The COVID-19 pandemic strained health care systems globally due to the precipitous increase in demand for health services for an illness that initially had no cure or vaccine. COVID-19 also affected the safe delivery of face-to-face mental health services, which had far-reaching effects on the practices and well-being of mental health professionals across the world. These circumstances raised questions about factors that could promote or impede well-being in the mental health workforce. We also wanted to investigate the barriers and facilitators of adoption and appropriate implementation of telehealth (i.e., mental health services provided using remote technologies) to facilitate the continuity of mental health care. WHO’s Global Research Roadmap also called on the field to find feasible approaches to support the psychosocial needs of those providing care to COVID-19 patients and to elucidate how care-seeking practices changed across the pandemic.
To address these questions, an international team of researchers that had been working on the development and implementation of the ICD-11 joined forces to develop a multilingual, multinational effort to survey practicing mental health professionals worldwide. With grant funding from the Canadian Institutes of Health Research to Drs. Kogan, Reed, and Denny, the Longitudinal COVID-19 Survey of Mental Health Professionals Project was launched in the summer of 2020 to collect data during the pandemic from members of the WHO’s Global Clinical Practice Network (GCPN). The GCPN is the largest, most diverse international practice-based research network, now comprising over 19,000 clinicians from 163 countries representing all global regions. Over half of GCPN members are physicians, primarily psychiatrists, and over 30% are psychologists.
GCPN member responded to surveys on three separate occasions about the impact of the pandemic, including to their mental health, clinical practice changes including telehealth use, experiences of burnout and violence, attitudes about COVID-19 vaccination, and perceptions of institutional support to help them cope with the effects of the pandemic.
Results of the first wave of data collection in July 2020 provided the first glimpse of practice changes related to the adoption and satisfaction with telehealth services for delivery of mental health services. Since the pandemic began, 90.5% of clinician respondents started or increased their use of telehealth services, primarily using phone and videoconferencing. Interestingly, nearly half of respondents reported lacking any training on delivery of mental health services using telehealth technologies. Those without training, or with limited training, had varying perceptions of effectiveness and patient satisfaction. Concerns centered on quality of care compared to in-person visits and technical issues, with findings differing by WHO region, income level, and profession. Overall, the data indicate a global shift towards telehealth in mental health care, highlighting the need for enhanced training and support to address ongoing challenges.
A variety of occupational and personal stressors were associated with the pandemic. For mental health professionals this included increasing demands for their services including for COVID-19 infected patients, task shifting to other non-mental health duties, shifting to telehealth, and violence directed toward health care workers. We examined the impact of these stressors on psychological symptoms and well-being among GCPN members across three timepoints during the pandemic. On average, respondents’ well-being declined over the timeframe examined, while posttraumatic stress symptoms improved modestly. Linear modeling showed that female gender, younger age, providing in-person care to individuals with COVID-19, experiencing COVID-related violence, and living in low- or middle-income countries or countries with a high COVID-19 death rate were linked to poorer well-being and higher stress levels. Importantly, most mental health professionals maintained moderate, non-clinical stress and stable well-being, or improved after initial difficulties. However, a quarter of respondents faced deteriorating well-being near clinical thresholds, and a fifth reported persistently high posttraumatic stress symptoms. Overall, while many mental health professionals fared well during the pandemic, a significant minority experienced ongoing psychological challenges.
Despite the proven efficacy of COVID-19 vaccines, attitudes among mental health professionals about vaccine efficacy and safety may vary. Because of their role in health behaviour promotion especially among vulnerable patients, their attitudes could influence patient education on vaccination as well as their own willingness to get vaccinated, which in turn, increases the likelihood for the spread of infection. To explore these attitudes, we developed and administered the COVID-19 Vaccine Attitudes Questionnaire (C-VAQ) to members of the WHO’s Global Clinical Practice Network (GCPN). The C-VAQ demonstrated good internal consistency and validity, identifying factors influencing attitudes. Positive attitudes were linked to receiving the vaccine, higher country mortality rates, and stricter COVID-19 responses. Conversely, younger age, living in low- or middle-income countries, and residing in Asia correlated with less positive attitudes. Additionally, concerns about vaccination were negatively correlated with C-VAQ scores. Overall, the findings highlight the need for targeted interventions to improve vaccine attitudes among mental health professionals globally.
Additional findings will be coming out soon and will be added to this page.