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yoav-aziz-T4ciXluAvIE-unsplash.jpgAs we enter the fourth year of the COVID-19 pandemic, the pandemic’s impact on population mental health is of uncertain magnitude and duration (Manchia et al., 2022), but evidence from numerous surveys indicate adverse outcomes for girls and women (Sun et al., 2023), gender minority individuals (Nowaskie & Roesler, 2022), individuals with physical health problems (Robinson et al., 2022), older adults, and children and adolescents (Zolopa et al., 2022). A particularly vulnerable group, despite having a high level of resilience, are healthcare workers and organizations, and the mental/behavioral health impact on medical, nursing and other physical healthcare providers is well recognized (e.g., Ford et al., 2022; Hannemann et al., 2022; Sahebi et al., 2021). However, the toll on mental/behavioral health and human services providers has not been systematically evaluated, with only two surveys to date. One, conducted in 2020 with 110 psychotherapists from the United Kingdom, identified burnout as prevalent (Kotera et al., 2021). The second, a survey of child/adolescent, couples and family therapists in Canada (N=1280 in July 2020; 905 in June 2021), found that therapists reported better mental health than the general population but increasing difficulties with sleep, anxiety, sadness, irritability and mood swings in 2021 compared to 2020 (Battam & Hilbrecht, 2021).
 
Surveys of psychologists’ practice patterns suggest that practitioners are coping with a consistent rise in demand for mental healthcare not only in the acute phases of the pandemic but on an ongoing basis. Surveys of licensed psychologists in April 2020, September 2020 and June 2021 in the United States (Sammons, 2022) and in May to July 2020 in Italy (Cantone et al., 2022) documented the highly stressful (Kane et al., 2022; Morgan et al., 2022) shift to telehealth services and rapidly increasing caseloads with greater symptom acuity and suicidality (Sammons, 2022). As recently as an American Psychological Association survey in October 2022 (https://www.apa.org/pubs/reports/practitioner/2022-covid-psychologist-workload) and a mid-2022 survey of psychotherapists in Austria (Winter et al., 2022), mental health services professionals were reporting continuing, and in many cases escalating, difficulties with high workloads and acutely distressed clients.   
 
Therefore, in order to connect the dots between the apparent pressures facing mental health and human services providers internationally both personally and professionally in the pandemic and its slowly unwinding endemic aftermath, an international team of health services researchers has developed a prospective survey as a project of the Global Collaboration on Psychotrauma (https://www.global-psychotrauma.net/covid-19-projects). The goal is to learn how mental health and human services providers in practice and in training have been impacted by the pandemic personally and professionally. The survey was launched in February 2023 in China, and in in an English language version in April 2023. Using a Qualtrics platform for secure data acquisition and privacy protection the survey is designed for mental health and human services professional and paraprofessional providers and graduate trainees from multiple disciplines (i.e., addiction treatment, counseling, legal/forensic, marriage and family therapy, psychiatry, psychiatric nursing, psychology, psychotherapy and social work). The survey is being translated and adapted, and will be disseminated, by an international team of traumatic stress experts from Australia, Brazil, Chile, China, France, Italy, Japan, Lebanon, Portugal and the United States, beginning two years after the start of the pandemic (June 2022) with repeated waves every six months.
 
The survey takes 20-30 minutes to complete and is anonymous to ensure privacy, with well validated and meaningful measures of pandemic stressors, their impact (including general and secondary traumatic stress and burnout), and resilience factors including a unique set of items reflecting ways of coping with burnout and secondary traumatic stress. Survey items cover a wide range of personal and professional experiences and impacts, including: (1) demographics, (2) a newly developed measure of personal and social impacts of the pandemic for mental health providers (EPII-Brief and-MH; Grasso et al., 2021), (3) depression and anxiety symptoms, (4) trauma history and PTSD symptoms (Global Psychotrauma Screen), (5) CPTSD DSO symptoms (International Trauma Questionnaire) (6) moral injury symptoms, (7) experiential avoidance symptoms, (8) secondary traumatic stress reactions, (9) burnout symptoms, (10) resiliency factors and ways of coping with STS and burnout, and (11) social support.

