“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

Abstract

This study aimed to describe experiences of managing mental health and psychosocial activities during the first six months of the COVID-19 pandemic in Sweden. A national survey was answered by a non-probability sample of 340 involved in the psychosocial response. The psychosocial response operations met several challenges, mainly related to the diverse actors involved, lack of competence, and lack of preparations. Less than 80% of the participants had received specific training in the provision of psychosocial support during major incidents. The interventions used varied, and no large-scale interventions were used. The psychosocial response organizations were overwhelmed by the needs of health care staff and failed to meet the needs of patients and family members. An efficient and durable psychosocial response in a long-term crisis requires to be structured, planned and well-integrated into the overall pandemic response. All personnel involved need adequate and specific competence in evidence-based individual and large-scale interventions to provide psychosocial support in significant incidents. By increasing general awareness of mental wellbeing and psychosocial support amongst health professionals and their first-line managers, a more resilient health care system, both in everyday life and during major incidents and disasters, could be facilitated.

Use it or lose it? Identifying reasons for the low use of psychosocial support by hospital staff

“…Being in close contact with their staff, they are in the position to closely monitor staff well-being, create awareness, and refer those who potentially need support to the right channels. Research has, however, shown that team leaders can lack the necessary skills to do so, especially considering the sensitivity of the subject [ 52 ]. It can be a worthwhile strategy to train team leaders to acquire the necessary skills, including how to promote self-caring strategies, and how early signs of distress can be recognized [ 53 ].…”

Bringing risk back in: managers' prioritization of the work environment during the pandemic

“…When the work situation changes, employers are responsible for considering all possible risks, to act and reduce the risks (Carvalhais et al, 2021). However, most managers lack competence regarding crisis management, probably because Sweden has been hit by few major crises or disasters during the last century (Hugelius et al, 2021). On the other hand, the study by Lethin et al (2021) showed that Swedish care staff reported more support from the management and clear guidelines during the Covid-19 pandemic compared to care staff in Italy, Germany and the UK.…”

“…, 2021). However, most managers lack competence regarding crisis management, probably because Sweden has been hit by few major crises or disasters during the last century (Hugelius et al. , 2021).…”

Integration of Mental Health Support Teams in COVID-19 Units within French General Hospitals: A Qualitative Study

“…Due to unprecedented pressures on health systems and their unpreparedness for such a pandemic, crisis of coronavirus disease 2019 (COVID- 19) challenged care integration at all these different levels (i.e. macro, meso, and micro) [5][6][7][8], with particular risk of fragmentation between general and mental health care services [9][10][11]. In France, the first wave resulted in hospitalization of more than 90,000 people between March and June 2020 -19% of whom went through intensive care [12] -and in death of more than 30,000 people [13].…”