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Brooks SK, Greenberg N. Recurrence of post-traumatic stress disorder: systematic review of definitions, prevalence and predictors. BMC Psychiatry 2024; 24:37. [PMID: 38195482 PMCID: PMC10777598 DOI: 10.1186/s12888-023-05460-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/13/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Many people will experience a potentially traumatic event in their lifetime and a minority will go on to develop post-traumatic stress disorder (PTSD). A wealth of literature explores different trajectories of PTSD, focusing mostly on resilient, chronic, recovered and delayed-onset trajectories. Less is known about other potential trajectories such as recurring episodes of PTSD after initial recovery, and to date there has been no estimate of what percentage of those who initially recover from PTSD later go on to experience a recurrence. This systematic review aimed to synthesise existing literature to identify (i) how 'recurrence' of PTSD is defined in the literature; (ii) the prevalence of recurrent episodes of PTSD; and (iii) factors associated with recurrence. METHODS A literature search of five electronic databases identified primary, quantitative studies relevant to the research aims. Reference lists of studies meeting pre-defined inclusion criteria were also hand-searched. Relevant data were extracted systematically from the included studies and results are reported narratively. RESULTS Searches identified 5,398 studies, and 35 were deemed relevant to the aims of the review. Results showed there is little consensus in the terminology or definitions used to refer to recurrence of PTSD. Because recurrence was defined and measured in different ways across the literature, and prevalence rates were reported in numerous different ways, it was not possible to perform meta-analysis to estimate the prevalence of recurrence. We also found no consistent evidence regarding predictors of PTSD recurrence. CONCLUSION A clear and consistent evidence-based definition of recurrence is urgently needed before the prevalence and predictors of recurrence can be truly understood.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, SE5 9RJ, London, United Kingdom.
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, SE5 9RJ, London, United Kingdom
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Hall CE, Brooks SK, Mills F, Greenberg N, Weston D. Experiences of working from home: umbrella review. J Occup Health 2024; 66:uiad013. [PMID: 38258944 PMCID: PMC11020277 DOI: 10.1093/joccuh/uiad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/09/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION The concept of "working from home" is extremely topical following the COVID-19 pandemic; therefore, it is unsurprising that there has been an increased interest in collating research related to homeworking. This has been carried out by multiple reviews, all with slightly different research aims and methodologies. Collating the findings from the available reviews is therefore highly beneficial to establish the experience of homeworking to create recommendations for the future of home-based work. METHODS An umbrella review was carried out. In June 2022, literature searches were conducted across 4 electronic databases. Published reviews of literature that used a systematic process, were focused on working from home populations, and detailed factors that could be related to the personal experience of homeworking (eg, barriers, facilitators, advantages, disadvantages) were included. RESULTS A total of 1930 records were screened and 6 review articles were included. Results report on the following sections: working environment (eg, workplace design, space conditions), personal impact (eg, satisfaction, career impact), and health (eg, physical health, well-being) including a total of 19 themes. Mixed findings were apparent for nearly all included themes, highlighting the need to consider individual and contextual circumstances when researching working from home. CONCLUSIONS This review establishes the importance of retaining flexibility while homeworking for employees, managers, and organizations. Essentially, a one-size-fits-all approach to working from home is impractical as individual circumstances limit application. Eight recommendations for the future of working from home are suggested.
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Affiliation(s)
- Charlotte E. Hall
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London, SE5 9RJ, United Kingdom
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UKHSA, Porton Down, Salisbury, SP4 0JG, United Kingdom
| | - Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London, SE5 9RJ, United Kingdom
| | - Freya Mills
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UKHSA, Porton Down, Salisbury, SP4 0JG, United Kingdom
- School of Psychology, University of Sussex, Brighton, BN1 9QH, United Kingdom
| | - Neil Greenberg
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London, SE5 9RJ, United Kingdom
| | - Dale Weston
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UKHSA, Porton Down, Salisbury, SP4 0JG, United Kingdom
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Hall CE, Wehling H, Stansfield J, South J, Brooks SK, Greenberg N, Amlôt R, Weston D. Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review. BMC Public Health 2023; 23:2482. [PMID: 38082247 PMCID: PMC10714503 DOI: 10.1186/s12889-023-17242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.
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Grants
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia
- Office for Health Improvement and Disparities, Department of Health and Social Care, as part of a Collaborative Agreement with Leeds Beckett University.
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Affiliation(s)
- C E Hall
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - H Wehling
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - J Stansfield
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
| | - J South
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
| | - S K Brooks
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - N Greenberg
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
- King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - R Amlôt
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - D Weston
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK.
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Brooks SK, Patel D, Greenberg N. "Exceptionally challenging time for all of us": Qualitative study of the COVID-19 experiences of partners of diplomatic personnel. PLoS One 2023; 18:e0293557. [PMID: 37917599 PMCID: PMC10621840 DOI: 10.1371/journal.pone.0293557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Although the romantic partners of diplomatic personnel frequently accompany their spouses to overseas postings and face the challenges of having to adjust to new cultures and separation from friends and family, they have rarely been the focus of academic research. This study explores the lived experiences of the partners/spouses of diplomatic personnel from the United Kingdom's Foreign, Commonwealth and Development Office (FCDO) during the COVID-19 pandemic. METHODS Partners of FCDO staff took part in semi-structured interviews about how COVID-19 had affected their lives and their perceptions of the organisation's response to the pandemic. Thematic analysis was used to analyse the data. RESULTS Eleven partners of FCDO staff took part, who between them had lived in 14 different countries during the pandemic. The analysis identified six key themes: deployment-specific challenges such as travel restrictions, quarantine and evacuation; children; impacts of the pandemic including financial and psychological; perceptions of the organisational response to COVID-19; support and help-seeking; and suggestions for the future. Overall participants reported experiencing a number of challenges, many of which left them feeling powerless and not in control of their own lives. Participants frequently described a lack of clarity around policies and support. Social support appeared to be valuable, but many participants wanted more support from the organisation and from informal networks. CONCLUSIONS Diplomatic (and similar) organisations could enhance the wellbeing of the partners of their staff through improved communication and support. Keeping families informed about restrictions, requirements, policies and available help during a crisis, and reaching out to them to offer advice and support, would likely be beneficial. It is important that lessons are learned from the COVID-19 crisis in order for organisations to be able to support their employees and families if another prolonged crisis were to occur.
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Affiliation(s)
- Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Dipti Patel
- Overseas Health and Welfare, Foreign, Commonwealth and Development Office, London, United Kingdom
| | - Neil Greenberg
- Department of Psychological Medicine, King’s College London, London, United Kingdom
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Brooks SK, Greenberg N. The Well-Being of Companion Animal Caregivers and Their Companion Animals during the COVID-19 Pandemic: Scoping Review. Animals (Basel) 2023; 13:3294. [PMID: 37894018 PMCID: PMC10604194 DOI: 10.3390/ani13203294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
It is important to understand the effects of the COVID-19 pandemic on animal caregivers and their companion animals in order to inform responses to future crises. Prior research is inconsistent, with the benefits of animal companionship believed to be overstated. In this scoping review, we searched four electronic databases and hand-searched reference lists of included studies. Over 4000 citations were found, and 122 were included in the review. Reflecting on the pre-COVID literature, quantitative evidence of the association between psychological well-being and animal companionship during the pandemic was mixed, with numerous positive, negative, and null findings reported. Studies highlighted the benefits of animal companionship during the pandemic, with animals reported to provide their caregivers with a routine, a sense of greater purpose, a positive distraction from COVID-19, companionship, and emotional support. However, participants also reported concerns about meeting animals' needs, fears of animals catching or spreading the virus, and financial worries. Concerns about what would happen to animals if caregivers were hospitalized led some to delay COVID-19 testing or treatment. Animals also experienced benefits (such as increased companionship and calmer mood) and negative impacts (such as increased clinginess and separation anxiety). Companion animals should be a key consideration in emergency preparedness plans.
