, a phone support line, Staff Support Centers (SSCs), a clinical treatment program, team support sessions, peer support outreach, mental health and wellness programs, and clergy support. The most heavily used service during the pandemic were the SSCs, and the least used service was the clergy support.

Insights: With institutional encouragement and the collective efforts of more than 150 mental health professionals and other staff, it was possible to set up durable mental health supports with multiple points of access. Although many services were available to both clinical and nonclinical staff, outreach was primarily to clinical staff. Additional efforts in the future are needed to more fully reach nonclinical frontline workers.

Next Steps: The organization's next steps include evaluation of emotional health and distress among clinical and nonclinical staff using validated self-report measures administered over multiple time intervals. Lessons learned about staff support during COVID-19 will also be integrated into future efforts to support staff well-being more broadly.

Research on prior disease outbreaks has demonstrated major impacts on the mental health of frontline health care workers. During the COVID-19 pandemic, preliminary studies revealed that a significant proportion of health care professionals, particularly at the epicenters, were experiencing unprecedented levels of anxiety, insomnia, depression, and distress.1.,2. Montefiore Medical Center (MMC), located in the Bronx, the borough hardest hit in New York City (NYC),3. implemented various mental health services to support the emotional needs of staff. Preliminary insights were gained on the acceptability and utility of each type of support.

Montefiore Health System (MHS) is a multisite complex health care system located in NYC and surrounding counties, serving a diverse patient population—including communities disproportionately affected by COVID-19. In addition to a robust ambulatory care network, MHS has 2,977 inpatient acute care beds and 150 skilled nursing beds. MMC is the tertiary care academic component of MHS and includes 1,558 licensed beds, of which 136 comprise the Children's Hospital at Montefiore (CHAM). MMC includes three legacy campuses—Moses, Weiler, and Wakefield—and serves more than 600,000 unique patients. MMC is also the largest employer in the Bronx, with many employees living in the diverse communities we serve. On March 11, 2020, the Moses campus admitted two patients diagnosed with COVID-19. Subsequently, at the time of this writing, more than 6,000 patients with COVID-19 were admitted to MMC (91% from the Bronx), and more than 2,200 patients and 21 staff have died.4.

From the outset, there was concern that a surge of patients could overwhelm capacity for care and that MMC's workforce might experience unprecedented levels of stress and trauma. On March 15, 2020, psychiatry leadership collaborated with leadership from various sectors of MMC to establish the Staff Emotional Support (SES) Team. Over 10 weeks during the initial phase of the pandemic, the SES Team created a variety of mental health services to meet the needs of as many staff as possible, understanding that individuals respond to traumatic experiences and to support services in diverse ways. These services (in order of implementation) included psychoeducational resources, an emotional support line, Staff Support Centers (SSCs), individual clinical treatment services, team support sessions, peer support outreach, a wellness series, and clergy support. Support services were primarily communicated to faculty by word of mouth, through the Montefiore website, and through informational meetings such as grand rounds and other departmental/division meetings. Many of these services are ongoing, and the SES Team continues to meet regularly to plan, debrief, and support one another.

Recognizing that other hospital systems across the globe are facing similar circumstances, we provide an overview of the support services implemented at MMC in order of execution. Although no systematic analyses or evaluations were conducted at the time, we provide preliminary insights on the utilization and perceived favorability of these services. We hope to shed light on feasible interventions that other hospital systems can implement to support frontline workers’ mental health in the midst of an infectious disease pandemic.

To Cite: Bernstein, C. A., Bhattacharyya, S., Adler, S., & Alpert, J. E. (2021). Staff emotional support at Montefiore Medical Center during the COVID-19 pandemic. The Joint Commission Journal on Quality and Patient Safety, 47(3), 185-189. https://doi.org/10.1016/j.jcjq.2020.11.009

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Abstract

Context: During the COVID-19 pandemic, frontline workers have experienced high levels of stress and anxiety. Montefiore Medical Center recognized the urgent need for mental health support to mitigate and treat psychological distress among staff. Various mental health support services were implemented. This report provides an overview of the interventions implemented at Montefiore and provides preliminary insights on the utilization and value of these ongoing services.

Outcomes: The interventions instituted at Montefiore included psychoeducational resources, a phone support line, Staff Support Centers (SSCs), a clinical treatment program, team support sessions, peer support outreach, mental health and wellness programs, and clergy support. The most heavily used service during the pandemic were the SSCs, and the least used service was the clergy support.

Insights: With institutional encouragement and the collective efforts of more than 150 mental health professionals and other staff, it was possible to set up durable mental health supports with multiple points of access. Although many services were available to both clinical and nonclinical staff, outreach was primarily to clinical staff. Additional efforts in the future are needed to more fully reach nonclinical frontline workers.

Next Steps: The organization’s next steps include evaluation of emotional health and distress among clinical and nonclinical staff using validated self-report measures administered over multiple time intervals. Lessons learned about staff support during COVID-19 will also be integrated into future efforts to support staff well-being more broadly.

To Cite: Adler, S., & Bhattacharyya, S. (2021). Beyond the Nurses and Doctors: Structural Racism and the Unseen Frontline Service Workers During the COVID-19 Pandemic. Psychiatric Services, 72(5)594-596. https://doi.org/10.1176/appi.ps.202000569

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