Skip to main content
. 2020 Nov 5;2020(11):CD013779. doi: 10.1002/14651858.CD013779

3. Candidate interventions and strategies to support resilience and mental health reported in excluded studies.

  Interventions
Author (year) Workplace Support basic daily needs Psychological Pharmacological Other
Banerjee 2020
  • Education about common adverse psychological consequences

  • Sleep hygiene

  • Activity scheduling

  • Exercising

  • Social connections,

  • Avoiding social media

  • Relaxation techniques

  • Signposting resources

  • Encouraging health‐promoting behaviours; empowerment of HCWs (e.g. ensuring availability of adequate PPE)

  • Encouraging self‐care (e.g. peer support, supportive therapy)

  • Integrating available healthcare

  • Facilitate problem solving

Barrett 2020
  • MindReading project uses literature to support mental well‐being


(ucd.ie/medicine/capsych/mindreading)
Behan 2020
  • Meditation, MBCT, MBSR

Bohan 2020
  • "self‐care handbook" with recommendations and strategies for each stage of the pandemic. Based on the British Psychological Society 2020 model of stepped delivery of formal psychological care including (a) basic physical needs; (b) access to reliable information; (c) peer support and PFA and (d) psychological assessment and/or intervention

  • Appendices also include instructions for brief relaxation exercises, daily schedule template, plus list of resources and websites

Booth 2005
  • Emotional support provided through regular meetings (including debriefing) and psychological interventions

  • Letter from the "hospitals of Ontario" which was entitled "A tribute to Heroes on the Front‐line" which was written "to encourage and congratulate front‐line workers for getting the job done"

Chou 2010
  • Information from the hospital information board

  • Adjusting daily activities (e.g. "by such things as reading, watching television, and surfing the Internet. They used their cell phones for contact with their friends and family members")

  • Maximising health

  • Balancing physiological needs (e.g. PPE, hydration)

  • Sharing of information, peer support and getting support from "someone important" maintaining a positive attitude

  • Protecting families

  • Advice to avoid watching media coverage

Fukuti 2020
  • Adequate PPE and working conditions, rapid access to occupational health, information and resources to avoid taking the infection home, accommodation for HCWs at high risk and those working rapid‐cycle shifts, mass communication on constructive coping methods

  • Support for physical needs (healthy meals, hydration breaks), transportation assistance, support for childcare needs

  • Mental health care delivered by mental health specialists

  • Telephone hotline,

  • Occupational therapy

  • PFA

  • Listening groups, social service support for HCWs personal and family needs, psychoeducation

  • Peer‐support groups

  • Interventions from PC and OT teams,

  • Assisted mourning

  • 6 hours of short video classes. Available at sites.google.com/hc.fm.usp.br/comvc-19/comvc-19

Greenberg 2015
  • Organisations should reflect on suitability and preparedness before deploying individual staff building bonds between team members

  • Organisations to actively promote both symptom recognition and to reduce stigma in order to increase help‐seeking

  • Peer‐support training with active monitoring (e.g. TRiM programme, or PFA programmes), use of trauma‐focused CBT and EMDR

  • "Antidepressants may have a secondary role to play for some people with PTSD, especially those with co‐morbid depression, they are not recommended as first line treatments"

Liu 2020
  • Preparedness training including knowledge related to COVID‐19 and epidemic control methods; staff were also advised of their roles and responsibilities

  • Selection of experienced nursing staff in leadership roles; workload planning: shift lengths were adjusted, co‐ordinated training arrangements, focused supervision

  • "official WeChat account of the Nursing Department

  • Mobile phone messaging used to deliver protection reminders and consolation messages"

  • Positive encouragement,

  • Psychological counselling and support was provided

  • Family members of nurses were treated in timely manner

Meyer 2018
  • Communication plans are put in place to update staff, patients, and the public about high‐risk patients

  • Updated PPE guidance and observers for donning and doffing PPE

  • Training (PPE, emergency drills, infection control)

  • Sufficient staffing levels including cross‐trained staff

  • Support systems are in place for personnel responding to high‐risk patients

  • 2 checklists to mitigate challenges and improve resilience:

    • 1 that details recommendations for healthcare facilities

    • 1 that details recommendations for the healthcare workforce

Singh 2020
  • Optimal sleep health suggestions and signs to look for

  • Lifestyle modification and CBTi

  • Poster outlines the advantages and disadvantages of different sleeping medications including OTC sleeping pills and melatonin