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Affiliation(s)
- Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, Cutcombe Road, London SE5 9RJ, UK
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Woodland L, Smith LE, Brooks SK, Webster RK, Amlôt R, Rubin A, Rubin GJ. Parent-reported child's close contact with non-household family members and their well-being during the COVID-19 pandemic: A cross-sectional survey. PLoS One 2023; 18:e0292344. [PMID: 37856464 PMCID: PMC10586646 DOI: 10.1371/journal.pone.0292344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
In England (UK), at the start of the COVID-19 pandemic the public were required to reduce their physical contacts to slow the spread of COVID-19. We investigated the factors associated with children having: 1) close contact with family members from outside their household ('non-adherent behaviour'); and 2) low well-being (Revised Child Anxiety and Depression Scale). We conducted an online cross-sectional survey, completed at any location of the participant's choice between 8 and 11 June 2020 in parents (n = 2,010) who were aged eighteen years or over and had a school-aged child (4-18 years old). Parents reported that 15% (n = 309) of children had non-adherent contact and that 26% (n = 519) had low well-being. We used a series of binary logistic regressions to investigate associations between outcomes and child and parent characteristics. Children had higher odds of having non-household contact when they had special educational needs [adjusted odds ratio, 2.19 (95% CI, 1.47 to 3.27)], lower well-being [2.65 (95% CI, 2.03 to 3.46)], were vulnerable to COVID-19 [2.17 (95% CI, 1.45 to 3.25)], lived with someone who was over 70 years old [2.56 (95% CI, 1.55 to 4.24)] and their parent had low well-being [1.94 (95% CI, 1.45 to 2.58)]. Children had higher odds of lower well-being when they had special educational needs [4.13 (95% CI, 2.90 to 5.87)], were vulnerable to COVID-19 [3.06 (95% CI, 2.15 to 4.36)], lived with someone else who was vulnerable to COVID-19 [2.08 (95% CI, 1.64 to 2.64)], or lived with someone who was over 70 years old [2.41 (95% CI, 1.51 to 3.83)]. Many children came into contact with non-household family members, mainly for childcare. Factors relating to COVID-19, children's well-being and education were also important. If school closures are needed in future, addressing these issues may help reduce contact.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
| | - Louise E. Smith
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
| | - Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
| | - Rebecca K. Webster
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, United Kingdom
| | - Antonia Rubin
- Trustee at Weald of Kent Grammar School, Tonbridge, Kent, United Kingdom
| | - G. James Rubin
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
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Parkes S, Croak B, Brooks SK, Stevelink SAM, Leightley D, Fear NT, Rafferty L, Greenberg N. Evaluating a Smartphone App (MeT4VeT) to Support the Mental Health of UK Armed Forces Veterans: Feasibility Randomized Controlled Trial. JMIR Ment Health 2023; 10:e46508. [PMID: 37639295 PMCID: PMC10495851 DOI: 10.2196/46508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Previous research demonstrates that less than 50% of military veterans experiencing mental health difficulties seek formal support. Veterans often struggle to identify problems as mental health difficulties. In addition, they may fail to recognize the need for support before reaching a crisis point and face difficulties navigating care pathways to access support. OBJECTIVE A feasibility trial was conducted to assess a novel digital smartphone app (Mental Health Toolkit for Veterans Project [MeT4VeT]) for UK Armed Forces (UKAF) veterans experiencing mental health difficulties. The trial aimed to explore the feasibility and acceptability of trial procedures for a later randomized controlled trial (RCT) and to assess the acceptability of the MeT4VeT app. METHODS Participants were recruited at UK military medical centers, by advertising on social media, and through veteran third-sector organizations between February and November 2021, and assessed for eligibility (male, owned a smartphone, served at least 2 years in the UKAF, left the UKAF within the last 2 years, not undertaking formal mental health treatment). Eligible participants were assigned, on a 1:1 ratio, to either the intervention group (full app) or a control group (noninteractive app with signposting information). Three key objectives were determined a priori to assess the practicality of running an RCT including an assessment of recruitment and retention, evaluation of the technical app delivery and measurement processes, and acceptability and usability of the intervention. RESULTS In total, 791 individuals completed the participant information sheet, of which 261 (33%) were ineligible, 377 (48%) declined or were unable to be contacted for consent, and 103 (13%) did not download the app or complete the baseline measures. Of this, 50 participants completed baseline measures and were randomly assigned to the intervention group (n=24) or the control group (n=26). The trial was effective at enabling both the technical delivery of the intervention and collection of outcome measures, with improvements in mental health demonstrated for the intervention group from baseline to the 3-month follow-up. Recruitment and retention challenges were highlighted with only 50 out of the 530 eligible participants enrolled in the trial. The acceptability and usability of the MeT4VeT app were generally supported, and it was reported to be a useful, accessible way for veterans to monitor and manage their mental health. CONCLUSIONS The results highlighted that further work is needed to refine recruitment processes and maintain engagement with the app. Following this, an RCT can be considered to robustly assess the ability of the app to positively affect mental health outcomes indicated within this trial. TRIAL REGISTRATION ClinicalTrials.gov NCT05993676; https://clinicaltrials.gov/ct2/show/NCT05993676.
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Affiliation(s)
- Steven Parkes
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Bethany Croak
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Samantha K Brooks
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Sharon A M Stevelink
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Daniel Leightley
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Nicola T Fear
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
- Academic Department of Military Mental Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Laura Rafferty
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Neil Greenberg
- King's Centre for Military Health Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
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Brooks SK, Patel SS, Greenberg N. Struggling, Forgotten, and Under Pressure: A Scoping Review of Experiences of Sex Workers During the COVID-19 Pandemic. Arch Sex Behav 2023; 52:1969-2010. [PMID: 37311934 PMCID: PMC10263380 DOI: 10.1007/s10508-023-02633-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/19/2023] [Accepted: 05/21/2023] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic profoundly affected physical, mental, and economic well-being across the globe and has disproportionately affected certain vulnerable groups. This paper provides a scoping review of literature on the impact of the COVID-19 pandemic on sex workers, published between December 2019 and December 2022. Six databases were systematically searched, identifying 1009 citations; 63 studies were included in the review. Thematic analysis revealed eight main themes: financial issues; exposure to harm; alternate ways of working; COVID-19 knowledge, protective behaviors, fear, and risk; well-being, mental health, and coping; access to support; access to health care; and the impact of COVID-19 on research with sex workers. COVID-associated restrictions led to reduced work and income, leaving many sex workers struggling to cover basic needs; additionally, government protections excluded those working in the informal economy. Fearing the loss of their already reduced number of clients, many felt compelled to compromise both prices and protective measures. Although some engaged in online sex work, this raised concerns about visibility and was impossible for those without technological access or skills. Many feared COVID-19, but felt pressure to continue working, often with clients who refused to wear masks or share exposure history. Other negative impacts on well-being related to the pandemic included reduced access to financial support or health care. Marginalized populations (and especially those in professions which require close contact like sex workers) need further support and capacity-building within the community to recover from the impact of COVID-19.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK.