The survey team welcomes the participation of ISTSS members and their colleagues, and will report on the results of the survey in future publications for the ISTSS membership. Your input based upon the challenges you’ve faced personally and professionally as a mental or human services provider in the pandemic will provide valuable guidance for policy, practice and programs affecting these often-overlooked services providers and trainees worldwide.

The survey can be accessed through the following link: https://uconn.co1.qualtrics.com/jfe/form/SV_0Gr8GzAtkTYnBga

About the author 

Julian Ford, PhD, is a clinical psychologist and Professor of Psychiatry and Law at the University of Connecticut. He has been a member of the International Society for Traumatic Stress Studies for more than three decades, serving on the Board of Directors, and as Secretary, Vice President and President from 2018-2019. jford@uchc.edu 

References

Battams, N., & Hilbrecht, M. (2021). COVID-19 Impacts: Family Therapists Survey -- Final Report. Ottawa, CA: Vanier Institute of the Family. www.vanierinstitute.ca
 
Cantone, D., Guerriera, C., Architravo, M., Alfano, Y. M., Cioffi, V., Moretto, E., Mosca, L. L., Longobardi, T., Muzii, B., Maldonato, N. M., & Sperandeo, R. (2021). A sample of Italian psychotherapists express their perception and opinions of online psychotherapy during the covid-19 pandemic. Rivista di Psichiatria, 56(4), 198-204. https://doi.org/10.1708/3654.36347
 
Ford, J. D., Marengo, D., Olff, M., Armour, C., Elhai, J. D., Almquist, Z., & Spiro, E. S. (2022). Temporal trends in health worker social media communication during the COVID-19 pandemic. Research in Nursing and Health, 45(6), 636-651. https://doi.org/10.1002/nur.22266
 
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Kane, H., Gourret Baumgart, J., El-Hage, W., Deloyer, J., Maes, C., Lebas, M. C., Marazziti, D., Thome, J., Fond-Harmant, L., & Denis, F. (2022). Opportunities and Challenges for Professionals in Psychiatry and Mental Health Care Using Digital Technologies During the COVID-19 Pandemic: Systematic Review. JMIR Hum Factors, 9(1), e30359. https://doi.org/10.2196/30359
 
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Morgan, A., Davies, C., Olabi, Y., Hope-Stone, L., Cherry, M. G., & Fisher, P. (2022). Therapists' experiences of remote working during the COVID-19 pandemic. Frontiers in Psychology, 13, 966021. https://doi.org/10.3389/fpsyg.2022.966021
 
Robinson, E., Sutin, A. R., Daly, M., & Jones, A. (2022). A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. Journal of Affective Disorders, 296, 567-576. https://doi.org/10.1016/j.jad.2021.09.098
 
Sahebi, A., Yousefi, A., Abdi, K., Jamshidbeigi, Y., Moayedi, S., Torres, M., Wesemann, U., Sheikhbardsiri, H., & Golitaleb, M. (2021). The Prevalence of Post-traumatic Stress Disorder Among Health Care Workers During the COVID-19 Pandemic: An Umbrella Review and Meta-Analysis. Frontiers in Psychiatry, 12, 764738. https://doi.org/10.3389/fpsyt.2021.764738
 
Sammons, M. T. (2022). Unmet Mental Health Needs Associated With Covid Must Be Addressed. Journal of Health Service Psychology, 1-2. https://doi.org/10.1007/s42843-022-00057-6
 
Sun, Y., Wu, Y., Fan, S., Dal Santo, T., Li, L., Jiang, X., Li, K., Wang, Y., Tasleem, A., Krishnan, A., He, C., Bonardi, O., Boruff, J. T., Rice, D. B., Markham, S., Levis, B., Azar, M., Thombs-Vite, I., Neupane, D., Agic, B., Fahim, C., Martin, M. S., Sockalingam, S., Turecki, G., Benedetti, A., & Thombs, B. D. (2023). Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. BMJ, 380, e074224. https://doi.org/10.1136/bmj-2022-074224
 
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