{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T16:27:21Z","timestamp":1788971241553,"version":"build-2803163510"},"reference-count":50,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T00:00:00Z","timestamp":1684972800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["201292\/Z\/16\/Z"],"award-info":[{"award-number":["201292\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010248","name":"Royal College of Psychiatrists","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010248","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:sec id=\"S2056472423000662_sec_a1\"><jats:title>Background<\/jats:title><jats:p>The COVID-19 pandemic has disproportionally affected the mental health of health and social care workers (HSCWs), with many experiencing symptoms of depression, anxiety and post-traumatic stress disorder. Psychological interventions have been offered via mental health services and in-house psychology teams, but their effectiveness in this context is not well documented.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000662_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To evaluate a stepped-care psychological support pathway for HSCWs from Homerton Healthcare Foundation Trust in London, which offered psychological first aid, evidence-based psychological therapies and group-based well-being workshops.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000662_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>The service evaluation used a pre\u2013post approach to assess depression, anxiety, functional impairment and post-traumatic stress disorder symptom change for those who attended sessions of psychological first aid, low- or high-intensity cognitive\u2013behavioural therapy or a combination of these. In addition, the acceptability of the psychological first aid sessions and well-being workshops was explored via feedback data.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000662_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>Across all interventions, statistically significant reductions of depression (<jats:italic>d<\/jats:italic>= 1.33), anxiety (<jats:italic>d<\/jats:italic>= 1.37) and functional impairment (<jats:italic>d<\/jats:italic>= 0.93) were observed, and these reductions were equivalent between the interventions, as well as the demographic and occupational differences between the HSCWs (ethnicity, staff group and redeployment status). HSCWs were highly satisfied with the psychological first aid and well-being workshops.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472423000662_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>The evaluation supports the utility of evidence-based interventions delivered as part of a stepped-care pathway for HSCWs with common mental health problems in the context of the COVID-19 pandemic. Given the novel integration of psychological first aid within the stepped-care model as a step one intervention, replication and further testing in larger-scale studies is warranted.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjo.2023.66","type":"journal-article","created":{"date-parts":[[2023,5,25]],"date-time":"2023-05-25T06:21:02Z","timestamp":1684995662000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":4,"title":["A service evaluation of phased- and stepped-care psychological support for health and social care workers during the COVID-19 pandemic"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4887-751X","authenticated-orcid":false,"given":"Charles L.","family":"Cole","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Barry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-8729","authenticated-orcid":false,"given":"Rob","family":"Saunders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1238-2440","authenticated-orcid":false,"given":"Jo","family":"Billings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Stott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2281-0907","authenticated-orcid":false,"given":"Joshua E. J.","family":"Buckman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3044-2841","authenticated-orcid":false,"given":"Talya","family":"Greene","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Cirkovik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7361-8202","authenticated-orcid":false,"given":"Stephen","family":"Pilling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jon","family":"Wheatley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2023,5,25]]},"reference":[{"key":"S2056472423000662_ref1","unstructured":"1 Office for National Statistics. Coronavirus (COVID-19) Latest Insights. Office for National Statistics, 2022 (https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/healthandsocialcare\/conditionsanddiseases\/articles\/coronaviruscovid19\/latestinsights)."},{"key":"S2056472423000662_ref45","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291721001367"},{"key":"S2056472423000662_ref44","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1996.tb10671.x"},{"key":"S2056472423000662_ref23","unstructured":"23 Future Learn. COVID-19: Psychological First Aid. Public Health England, 2021 (https:\/\/www.futurelearn.com\/courses\/psychological-first-aid-covid-19)."},{"key":"S2056472423000662_ref3","unstructured":"3 The King's Fund. Covid-19 Recovery and Resilience: What Can Health and Care Learn from Other Disasters?. The King's Fund, 2021 (https:\/\/features.kingsfund.org.uk\/2021\/02\/covid-19-recovery-resilience-health-care\/)."},{"key":"S2056472423000662_ref39","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-050817-084833"},{"key":"S2056472423000662_ref27","unstructured":"27 National Institute for Health and Care Excellence (NICE). Anxiety Disorders. Quality Standard [QS53]. NICE, 2014 (https:\/\/www.nice.org.uk\/guidance\/qs53)."},{"key":"S2056472423000662_ref24","doi-asserted-by":"publisher","DOI":"10.1521\/psyc.2007.70.4.283"},{"key":"S2056472423000662_ref34","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.180.5.461"},{"key":"S2056472423000662_ref36","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.181.2.158"},{"key":"S2056472423000662_ref13","doi-asserted-by":"publisher","DOI":"10.1177\/0020764017752021"},{"key":"S2056472423000662_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqaa098"},{"key":"S2056472423000662_ref11","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-053396"},{"key":"S2056472423000662_ref16","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2021.1954674"},{"key":"S2056472423000662_ref48","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.669009"},{"key":"S2056472423000662_ref9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0256454"},{"key":"S2056472423000662_ref19","unstructured":"19 World Health Organization (WHO). Psychological First Aid: Guide for Field Workers. WHO, 2021 (https:\/\/apps.who.int\/iris\/rest\/bitstreams\/53113\/retrieve)."