| | - Sonny S Patel
- Transcultural Conflict and Violence Initiative, Georgia State University, Atlanta, GA, USA
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK
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Hall CE, Davidson L, Brooks SK, Greenberg N, Weston D. The relationship between homeworking during COVID-19 and both, mental health, and productivity: a systematic review. BMC Psychol 2023; 11:188. [PMID: 37370153 DOI: 10.1186/s40359-023-01221-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND As of March 2020, the UK public were instructed to work from home where possible and as a result, nearly half of those in employment did so during the following month. Pre-pandemic, around 5% of workers chose to work from home; it was often seen as advantageous, for example due to eliminating commuting time and increasing flexibility. However, homeworking also had negative connotations, for example, blurred boundaries between work and home life due to a sense of constant connectivity to the workplace. Understanding the psychological impact of working from home in an enforced and prolonged manner due to the COVID-19 pandemic is important. Therefore, this review sought to establish the relationship between working from home, mental health, and productivity. METHODS In January 2022, literature searches were conducted across four electronic databases: Medline, Embase, PsycInfo and Web of Science. In February 2022 grey literature searches were conducted using Google Advanced Search, NHS Evidence; Gov.uk Publications and the British Library directory of online doctoral theses. Published and unpublished literature which collected data after March 2020, included participants who experienced working from home for at least some of their working hours, and detailed the association in terms of mental health or productivity were included. RESULTS In total 6,906 citations were screened and 25 papers from electronic databases were included. Grey literature searching resulted in two additional papers. Therefore, 27 studies were included in this review. Findings suggest the association between homeworking and both, mental health and productivity varies considerably, suggesting a complex relationship, with many factors (e.g., demographics, occupation) having an influence on the relationship. CONCLUSION We found that there was no clear consensus as to the association between working from home and mental health or productivity. However, there are indications that those who start homeworking for the first time during a pandemic are at risk of poor productivity, as are those who experience poor mental health. Suggestions for future research are suggested.
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Affiliation(s)
- Charlotte E Hall
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK.
- Evaluation & Translation Directorate, Science Group, Behavioural Science and Insights Unit, UKHSA, Porton Down, Salisbury, SP4 0JG, UK.
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK.
| | - Louise Davidson
- Evaluation & Translation Directorate, Science Group, Behavioural Science and Insights Unit, UKHSA, Porton Down, Salisbury, SP4 0JG, UK
- School of Psychology, University of Sussex, Brighton, BN1 9QH, UK
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Dale Weston
- Evaluation & Translation Directorate, Science Group, Behavioural Science and Insights Unit, UKHSA, Porton Down, Salisbury, SP4 0JG, UK
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Woodland L, Brooks SK, Webster RK, Amlôt R, Rubin GJ. Risk factors for school-based presenteeism in children: a systematic review. BMC Psychol 2023; 11:169. [PMID: 37221597 DOI: 10.1186/s40359-023-01207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Children attending school whilst unwell, known as school-based presenteeism, results in negative impacts on education and mental and physical health. We aimed to identify the risk factors for this behaviour. METHOD We conducted a systematic search of five databases (11 July 2022) using words associated with school (e.g., school and childcare) and presenteeism (e.g., presenteeism and sick leave). The studies are synthesised according to the risk factors associated with school-based presenteeism and are grouped into themes by related topics. RESULTS Our review included 18 studies, with quantitative, qualitative, and mixed-method study designs. Children, parents, and school staff reported past incidents and intentions for future presenteeism. We identified five themes from these reports: perceptions about the illness / signs and symptom(s); children's characteristics; children's and parents' motivations and attitudes towards school; organisational factors; and school sickness policy. Increased risk of school-based presenteeism was commonly linked to symptoms that were perceived low in severity and unidentifiable, children with a high school absence record, disbelief in children's illness, unsupportive employers, vague school policies and financial consequences. CONCLUSIONS School-based presenteeism is complex due to the competing interests of the multiple individuals involved, such as children, parents, and school staff. Sickness policies need to include clear and specific guidance about illness and the signs and symptoms of diseases and should be communicated to all relevant individuals to mitigate against discrepancies in how the policy is interpreted. Furthermore, parents and school staff need support, such as financial and childcare, to be able to manage children when they are unwell.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King's College London, London, UK.
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom.
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
| | | | - Richard Amlôt
- Behavioural Science and Insights Unit, Health Security Agency, Salisbury, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
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11
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Brooks SK, Greenberg N. Climate change effects on mental health: are there workplace implications? Occup Med (Lond) 2023; 73:133-137. [PMID: 36170162 PMCID: PMC10132205 DOI: 10.1093/occmed/kqac100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Climate change can negatively affect mental health, and poor mental health can negatively affect work. However, less is known about the relationship between mental health and workplace behaviours within the climate change context. AIMS To explore existing literature relating to climate-induced mental ill-health as a potential predictor of workplace behaviours. METHODS Scoping review, searching five databases for relevant literature using two separate search strategies. RESULTS Only five studies with any relevant data were found. Results could not be easily synthesized because each of the five considered different work-related outcomes. However, the available data suggest that the psychological impact of extreme events could lead to increased job tension, higher turnover intentions and workplace hostility. Stress about extreme weather could also impede the ability to make essential work-related decisions and, for those who work in the environmental sector, concerns about climate could lead to overcommitment to work. There was some evidence that social support might lessen the effects of climate-induced stress on work outcomes. CONCLUSIONS Very little literature considers the impacts of climate change on employees' mental health and associated workplace function. The available evidence suggests there are potential negative impacts which may be mitigated by social support. It is important for future research to explore ways of supporting staff and fostering resilience.
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Affiliation(s)
- S K Brooks
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
| | - N Greenberg
- Department of Psychological Medicine, King’s College London, London SE5 9RJ, UK
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12
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Brooks SK, Patel D, Greenberg N. Mental health of diplomatic personnel: scoping review. Occup Med (Lond) 2023; 73:155-160. [PMID: 36893355 PMCID: PMC10132204 DOI: 10.1093/occmed/kqad032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Diplomatic personnel frequently relocate as part of their roles, requiring them to adapt to various cultural and political conditions; many are also at risk of experiencing trauma from being deployed to high-threat postings. With diplomatic personnel having to balance the usual pressures of their work with the uncertainties of COVID-19 in recent years, it is particularly important now to understand how to protect their mental health. AIMS To synthesize existing literature on the well-being of diplomatic personnel to improve understanding of how to protect their mental health. METHODS A scoping review was carried out to explore what is already known about the well-being of staff working in diplomatic roles. Four databases were searched and reference lists, as well as one key journal, were hand-searched. RESULTS Fifteen relevant publications were included. There was little consensus as to how the psychological well-being of diplomatic personnel compares to other populations or which factors predict well-being. Diplomats' psychological responses to traumatic experiences appeared similar to those of other trauma-exposed occupational groups. CONCLUSIONS Further research is needed to better understand the well-being of diplomatic personnel, particularly those not deployed to high-threat posts.
