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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Case study of a stepped-care psychological service for healthcare professionals working in critical care

Connie Galati https://orcid.org/0000-0003-1759-0791 A C , Bronwyn Avard B and Louise Ramsay A
+ Author Affiliations
- Author Affiliations

A Canberra Health Services, Division of Mental Health, Justice Health, Alcohol & Drug Services, City Health Building, Level 3, 1 Moore Street, Canberra City, ACT 2601, Australia. Email: louise.ramsay@act.gov.au

B Canberra Health Services, Canberra ICU, Canberra Hospital, PO Box 11, Woden, ACT 2605, Australia. Email: bronwyn.avard@act.gov.au

C Corresponding author. Email: connie.galati@act.gov.au

Australian Health Review 45(5) 633-637 https://doi.org/10.1071/AH20316
Submitted: 4 November 2020  Accepted: 19 February 2021   Published: 1 June 2021

Abstract

Psychological injury is common among healthcare professionals and is expected to be further exacerbated by the current global pandemic, with the far-reaching impacts of this workplace trauma yet to be fully realised. Our Intensive Care Unit and Emergency Department sought to proactively introduce strategies that might reduce the anticipated short- and longer-term negative impact of the pandemic on staff and ultimately patients and families. Our organisation facilitated the temporary redeployment of senior psychologists to provide staff-focused support. Interventions included leader targeted training to increase the skills in this group, specifically for this situation, and site visits to allow for staff to meet with psychologists. Staff experiences of the intervention were explored through the direct observations of the psychologists leading the approach maintained through contemporaneous activity tracking records. An internal and embedded staff psychological service fosters help-seeking behaviours and is considered a desirable and acceptable model for healthcare leaders and professionals.

What is known about the topic? Healthcare professionals are at increased risk of psychological distress and injury caused by the inherent stress of their role.

What does this paper add? This paper provides service providers with insights into the benefits of an embedded staff psychological service to support the psychological wellbeing of healthcare professionals and teams within an Australian public health service context.

What are the implications for practitioners? An embedded staff psychological service can better meet the psychological needs of healthcare professionals and teams by focusing on prevention and early intervention strategies through targeted and tailored systems, teams, and individual interventions.


References

[1]  Peckham C. Physician lifestyle report. Medscape 2015. Available at: www.medscape.com/slideshow/lifestyle-2015-overview-6006535 [verified 18 May 2021]

[2]  Donchin Y, Seagull FJ. The hostile environment of the intensive care unit. Curr Opin Crit Care 2002; 8 316–20.
The hostile environment of the intensive care unit.Crossref | GoogleScholarGoogle Scholar | 12386492PubMed |

[3]  Mealer ML, Shelton A, Berg B, Rothbaum B, Moss M. Increased prevalence of post traumatic stress disorder symptoms in critical care nurses. Am J Respir Crit Care Med 2007; 175 693–7.
Increased prevalence of post traumatic stress disorder symptoms in critical care nurses.Crossref | GoogleScholarGoogle Scholar | 17185650PubMed |

[4]  Moss M, Good VS, Gozal D, Kleinpell R, Sessler CN. A Critical Care Societies Collaborative Statement: Burnout Syndrome in critical care health-care professionals. A call for action. Am J Respir Crit Care Med 2015; 194 106–108.
A Critical Care Societies Collaborative Statement: Burnout Syndrome in critical care health-care professionals. A call for action.Crossref | GoogleScholarGoogle Scholar |

[5]  Highfield JA. The sustainability of the critical care workforce. Nurs Crit Care 2019; 24 6–8.
The sustainability of the critical care workforce.Crossref | GoogleScholarGoogle Scholar | 30628758PubMed |

[6]  Danella N, Hamilton S, Heinrich C. Postraumatic stress disorder in critical care nurses. Nurs Crit Care 2017; 12 40–6.
Postraumatic stress disorder in critical care nurses.Crossref | GoogleScholarGoogle Scholar |

[7]  Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety 2009; 26 1118–26.
The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses.Crossref | GoogleScholarGoogle Scholar | 19918928PubMed |

[8]  Chen Q, Liang M, Li Y, et al Mental health for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 2020; 7 e15–16.
Mental health for medical staff in China during the COVID-19 outbreak.Crossref | GoogleScholarGoogle Scholar | 32085839PubMed |

[9]  Maunder RG, Lancee WJ, Balderson KE, et al Long term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis 2006; 12 1924–32.
Long term psychological and occupational effects of providing hospital healthcare during SARS outbreak.Crossref | GoogleScholarGoogle Scholar | 17326946PubMed |

[10]  Cenat JM, Mukunzi JN, Noorishad P, Rousseau C, Derivois D, Bukaka J. A systematic review of mental health programs among populations affected by the Ebola virus disease. J Psychosom Res 2020; 194 106–8.

[11]  Athanasiades C, Winthrop A, Gough B. Factors affecting self-referral to counselling services in the workplace: A qualitative study. Br J Guid Counc 2008; 36 257–76.
Factors affecting self-referral to counselling services in the workplace: A qualitative study.Crossref | GoogleScholarGoogle Scholar |

[12]  Liu Z, Han B, Jiang R, et al Mental health status of doctors and nurses during COVID-19 epidemic in China. The Lancet 2020;
Mental health status of doctors and nurses during COVID-19 epidemic in China.Crossref | GoogleScholarGoogle Scholar | 33278345PubMed |

[13]  Highfield JA. Advice for sustaining staff wellbeing in critical care during and beyond COVID-19. Intensive Care Society. Available at https://www.ics.ac.uk/ICS/Education/Wellbeing/ICS/Wellbeing.aspx [verified 10 October 2020].

[14]  Costa DK, Moss M. The cost of caring: emotion, burnout and psychological distress in critical care clinicians. Ann Am Thorac Soc 2018; 15 787–90.
The cost of caring: emotion, burnout and psychological distress in critical care clinicians.Crossref | GoogleScholarGoogle Scholar | 29727197PubMed |

[15]  Azzone V, McCann B, Levy Merrick E, Hiatt D, Hodgkin D, Horgan D. Workplace stress, organisational factors and employee assistance program utilisation. J Workplace Behav Health 2009; 24 344–56.
Workplace stress, organisational factors and employee assistance program utilisation.Crossref | GoogleScholarGoogle Scholar | 24058322PubMed |

[16]  Joseph B, Walker A. Employee assistance programs in Australia: the perspectives of organisational leaders across sectors. Asia Pac J Hum Resour 2017; 55 177–91.
Employee assistance programs in Australia: the perspectives of organisational leaders across sectors.Crossref | GoogleScholarGoogle Scholar |

[17]  Kirk AK, Brown DF. Employee Assistance programs: a review of the management of stress and wellbeing through workplace counselling and consulting. Aust Psychol 2003; 38 138–43.
Employee Assistance programs: a review of the management of stress and wellbeing through workplace counselling and consulting.Crossref | GoogleScholarGoogle Scholar |

[18]  Inter-Agency Standing Committee’s Reference Group on Mental Health and Psychosocial Support. Briefing note on addressing mental health and psychosocial aspects of COVID-19 outbreak - version 1.1. Available at https://interagencystandingcommittee.org/iasc-reference-group-mental-health-and-psychosocial-support-emergency-settings/interim-briefing [verified 16 October 2020].

[19]  Brooks SK, Dunn R, Amlot R, Rubin GJ, Greenburg N. A sytematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occup Environ Med 2018; 60 248–57.
A sytematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak.Crossref | GoogleScholarGoogle Scholar | 29252922PubMed |