},{"key":"S2056472423000662_ref41","doi-asserted-by":"publisher","DOI":"10.1111\/pcn.13170"},{"key":"S2056472423000662_ref14","unstructured":"14 National Institute for Health and Care Excellence (NICE). Common Mental Health Problems: Identification and Pathways to Care. Clinical Guideline [CG123]. NICE, 2011 (https:\/\/www.nice.org.uk\/guidance\/cg123)."},{"key":"S2056472423000662_ref7","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.01960"},{"key":"S2056472423000662_ref20","unstructured":"20 Bisson, JI , Lewis, C . Systematic Review of Psychological First Aid. World Health Organization, 2009 (https:\/\/www.researchgate.net\/publication\/265069490_Systematic_Review_of_Psychological_First_Aid)."},{"key":"S2056472423000662_ref40","doi-asserted-by":"publisher","DOI":"10.1186\/s40359-016-0120-9"},{"key":"S2056472423000662_ref49","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22888"},{"key":"S2056472423000662_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S1754470X20000148"},{"key":"S2056472423000662_ref2","doi-asserted-by":"publisher","DOI":"10.1080\/20008198.2021.1882781"},{"key":"S2056472423000662_ref4","unstructured":"4 The British Psychological Society. The Psychological Needs of Healthcare Staff As a Result of the Coronavirus Pandemic. The British Psychological Society, 2020 (https:\/\/eprints.bbk.ac.uk\/id\/eprint\/47066\/)."},{"key":"S2056472423000662_ref30","unstructured":"30 National Collaborating Centre for Mental Health. The Improving Access to Psychological Therapies Manual. National Collaborating Centre for Mental Health, 2021 (https:\/\/www.england.nhs.uk\/publication\/the-improving-access-to-psychological-therapies-manual\/)."},{"key":"S2056472423000662_ref31","unstructured":"31 Compassion Practices. Guidance for 20-Minute Care Space (Face to Face). Compassion Practices, 2021 (https:\/\/compassionpractices.net\/20-minute-care-space\/)."},{"key":"S2056472423000662_ref15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0254821"},{"key":"S2056472423000662_ref32","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525-1497.2001.016009606.x"},{"key":"S2056472423000662_ref26","unstructured":"26 National Institute for Health and Care Excellence (NICE). Depression in Adults: Recognition and Management. Clinical Guideline [CG90]. NICE, 2009 (https:\/\/www.nice.org.uk\/guidance\/cg90)."},{"key":"S2056472423000662_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1211"},{"key":"S2056472423000662_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-020-01990-x"},{"key":"S2056472423000662_ref17","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2021.29"},{"key":"S2056472423000662_ref37","volume-title":"IBM SPSS Statistics for Windows Version 27.0","year":"2020"},{"key":"S2056472423000662_ref35","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001270"},{"key":"S2056472423000662_ref38","unstructured":"38 Homerton University Hospital NHS Foundation Trust. Annual Report and Accounts 2019\/20. Homerton University Hospital NHS Foundation Trust, 2020 (https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2021\/08\/homerton-university-hospital-nhs-foundation-trust-ara-2019-20.pdf)."},{"key":"S2056472423000662_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2021.01.013"},{"key":"S2056472423000662_ref18","doi-asserted-by":"publisher","DOI":"10.1017\/S1352465821000187"},{"key":"S2056472423000662_ref21","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0114714"},{"key":"S2056472423000662_ref33","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"key":"S2056472423000662_ref28","unstructured":"28 National Institute for Health and Care Excellence (NICE). Post-Traumatic Stress Disorder. NICE Guideline [NG116]. NICE, 2018 (https:\/\/www.nice.org.uk\/guidance\/ng116)."},{"key":"S2056472423000662_ref43","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph182312474"},{"key":"S2056472423000662_ref42","unstructured":"42 Cole, CL . Barriers to Help-Seeking among Hospital Staff during Covid-19. UCL Unit for Stigma Research and Homerton University Hospital NHS Foundation Trust, 2021 (https:\/\/www.ucl.ac.uk\/pals\/events\/2021\/jul\/healthcare-provider-mental-health-going-beyond-wellbeing-narratives)."},{"key":"S2056472423000662_ref47","first-page":"228","article-title":"Development of a remote psychological first aid protocol for healthcare workers following the COVID-19 pandemic in a university teaching hospital","volume":"8","author":"Sulaiman","year":"2020","journal-title":"Malays Healthcare (Basel)"},{"key":"S2056472423000662_ref50","first-page":"12","article-title":"Who helps the helpers?","volume":"21","author":"Billings","year":"2021","journal-title":"Healthcare Couns Psychother J"},{"key":"S2056472423000662_ref25","unstructured":"25 Cole, CL . Supporting Hospital and Community Staff \u2013 A Guide to Psychological First Aid (PFA). Homerton University Hospital NHS Foundation Trust and Talk Changes, 2021 (https:\/\/www.traumagroup.org\/_files\/ugd\/95d7e1_7f6420efd937473081171818f96b5976.pdf)."},{"key":"S2056472423000662_ref29","doi-asserted-by":"publisher","DOI":"10.3109\/09540261.2011.606803"},{"key":"S2056472423000662_ref46","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1017\/S0033291721001616","article-title":"Predicting prognosis for adults with depression using individual symptom data: a comparison of modelling approaches","volume":"53","author":"Buckman","year":"2021","journal-title":"Psychol Med"},{"key":"S2056472423000662_ref22","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18094594"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472423000662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T23:55:59Z","timestamp":1702511759000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472423000662\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,5]]}},"alternative-id":["S2056472423000662"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2023.66","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2023. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e95"}}