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Affiliation(s)
- S K Brooks
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London SE5 9RJ, UK
| | - D Patel
- Overseas Health and Welfare, Foreign, Commonwealth and Development Office, King Charles Street, London SW1A 2AH, UK
| | - N Greenberg
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London SE5 9RJ, UK
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13
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Brooks SK. A Research Agenda for Workplace Stress and Well-being. Occup Med (Lond) 2022. [DOI: 10.1093/occmed/kqac115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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14
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Brooks SK, Greenberg N. Mental health and wellbeing of border security personnel: scoping review. Occup Med (Lond) 2022; 72:636-640. [PMID: 36315001 PMCID: PMC9805299 DOI: 10.1093/occmed/kqac108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Whilst the wellbeing of law enforcement personnel has been widely researched, border security personnel as a discrete group appear to be far less discussed, despite their roles frequently exposing them to potentially traumatic and challenging events such as contact with criminals or witnessing personal tragedies due to trafficking or smuggling. AIMS This scoping review aimed to explore existing literature to better understand the mental health of border security personnel and the factors affecting their wellbeing. METHODS Four electronic databases and grey literature were systematically searched for studies relevant to the review's aims. Following the extraction of relevant data from each study, thematic analysis was used to synthesize findings. RESULTS Thirteen studies included relevant data and were included in the review, identifying stressors including poor management; fatigue; negative public attitudes; inadequate staffing levels, resources, and training; poor opportunities for promotion; low pay; work overload; dangerous working environments; and work-related moral dilemmas. CONCLUSIONS The review found that there has been little academic attention paid to border security personnel as a specific branch of law enforcement. Many of the stressors identified in this review are those also reported by law enforcement generally, although negative attitudes from the public and exposure to moral dilemmas appear to be more relevant for border security staff. Directly addressing work-related stress (e.g. by fostering a supportive organizational culture, addressing mental health stigma, and encouraging help-seeking) may be useful in enhancing the resilience of border security personnel.
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Affiliation(s)
- S K Brooks
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London SE5 9RJ, UK
| | - N Greenberg
- Department of Psychological Medicine, King’s College London, Weston Education Centre, London SE5 9RJ, UK
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15
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Brooks SK, Hall CE, Patel D, Greenberg N. “In the office nine to five, five days a week… those days are gone”: qualitative exploration of diplomatic personnel’s experiences of remote working during the COVID-19 pandemic. BMC Psychol 2022; 10:272. [PMID: 36397178 PMCID: PMC9670069 DOI: 10.1186/s40359-022-00970-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022] Open
Abstract
Background Many employees had to work remotely during the COVID-19 pandemic. Literature suggests there are both challenges and benefits to remote working and that remote working can have detrimental effects on mental health. This study aimed to explore diplomatic personnel’s perceptions and experiences of working from home during the pandemic. Methods Twenty-five employees of the Foreign, Commonwealth and Development Office took part in semi-structured interviews. Thematic analysis was carried out to extract recurring themes from the data. Results Seven main themes emerged from the data: impact of the pandemic on work; relationships with colleagues; benefits of working from home; challenges of working from home; family; moving posts during the pandemic; and perceptions and predictions of post-pandemic work. Participants provided mixed views on how remote working had affected productivity and relationships with colleagues. Benefits of working from home included greater freedom and flexibility; new opportunities; and inclusivity of remote meetings. Challenges included being in different time zones to the countries they were working for; unsuitable home ergonomics; technological issues; and difficulties finding appropriate work-life balance. Those with young children reported difficulties juggling work and childcare. Adjusting to new posts at a time when staff were working remotely appeared particularly challenging. However, most did not want or expect to return to entirely office-based work. They predicted a hybrid model of working in the future, involving both office work and remote work; they stressed the importance of flexibility and suggested there would not be a one-size-fits-all approach to returning to face-to-face work. Conclusions Remote working during the COVID-19 pandemic has changed the ways in which employees work, showing them that they do not have to be in the office to successfully achieve their work goals and leaving many wanting flexibility to make their own decisions about working from home (or not). There are both benefits and challenges to remote working; managers can take steps to reduce some of the challenges by being available to support their employees, organising regular remote meetings and allowing employees autonomy in terms of when and where they work. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-022-00970-x.
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16
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Rubin GJ, Wessely S, Greenberg N, Brooks SK. Quality appraisal of evidence generated during a crisis: in defence of 'timeliness' and 'clarity' as criteria. BMJ Evid Based Med 2022; 27:189. [PMID: 34168011 DOI: 10.1136/bmjebm-2021-111760] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 11/04/2022]
Affiliation(s)
- G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, London, UK
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
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17
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Brooks SK, Greenberg N. Mental health and psychological wellbeing of maritime personnel: a systematic review. BMC Psychol 2022; 10:139. [PMID: 35637491 PMCID: PMC9150387 DOI: 10.1186/s40359-022-00850-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 05/23/2022] [Indexed: 01/09/2023] Open
Abstract
Background Seafaring has frequently been reported to be a ‘risky occupation’ in terms of both physical and mental health. Individuals working in seafaring professions are exposed to various stressors in the workplace, including social isolation, exposure to poor physical conditions and long work hours. This systematic review aimed to update previous reviews by collating recent literature (published between 2012 and 2021) on the factors associated with mental health and wellbeing in seafaring personnel. Methods Four electronic databases were searched in April 2021 for primary peer-reviewed studies on factors associated with the mental health and psychological wellbeing of seafarers or interventions to improve the wellbeing of seafarers, published in English in or after the year 2012. Thematic analysis was used to synthesise the data and standardised measures of quality appraisal were used to assess risk of bias. Results Sixty-three studies were reviewed. Risk factors for poor mental health among seafarers appear to be younger age; being single; poor physical health; exposure to noise/vibration; feeling unsafe; high job demands; long working hours; night/irregular shifts; poor sleep; poor team cohesion; poor perception of management; poor social support; lack of autonomy; scheduling uncertainties; long duration at sea; and over-commitment. Conclusions There are numerous steps that maritime managers could take to improve the wellbeing of their personnel, including increased monitoring of the potential for poor mental health in their staff, increasing crew numbers and provision of education and support.
