Mental health and psychosocial support strategies in highly contagious emerging disease outbreaks of substantial public concern: A systematic scoping review

Abstract

Background Acute disease outbreaks such as the COVID-19 pandemic cause a high burden of psychological distress in people worldwide. Interventions to enable people to better cope with such distress should be based on the best available evidence. We therefore performed a scoping review to systematically identify and summarize the available literature of interventions that target the distress of people in the face of highly contagious disease outbreaks. Methods MEDLINE, Cochrane CENTRAL, Web of Science (January 2000 to May 7, 2020), and reference lists were systematically searched and screened by two independent reviewers. Quantitative and qualitative studies investigating the effects of psychological interventions before, during, and after outbreaks of highly contagious emerging infectious diseases, such as SARS, MERS, Ebola, or COVID-19 were included. Study effects were grouped (e.g. for healthcare professionals, community members, people at risk) and intervention contents at the individual and organizational level summarized. We assessed the level of evidence using a modified scheme from the Oxford Centre for Evidence-based Medicine and the Australian National Health and Medical Research Council. Results Of 4030 records found, 19 studies were included (two RCTs). Most interventions were delivered during-exposure and face-to-face, focused on healthcare workers and crisis personnel, and combined psychoeducation with training of coping strategies. Based on two high-quality studies, beneficial effects were reported for resilience factors (e.g. positive cognitive appraisal) and professional attitudes of healthcare workers, with mixed findings for mental health (e.g. depression). Across all studies, there was positive qualitative feedback from participants and facilitators. We identified seven ongoing studies mostly using online- and mobile-based deliveries. Conclusions There is preliminary evidence for beneficial effects of interventions to enable people to better cope with the distress of highly contagious emerging disease outbreaks. Besides the need for more high-quality studies, the summarized evidence may inform decision makers to plan interventions during the current pandemic and to develop pandemic preparedness plans.

Active Coping and Anxiety Symptoms during the COVID-19 Pandemic in Spanish Adults

“…Similarly, two of the coping styles, the active and the avoidant methods, were also associated in the expected way with the manifestations of anxiety. Both methods accurately represent the use of functional (active method) and dysfunctional (avoidant method) coping, so these results are similar to those found in the reviewed literature [19,28,31].…”

“…However, the obtained scores for these skills are still moderate, and some other functional strategies that could be also helpful for the management of anxiety symptoms have not been profusely used (e.g., social support for problem solving, suppression of distracting activities). The strategies used by the participants are similar to the strategies found in previous research where the importance of behavioral and emotional coping is highlighted, since they have turned out to be the most beneficial [19][20][21]28]. Nonetheless, the creation of intervention programs aimed at training the most effective and helpful coping strategies would be advisable in order to improve people's success when putting them into practice to deal with the emotional burden of a major life stressor such as a pandemic.…”

“…Behavioral, cognitive and emotional coping strategies have been found to be helpful for dealing with negative experiences, since they reduce the burden imposed by prolonged distress, enable cognitive resources to deal with everyday stressors and allow adaptation to environmental changing and demanding situations during pandemics and natural disasters [21,22]. Furthermore, coping has been demonstrated to be a key factor for psychological well-being and mental health issues during the COVID-19 era, with problem-focused coping strategies, cognitive reappraisal, social support and avoidant coping strategies along with other coping resources such as meaning in life and social connectedness as the most commonly used coping strategies [19,20,[23][24][25][26][27][28][29][30]. A review [31] has found that all the guidelines for coping with mental problems derived from COVID-19 included tips for maintaining good mental health, descriptions of a variety of psychological skills to help people cope with their anxiety and worries and the promotion of interpersonal connection at home to generate social support.…”

“We Thought We Were Prepared, but We Were Not”: Experiences from the Management of the Psychosocial Support Response during the COVID-19 Pandemic in Sweden. A Mixed-Methods Study

“…Being mentally prepared to be exposed to severe stress and having access to self-caring strategies and an organizational culture that supports each other are essential for frontline responders and should be implemented as part of their basic training [27]. Pre-incident psychological interventions, such as resilience training, could be beneficial for health professionals deployed in pandemics [28]. A worrying finding was that first-line managers within the health care sector lacked knowledge on acute crisis reactions and how to support their staff.…”

“…Pandemics and associated protective measures, such as social isolation, can have considerable psychosocial impacts on individuals and communities in both the short and long term [28]. Promoting closeness and contact with family members is the most essential part of crisis support in everyday emergencies, war, natural disasters, and pandemic outbreaks [5].…”