. 2022 Feb 22;13:812365. doi: 10.3389/fpsyt.2022.812365

Table 2.

Key themes around staff interventional response to virial epidemics/pandemics and our recommendations.

Key themes around staff intervention response	Our recommendations
1. Overall, there is an initial increase in anxiety and fear in staff, but this response generally does not reach the threshold for a diagnosis of a mental illness in most workers. A wide variety of staff support measures were implemented in response to the viral outbreak, but these were not always offered commensurately to staff needs and were not always structured as an escalating pathway according to mental health or wellbeing needs. 2. Effective communication in keeping staff updated with the latest information around the pandemic can help reduce anxiety in staff. There is a need to communicate to staff what support is available to them. 3. Staff respite spaces can reduce burnout in staff and promote safety and shared experiences. 4. Attitudes around mental health and stigma may vary between global cultures and may also vary within workplace cultures. 5. Some staff may be reluctant to seek mental health support due to fear of being reported on or a lack of privacy in the workplace. 6. It is important to consider the sustainability of the interventions (e.g., staff resources, hospital space, costs, evidence base of interventions). At-home based interventions such as music therapy and exercise therapy can be cost-effective initiatives for staff. 7. Staff should be provided with an opportunity to reflect on the interventions (both before and after implementation).	1. A stepped-care pathway to staff support is needed, with interventions to support staff at work to address initial concerns and anxiety, with stepped escalation to support increasing acuity and mental health needs, culminating in one-on-one mental health support (provided by psychiatrists or psychologists). 2. Ensure good and updated communication to staff about changing circumstances (e.g., an evolving pandemic). Ensure that staff are aware of all support initiatives that are available in the workplace, and additional external support (e.g. psychological). Leaders should be visible to front-line staff. 3. Ensure where possible that staff are well-rested, with access to meal breaks, respite areas, and social support as needed. Consider adapting, reforming or expanding existing staff wellbeing and care frameworks to meet current and future needs of healthcare workers 4. Reduce stigma around mental health for staff. Interventions should be tailored to local needs and be culturally appropriate. Teams should regularly discuss any concerns and anxiety staff may have related to the outbreak. 5. To remove barriers to support services, concerns about possible censure could be addressed prima-facie within health services. Psychological and psychiatric services should, where possible, be provided by services which are not linked directly to, or part of, the workplace. Confidential support should be available to staff. 6. Interventions should be sustainable long-term. Use telehealth and other technologies were appropriate to mitigate the spread of infection. 7. Demands on clinical staff will be high during a pandemic crisis, but if clinical staff have capacity to be involved in the development and implementation of support interventions, this could be beneficial. 8. Ensure training, supervision, and research opportunities are maintained throughout the outbreak.

Key themes around staff intervention response

Our recommendations

1. Overall, there is an initial increase in anxiety and fear in staff, but this response generally does not reach the threshold for a diagnosis of a mental illness in most workers. A wide variety of staff support measures were implemented in response to the viral outbreak, but these were not always offered commensurately to staff needs and were not always structured as an escalating pathway according to mental health or wellbeing needs.
2. Effective communication in keeping staff updated with the latest information around the pandemic can help reduce anxiety in staff. There is a need to communicate to staff what support is available to them.
3. Staff respite spaces can reduce burnout in staff and promote safety and shared experiences.
4. Attitudes around mental health and stigma may vary between global cultures and may also vary within workplace cultures.
5. Some staff may be reluctant to seek mental health support due to fear of being reported on or a lack of privacy in the workplace.
6. It is important to consider the sustainability of the interventions (e.g., staff resources, hospital space, costs, evidence base of interventions). At-home based interventions such as music therapy and exercise therapy can be cost-effective initiatives for staff.
7. Staff should be provided with an opportunity to reflect on the interventions (both before and after implementation).

1. A stepped-care pathway to staff support is needed, with interventions to support staff at work to address initial concerns and anxiety, with stepped escalation to support increasing acuity and mental health needs, culminating in one-on-one mental health support (provided by psychiatrists or psychologists).
2. Ensure good and updated communication to staff about changing circumstances (e.g., an evolving pandemic). Ensure that staff are aware of all support initiatives that are available in the workplace, and additional external support (e.g. psychological). Leaders should be visible to front-line staff.
3. Ensure where possible that staff are well-rested, with access to meal breaks, respite areas, and social support as needed. Consider adapting, reforming or expanding existing staff wellbeing and care frameworks to meet current and future needs of healthcare workers
4. Reduce stigma around mental health for staff. Interventions should be tailored to local needs and be culturally appropriate. Teams should regularly discuss any concerns and anxiety staff may have related to the outbreak.
5. To remove barriers to support services, concerns about possible censure could be addressed prima-facie within health services. Psychological and psychiatric services should, where possible, be provided by services which are not linked directly to, or part of, the workplace. Confidential support should be available to staff.
6. Interventions should be sustainable long-term. Use telehealth and other technologies were appropriate to mitigate the spread of infection.
7. Demands on clinical staff will be high during a pandemic crisis, but if clinical staff have capacity to be involved in the development and implementation of support interventions, this could be beneficial.
8. Ensure training, supervision, and research opportunities are maintained throughout the outbreak.