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18
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Brooks SK, Greenberg N. Mental health and wellbeing of seafaring personnel during COVID-19: Scoping review. J Occup Health 2022; 64:e12361. [PMID: 36134469 PMCID: PMC9494025 DOI: 10.1002/1348-9585.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/30/2022] [Accepted: 09/04/2022] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES We aimed to synthesize published literature on seafarers' mental health and wellbeing during the COVID-19 pandemic. METHODS This scoping review searched four electronic databases for literature on the mental health and wellbeing of seafarers during the COVID-19 pandemic. RESULTS Fourteen studies were included in the review. Few reported on the prevalence of mental health conditions. Only one compared mental health data gathered during the pandemic to pre-pandemic matched samples, suggesting symptoms of depression and anxiety were greater during the pandemic. There was some evidence that mental health worsened with longer stays on board during the pandemic and being on board longer than expected. Crew exchange difficulties forced many participants to extend their contracts or delay repatriation, often with little information as to when they might get to go home, leading them to feel they had no control over their lives and causing concern about fatigue and the potential for accidents and injuries. Participants described other challenges such as denial of shore leave; concerns about finances and future employment; loneliness and isolation; fears of COVID-19 infection; limited access to essential supplies; and feeling unsupported by management. CONCLUSIONS Maritime organizations must understand how best to support their staff in the aftermath of the COVID-19 pandemic and in any other prolonged crises that may arise in the future. Recommendations include ensuring that staff feel valued by their organization; enhancing work-related autonomy; ensuring that communication is accurate, consistent, and timely; and using lessons learned from the COVID-19 pandemic to inform emergency preparedness policies.
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Affiliation(s)
- Samantha K. Brooks
- Department of Psychological Medicine, King's College LondonWeston Education CentreLondonUK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College LondonWeston Education CentreLondonUK
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19
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Brooks SK, Greenberg N, Wessely S, Rubin GJ. Factors affecting healthcare workers' compliance with social and behavioural infection control measures during emerging infectious disease outbreaks: rapid evidence review. BMJ Open 2021; 11:e049857. [PMID: 34400459 PMCID: PMC8370838 DOI: 10.1136/bmjopen-2021-049857] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE The 2019-2020 outbreak of novel coronavirus has raised concerns about nosocomial transmission. This review's aim was to explore the existing literature on emerging infectious disease outbreaks to identify factors associated with compliance with infection control measures among healthcare staff. METHODS A rapid evidence review for primary studies relevant to healthcare workers' compliance with infection control measures. RESULTS Fifty-six papers were reviewed. Staff working in emergency or intensive care settings or with contact with confirmed cases appeared more likely to comply with recommendations. There was some evidence that anxiety and concern about the risk of infection were more associated with compliance, and that monitoring from superiors could improve compliance. Observed non-compliance of colleagues could hinder compliance. Staff identified many barriers to compliance related to personal protective equipment, including availability, perceived difficulty and effectiveness, inconvenience, discomfort and a negative impact on patient care. There were many issues regarding the communication and ease of understanding of infection control guidance. CONCLUSION We recommend provision of training and education tailored for different occupational roles within the healthcare setting, managerial staff 'leading by example', ensuring adequate resources for infection control and timely provision of practical evidence-based infection control guidelines.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
| | - N Greenberg
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - G J Rubin
- Department of Psychological Medicine, King's College London, London, UK
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20
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Brooks SK, Weston D, Wessely S, Greenberg N. Effectiveness and acceptability of brief psychoeducational interventions after potentially traumatic events: A systematic review. Eur J Psychotraumatol 2021; 12:1923110. [PMID: 34104355 PMCID: PMC8168745 DOI: 10.1080/20008198.2021.1923110] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Experiencing a potentially traumatic event can put individuals at risk for both short-term and long-term mental health problems. While many psychological interventions exist for those who have experienced potentially traumatic events, there remains controversy about the best ways to support them. Objective: This review explores the effect of brief psychoeducational interventions after potentially traumatic experiences on adult recipients' mental health, attitudes towards mental health, and trauma-related knowledge, as well as the perceived acceptability of psychoeducation. Methods: Four electronic databases were searched for relevant published literature. Results: Ten papers were included in the review. There was no evidence that psychoeducation was any more effective in terms of reducing mental health symptoms than other interventions or no intervention at all. There was some evidence that psychoeducation improved attitudes towards and knowledge of mental health immediately post-intervention; one study examined whether these improvements were sustained over the long term and found that they were not. However, psychoeducation was generally highly regarded by participants. Conclusions: This review did not find sufficient evidence to support routine use of brief psychoeducation as a stand-alone intervention.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK
| | - Dale Weston
- Behavioural Science Team, Emergency Response Department Science & Technology, Public Health England, Salisbury, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK
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21
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Abstract
Being wrongfully accused of criminal offences can lead to serious negative consequences to those wrongfully accused and their families. However, there is little research on the psychological and psychosocial impacts of wrongful accusations. We conducted a systematic literature review to collate the existing literature, searching four electronic literature databases and reference lists of relevant articles. Data were extracted from 20 relevant papers, and thematic analysis was conducted on the data. Eight main themes were identified: loss of identity; stigma; psychological and physical health; relationships with others; attitudes towards the justice system; impact on finances and employment; traumatic experiences in custody; and adjustment difficulties. The psychological consequences of wrongful accusations appear to affect the lives of those accused seriously, even after exoneration or overturning of convictions. Strategies for improving public perception of wrongful convictions should be explored, and specific mental-health systems should be established to support those who are wrongfully accused.
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Affiliation(s)
| | - Neil Greenberg
- Neil Greenberg, The Health Protection Research Unit, King’s College London, Weston Education Centre, Cutcombe Road, LondonSE5 9RJ, UK.
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22
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Brooks SK, Weston D, Greenberg N. Psychological impact of infectious disease outbreaks on pregnant women: rapid evidence review. Public Health 2020; 189:26-36. [PMID: 33142123 PMCID: PMC7605787 DOI: 10.1016/j.puhe.2020.09.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/28/2020] [Accepted: 09/11/2020] [Indexed: 02/06/2023]
Abstract
Objectives Infectious disease outbreaks can be distressing for everyone, especially those deemed to be particularly vulnerable such as pregnant women, who have been named a high-risk group in the current COVID-19 pandemic. This paper aimed to summarise existing literature on the psychological impact of infectious disease outbreaks on women who were pregnant at the time of the outbreak. Study design The design of this study is a rapid review. Methods Five databases were searched for relevant literature, and main findings were extracted. Results Thirteen articles were included in the review. The following themes were identified: negative emotional states; living with uncertainty; concerns about infection; concerns about and uptake of prophylaxis or treatment; disrupted routines; non-pharmaceutical protective behaviours; social support; financial and occupational concerns; disrupted expectations of birth, prenatal care and postnatal care and sources of information. Conclusions Pregnant women have unique needs during infectious disease outbreaks and could benefit from up-to-date, consistent information and guidance; appropriate support and advice from healthcare professionals, particularly with regards to the risks and benefits of prophylaxis and treatment; virtual support groups and designating locations or staff specifically for pregnant women. Pregnant women may be particularly susceptible to distress during pandemics. Infection fears and prophylaxis concerns may exacerbate distress. Disrupted routines, financial concerns and uncertainty are also stressors. Disrupted expectations of birth and related healthcare may be distressing. Pregnant women may benefit from clear information/guidance and support groups.
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Affiliation(s)
- S K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK.
| | - D Weston
- Behavioural Science Team, Emergency Response Department Science & Technology, Public Health England, Porton Down, Salisbury, SP4 0JG, UK.
| | - N Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, SE5 9RJ, UK.