Sprang 2015
  • Developed a series of guiding principles including:

    • employing the language of resilience and promoting strategies that build on strengths and abilities;

    • describe response, roles and responsibilities in context;

    • ensure consistency and promote interdisciplinary co‐ordination and collaboration while planning

    • focused guidance for children preparedness and response

    • support professional awareness and knowledge

Taylor 2019
  • Psychotherapy

  • Meditation, deep breathing

  • Spirituality, prayer, spiritual guidance, faith

Vymetal 2011
  • Supportive context

  • Early preventive psychosocial interventions

  • Early curative psychosocial interventions

  • Target group intervention programme including recovery groups, switchers groups, people at risk groups

  • Developing European guidelines for psychosocial aftercare and highlight a number of on‐going related projects which aim to standardise the care delivered

Wald 2020
  • Resilient organisational/system culture to support HCWs

  • Visible leadership

  • Address staff and trainee concerns

  • A "team approach"

  • "trauma‐informed educators"

  • Cultivate resilience in the learning environment

  • Support moral resilience

  • "appreciative inquiry lens" (i.e. what is going right?

  • Adopt healthy lifestyle behaviours ("healthy habits") including nutrition, rest, relaxation techniques, exercise and humour

  • Mindfulness, meditation

  • Ask for help and foster reflection with 'SOS' awareness for resilience

  • Humanities for healing ‐ reflective writing or journaling, and literature

  • "relationships matter" ‐ peer support, sense of community

  • Self‐compassion

WHO 2014b
  • Safety measures

  • Healthy work and life habits (e.g. rest, healthy eating)

  • Rest and reflection

  • Talk about experience with a supervisor, colleague or another trusted person

  • Reflect on what went well, what did not go well and limits of what was possible in the circumstances

  • Recommend specialist help if difficulties (e.g. upsetting thoughts or memories, trouble sleeping etc) continue for more than a month

WHO 2020b
  • Focus on longer‐term occupational capacity rather than repeated short‐term crisis responses

  • Good‐quality communication and accurate information updates are provided

  • Rotate workers from higher‐stress to lower‐stress functions

  • Partner ("buddy") inexperienced workers with more experienced colleagues

  • Encourage breaks, implement flexible schedules

  • Build in time for colleagues to provide social support to each other

  • Coping strategies (e.g. rest, respite, healthy eating, physical activity

  • Avoid using unhelpful coping strategies (e.g. tobacco, alcohol or other drugs

  • Stay connected with loved ones, including through digital methods

  • Turn to your colleagues, your manager or other trusted persons for social support

  • Ensure staff are aware of where and how they can access mental health and psychosocial support services and facilitate access to these services

  • Self‐care strategies to mitigate stress

  • Manage urgent mental health and neurological complaints

  • Ensure essential general psychotropic medications are available

  • People living with long‐term mental health conditions or epileptic seizures will need uninterrupted access to medication

  • "Use understandable ways to share messages with people with intellectual, cognitive and psychosocial disabilities. Where possible, include forms of communication that do not rely solely on written information" (p2)

  • Link to WHO Mental Health Gap Action Programme WHO 2018

WHO 2020d
  • Rapidly redistribute health workforce capacity, including by reassignment and task sharing

  • Multiple recommendations for identifying HCWs' safety, financial compensation and training

  • Highlight need for providing psychosocial support including monitoring for illness, stress and burnout

Yuen‐Tsang 2004
  • University‐Community partnership model provided "Anti‐SARS" hotlines, enquiry service, screening service, health education road shows and community ambassadors, friendly 'reach‐out' phone calls to isolated older adults, consultation and research

  • "Tree of Ten Thousands Blessings" ‐ 10,000 words of blessings and signatures were collected and built into a giant tree and dedicated to HCWs

CBT: cognitive behavioural therapy; CBTi: cognitive behavioural therapy for insomnia; EMDR: eye movement desensitisation and reprocessing; HCW: healthcare workers; HSCWs: health and social care workers; MBCT: mindfulness‐based cognitive therapy; MBSR: mindfulness‐based stress reduction; OT: occupation therapy; OTC: over the counter; PC: palliative care; PFA: psychological first aid; PPE: personal protective equipment; TRiM: Trauma Risk Management programme