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23
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Greenberg N, Brooks SK, Wessely S, Tracy DK. How might the NHS protect the mental health of health-care workers after the COVID-19 crisis? Lancet Psychiatry 2020; 7:733-734. [PMID: 32473664 PMCID: PMC7255732 DOI: 10.1016/s2215-0366(20)30224-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022]
Affiliation(s)
- Neil Greenberg
- The Health Protection Research Unit, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Samantha K Brooks
- The Health Protection Research Unit, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Simon Wessely
- The Health Protection Research Unit, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Derek K Tracy
- Cognition, Schizophrenia, and Imaging Laboratory, Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK; Oxleas NHS Foundation Trust, London, UK
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Patel SS, Webster RK, Greenberg N, Weston D, Brooks SK. Research fatigue in COVID-19 pandemic and post-disaster research: Causes, consequences and recommendations. Disaster Prev Manag 2020; 29:445-455. [PMID: 33679011 PMCID: PMC7932124 DOI: 10.1108/dpm-05-2020-0164] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE Research fatigue occurs when an individual or population of interest tires of engaging with research, consequently avoiding further participation. This paper considers research fatigue in the context of the current COVID-19 pandemic, to identify contributory factors and possible solutions for future post-disaster research. METHODOLOGY We draw on examples from the literature and our own observations from the recruitment and data collection phases of qualitative and quantitative studies, to provide an overview of possible research fatigue in the current COVID-19 pandemic, with implications for future post-disaster research. FINDINGS People affected by disasters sometimes receive multiple requests for study participation by separate teams who may not necessarily be coordinating their work. Not keeping participants informed of the research process or outcomes can lead to disillusionment. Being overburdened with too many research requests and failing to see any subsequent changes following participation may cause individuals to experience research fatigue. ORIGINALITY Guidelines for researchers wishing to reduce the occurrence of research fatigue include ensuring greater transparency within research; sharing of results; and using oversight or gatekeeper bodies to aid coordination. Failure to restrict the number of times that people are asked to participate in studies risks poor participation rates. This can subsequently affect the quality of information with which to inform policy-makers and protect the health of the public during the COVID-19 pandemic or other public health disasters/emergencies.
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Affiliation(s)
- Sonny S Patel
- Fellow, NIH Global Health Scholar, Department of Global Health and Population, Harvard Humanitarian Initiative, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rebecca K Webster
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Weston Education Centre and NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London SE5 9RJ, UK
| | - Dale Weston
- Behavioural Science Team, Emergency Response Department Science & Technology, Public Health England, Porton Down, Salisbury, SP4 0JG, UK
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre and NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London SE5 9RJ, UK
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Webster RK, Brooks SK, Smith LE, Woodland L, Wessely S, Rubin GJ. How to improve adherence with quarantine: rapid review of the evidence. Public Health 2020; 182:163-169. [PMID: 32334182 PMCID: PMC7194967 DOI: 10.1016/j.puhe.2020.03.007] [Citation(s) in RCA: 190] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/11/2020] [Accepted: 03/13/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The December 2019 outbreak of coronavirus has once again thrown the vexed issue of quarantine into the spotlight, with many countries asking their citizens to 'self-isolate' if they have potentially come into contact with the infection. However, adhering to quarantine is difficult. Decisions on how to apply quarantine should be based on the best available evidence to increase the likelihood of people adhering to protocols. We conducted a rapid review to identify factors associated with adherence to quarantine during infectious disease outbreaks. STUDY DESIGN The study design is a rapid evidence review. METHODS We searched Medline, PsycINFO and Web of Science for published literature on the reasons for and factors associated with adherence to quarantine during an infectious disease outbreak. RESULTS We found 3163 articles and included 14 in the review. Adherence to quarantine ranged from as little as 0 up to 92.8%. The main factors which influenced or were associated with adherence decisions were the knowledge people had about the disease and quarantine procedure, social norms, perceived benefits of quarantine and perceived risk of the disease, as well as practical issues such as running out of supplies or the financial consequences of being out of work. CONCLUSIONS People vary in their adherence to quarantine during infectious disease outbreaks. To improve this, public health officials should provide a timely, clear rationale for quarantine and information about protocols; emphasise social norms to encourage this altruistic behaviour; increase the perceived benefit that engaging in quarantine will have on public health; and ensure that sufficient supplies of food, medication and other essentials are provided.
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Affiliation(s)
- R K Webster
- Department of Psychology, University of Sheffield, United Kingdom.
| | - S K Brooks
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, United Kingdom
| | - L E Smith
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, United Kingdom
| | - L Woodland
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, United Kingdom
| | - S Wessely
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, United Kingdom
| | - G J Rubin
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, United Kingdom
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Brooks SK, Smith LE, Webster RK, Weston D, Woodland L, Hall I, Rubin GJ. The impact of unplanned school closure on children's social contact: rapid evidence review. Euro Surveill 2020. [PMID: 32265006 DOI: 10.1101/2020.03.17.20037457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
BackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited.AimThis review aimed to summarise existing literature on children's activities and contacts made outside the home during unplanned school closures.MethodsIn February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children's social activities during unplanned school closures. Main findings were extracted.ResultsA total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact.ConclusionEvidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Rebecca K Webster
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Dale Weston
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, United Kingdom
| | - Lisa Woodland
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Ian Hall
- Department of Mathematics and School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - G James Rubin
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
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Brooks SK, Smith LE, Webster RK, Weston D, Woodland L, Hall I, Rubin GJ. The impact of unplanned school closure on children's social contact: rapid evidence review. Euro Surveill 2020; 25:2000188. [PMID: 32265006 PMCID: PMC7140596 DOI: 10.2807/1560-7917.es.2020.25.13.2000188] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 03/24/2020] [Indexed: 11/20/2022] Open
Abstract
BackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited.AimThis review aimed to summarise existing literature on children's activities and contacts made outside the home during unplanned school closures.MethodsIn February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children's social activities during unplanned school closures. Main findings were extracted.ResultsA total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact.ConclusionEvidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Rebecca K Webster
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Dale Weston
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, United Kingdom
| | - Lisa Woodland
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
| | - Ian Hall
- Department of Mathematics and School of Health Sciences, University of Manchester, Manchester, United Kingdom
| | - G James Rubin
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, United Kingdom
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Abstract
The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK.
| | - Rebecca K Webster
- Department of Psychological Medicine, King's College London, London, UK
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Lisa Woodland
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, London, UK
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Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, Rubin GJ. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020; 395:912-920. [PMID: 32112714 PMCID: PMC7158942 DOI: 10.1016/s0140-6736(20)30460-8] [Citation(s) in RCA: 7558] [Impact Index Per Article: 1889.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/16/2020] [Accepted: 02/17/2020] [Indexed: 12/12/2022]
Abstract
The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK.
| | - Rebecca K Webster
- Department of Psychological Medicine, King's College London, London, UK
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Lisa Woodland
- Department of Psychological Medicine, King's College London, London, UK
| | - Simon Wessely
- Department of Psychological Medicine, King's College London, London, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, London, UK
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Ahluwalia J, Brooks SK, Weinman J, Rubin GJ. A systematic review of factors affecting adherence to malaria chemoprophylaxis amongst travellers from non-endemic countries. Malar J 2020; 19:16. [PMID: 31931813 PMCID: PMC6958680 DOI: 10.1186/s12936-020-3104-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 01/07/2020] [Indexed: 01/06/2023] Open
Abstract
Background The aim of this systematic review was to identify predictors of actual or intended adherence with malaria chemoprophylaxis amongst travellers from non-endemic countries visiting endemic countries. Methods A systematic review of the literature was conducted using MEDLINE, Embase, PsycINFO and Global Health databases for studies published up to April 2019. Studies were included if they assessed reasons for adherence among people travelling from a country where malaria was not endemic to a country where it was. Results Thirty-two studies were included. Predictors of adherence were categorized as relating to either the nature of the travel or the traveller themselves. The three main predictors associated with nature of travel included: destination (e.g. country visited, urban vs rural areas), length of travel and type of travel (e.g. package vs backpacking holiday). The four main traveller-associated predictors were: age, reason for travel (e.g. business, leisure or visiting friends and relatives), perceived risk of catching malaria and experienced or expected medication effects. Conclusions In order to improve adherence, clinicians should focus on travellers who are least likely to exhibit adherent behaviour. This includes travellers visiting destinations known to have lower adherence figures (such as rural areas), backpackers, business travellers, younger travellers and those travelling for longer periods of time. They should also check to ensure travellers’ perceptions of the risks of malaria are realistic. Where appropriate, misperceptions (such as believing that curing malaria is easier than taking prophylaxis or that travellers visiting relatives have some level of innate immunity) should be corrected. All travellers should be informed of the potential side-effects of medication and given guidance on why it is nonetheless beneficial to continue to take prophylaxis. Further research is required to test interventions to improve adherence.
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Affiliation(s)
- Julian Ahluwalia
- King's College London, GKT School of Medical Education, London, UK
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK
| | - John Weinman
- King's College London, Institute of Pharmaceutical Science, London, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK.
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Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. Protecting the psychological wellbeing of staff exposed to disaster or emergency at work: a qualitative study. BMC Psychol 2019; 7:78. [PMID: 31823824 PMCID: PMC6905092 DOI: 10.1186/s40359-019-0360-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 11/29/2019] [Indexed: 11/10/2022] Open
Abstract
Background Disasters are becoming more prevalent across the world and people are frequently exposed to them as part of their occupational groups. It is important for organisations to understand how best to support employees who have experienced a trauma such as a disaster. The purpose of this study was to explore employees’ perceptions of workplace support and help-seeking in the context of a disaster. Methods Forty employees in England took part in semi-structured interviews. Thematic analysis was used to extract recurring themes from the data. Results Participants reported both positive and negative psychological outcomes of experiencing a disaster or emergency at work. Most had little training in how to prepare for, and cope with, the psychological impact. They perceived stigma around mental health and treatment for psychological issues which often made them reluctant to seek help. Many reported that the psychological support available in the workplace was insufficient and tended to be reactive rather than proactive. Interpersonal relationships at work were viewed as being important sources of support, particularly support from managers. Participants suggested that psychosocial training in the workplace could be beneficial in providing education about mental health, encouraging supportive workplace relationships, and developing listening skills and empathy. Conclusions Organisations can take steps to reduce the psychological impact of disasters on employees. This could be done through provision of training workshops incorporating mental health education to reduce stigma, and team-building exercises to encourage supportive workplace relationships.
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Affiliation(s)
- Samantha K Brooks
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK.
| | - Rebecca Dunn
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science & Technology, Health Protection Directorate, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
| | - Neil Greenberg
- Department of Psychological Medicine, King's College London, Cutcombe Road, London, SE5 9RJ, UK
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Agarwal B, Brooks SK, Greenberg N. The Role of Peer Support in Managing Occupational Stress: A Qualitative Study of the Sustaining Resilience at Work Intervention. Workplace Health Saf 2019; 68:57-64. [PMID: 31538851 DOI: 10.1177/2165079919873934] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Peer support at work may support psychological resilience by enhancing coping skills and providing social support. The current study aimed to examine how a workplace peer support program, "Sustaining Resilience at Work" (StRaW), may support employee mental health from the perspective of the trained peer supporter. Method: Nine individuals from various public and private organizations who had completed StRaW peer supporter training participated in semi-structured interviews to explore their views on the StRaW program. Data were analyzed using inductive thematic analysis. Findings: Three main themes emerged: the impact of workplace stressors on employee mental health, the impact of StRaW, and feedback on StRaW. The results suggested positive effects of StRaW training on practitioners' ability to support colleagues and maintain their own psychological well-being. Discussion/Application to Practice: Our results indicated that peer support programs in the workplace may improve employees' well-being and relationships between employees. As such, occupational health professionals should recommend that their organizations invest in these types of programs to improve organizational resilience. They should encourage employees they consider to be capable of supporting their colleagues to undergo this training as evidence suggests this is beneficial to the trained employees' own well-being, rather than making them feel burdened or under pressure. Occupational health professionals should also view such programs as useful ways of improving attitudes toward mental health within their organizations.
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Brooks SK, Rubin GJ, Greenberg N. Traumatic stress within disaster-exposed occupations: overview of the literature and suggestions for the management of traumatic stress in the workplace. Br Med Bull 2019; 129:25-34. [PMID: 30544131 DOI: 10.1093/bmb/ldy040] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/30/2018] [Accepted: 11/27/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND Many people who experience a disaster will do so as part of an occupational group, either by chance or due to the nature of their role. SOURCES OF DATA This review is based on literature published in scientific journals. AREAS OF AGREEMENT There are many social and occupational factors, which affect post-disaster mental health. In particular, effective social support-both during and post-disaster-appears to enhance psychological resilience. AREAS OF CONTROVERSY There is conflicting evidence regarding the best way to support trauma-exposed employees. Many organisations carry out post-incident debriefing despite evidence that this is unhelpful. GROWING POINTS Employees who are well supported tend to have better psychological outcomes and as a result may be more likely to perform well at work. AREAS TIMELY FOR DEVELOPING RESEARCH The development and evaluation of workplace interventions designed to help managers facilitate psychological resilience in their workforce is a priority. Successful interventions could substantially increase resilience and reduce the risk of long-term mental health problems in trauma-exposed employees.
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Affiliation(s)
- Samantha K Brooks
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Emergency Preparedness and Response at King's College London, Weston Education Centre, 10 Cutcombe Road, London, UK
| | - G James Rubin
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Emergency Preparedness and Response at King's College London, Weston Education Centre, 10 Cutcombe Road, London, UK
| | - Neil Greenberg
- The National Institute for Health Research (NIHR) Health Protection Research Unit in Emergency Preparedness and Response at King's College London, Weston Education Centre, 10 Cutcombe Road, London, UK
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Brooks SK, Dunn R, Amlôt R, Greenberg N, Rubin GJ. Training and post-disaster interventions for the psychological impacts on disaster-exposed employees: a systematic review. J Ment Health 2018:1-25. [PMID: 29447058 DOI: 10.1080/09638237.2018.1437610] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/15/2017] [Accepted: 01/18/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND When organisations are exposed to traumatic situations, such as disasters, often staff are not prepared for the potential psychological impact which can negatively affect their wellbeing. AIMS To conduct a systematic review of the literature on psychological interventions aimed at improving staff wellbeing during or after disasters. METHOD Four electronic literature databases were searched. Reference lists of relevant articles were hand-searched. RESULTS Fifteen articles were included. Five studies suggested that pre-disaster skills training and disaster education can improve employee confidence. Ten studies on post-disaster interventions revealed mixed findings on the effectiveness of psychological debriefing and limited evidence for cognitive behavioural therapy, psychoeducation and meditation. CONCLUSIONS Pre-disaster training and education can improve employees' confidence in their ability to cope with disasters. The routine use of post-disaster psychological debriefings is not supported; further research is needed to determine if debriefing interventions could be useful in some circumstances. Further research is needed to provide more evidence on the potential positive effects of cognitive behavioural therapy, psychoeducation and meditation. More experimental studies on psychological disaster interventions are needed.
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Affiliation(s)
- Samantha K Brooks
- a Department of Psychological Medicine , King's College London , London , UK , and
| | - Rebecca Dunn
- a Department of Psychological Medicine , King's College London , London , UK , and
| | - Richard Amlôt
- b Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England , Salisbury , UK
| | - Neil Greenberg
- a Department of Psychological Medicine , King's College London , London , UK , and
| | - G James Rubin
- a Department of Psychological Medicine , King's College London , London , UK , and
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Sage CAM, Brooks SK, Greenberg N. Factors associated with Type II trauma in occupational groups working with traumatised children: a systematic review. J Ment Health 2017; 27:457-467. [PMID: 28898109 DOI: 10.1080/09638237.2017.1370630] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is evidence that "Type II trauma" (TTT) - repeated exposure to traumatic events - can lead to the development of post-traumatic stress disorder (PTSD). TTT frequently occurs in occupational groups working with children who are themselves victims of trauma. AIM To conduct a systematic review identifying risk factors for/protective factors against TTT-associated mental ill-health in employees working with traumatised children and explore how this type of work impacts upon social functioning. METHOD Databases were searched for relevant studies and supplemented by hand searches. RESULTS 836 papers were found and 13 were included in the review. The key themes identified were coping mechanisms; social support; personality; demographics; occupational support; work-related stressors; traumatic exposure; organisational satisfaction; training/experience and impact on life. CONCLUSION Unhelpful coping strategies (e.g. denial) appeared to increase the risk of TTT. Training and strong support may be protective and work-related stressors (e.g. excessive workload) appeared detrimental. Despite some positive impacts of the work (e.g. becoming more appreciative of life) many negative impacts were identified, demonstrating the importance of minimising risk factors and maximising protective factors for staff at risk of TTT.
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Affiliation(s)
- Clara A M Sage
- a Department of Psychological Medicine , King's College London , London , United Kingdom
| | - Samantha K Brooks
- a Department of Psychological Medicine , King's College London , London , United Kingdom
| | - Neil Greenberg
- a Department of Psychological Medicine , King's College London , London , United Kingdom
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Brooks SK, Dunn R, Amlôt R, Rubin GJ, Greenberg N. Social and occupational factors associated with psychological wellbeing among occupational groups affected by disaster: a systematic review. J Ment Health 2017. [DOI: 10.1080/09638237.2017.1294732] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- Samantha K. Brooks
- King’s College London, Department of Psychological Medicine, London, UK and
| | - Rebecca Dunn
- King’s College London, Department of Psychological Medicine, London, UK and
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science & Technology, Health Protection Directorate, Wilts, UK
| | - G. James Rubin
- King’s College London, Department of Psychological Medicine, London, UK and
| | - Neil Greenberg
- King’s College London, Department of Psychological Medicine, London, UK and
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Affiliation(s)
- Samantha K. Brooks
- King’s College London, King’s Centre for Military Health Research, Weston Education Centre, London, UK
| | - Neil Greenberg
- King’s College London, King’s Centre for Military Health Research, Weston Education Centre, London, UK
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Diehle J, Brooks SK, Greenberg N. Veterans are not the only ones suffering from posttraumatic stress symptoms: what do we know about dependents' secondary traumatic stress? Soc Psychiatry Psychiatr Epidemiol 2017; 52:35-44. [PMID: 27770173 PMCID: PMC5227001 DOI: 10.1007/s00127-016-1292-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 10/10/2016] [Indexed: 11/10/2022]
Abstract
PURPOSE Previous research has mainly focused on veterans' mental health problems, especially on posttraumatic stress disorder (PTSD). Less is known about the impact that the veteran's experienced potentially traumatic events (PTEs) might have on their significant others. Therefore, we reviewed the scientific literature to find out what is known about the prevalence of secondary traumatic stress (STS) in significant others of veterans. METHODS We systematically searched Pubmed, PsycINFO, Embase, Cochrane Library and PILOTS for relevant articles. This search resulted in 3100 records from which we included 48 articles. RESULTS Two studies that reported on parental PTSD did not find evidence that parents were affected by their offspring's experience. Nine studies that reported on PTSD in mainly adult children of veterans found only scant evidence that children were affected by their parent's experienced PTE. Twenty-seven studies investigated PTSD symptoms in partners of veterans. Here results varied largely between studies with PTSD rates between 0 and 51 %. CONCLUSIONS Overall, we found the strongest evidence of STS in partners of help-seeking veterans with PTSD. The lack of clarity provided by the currently available evidence suggests a pressing need for further work to examine this subject in more detail.
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Affiliation(s)
- Julia Diehle
- King's Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, King's College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ, UK.
| | | | - Neil Greenberg
- King’s Centre for Military Health Research, Department of Psychological Medicine, Institute of Psychiatry, King’s College London, Weston Education Centre, 10 Cutcombe Road, London, SE5 9RJ UK ,Academic Department of Military Mental Health, Department of Psychological Medicine, King’s College London, London, UK
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Brooks SK, Gerada C, Chalder T. The specific needs of doctors with mental health problems: qualitative analysis of doctor-patients' experiences with the Practitioner Health Programme. J Ment Health 2016; 26:161-166. [PMID: 27841030 DOI: 10.1080/09638237.2016.1244712] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The current paper aimed to explore doctor-patients' views about their treatment from the Practitioner Health Programme (PHP), a UK-based service treating health professionals with mental health/addiction problems. Aims were to gain insights into the issues most important to patients and consider whether a service specifically for doctors is important in helping to overcome barriers to accessing mental healthcare. METHODS Nine doctor-patients attending PHP took part in semi-structured interviews between September 2010 and June 2011. Thematic analysis was used to explore recurring patterns in the data. 134 written comments from PHP patients were also included. RESULTS Participants reported difficulties in finding appropriate treatment; problems were often severe by the time PHP was involved. Concerns about confidentiality, judgement and impact on career were obstacles to help-seeking and important issues during treatment. Analysis of written comments provided further support for these findings. CONCLUSION Whilst some of the needs of mentally unwell doctors mirror the needs of patients in general - e.g. a supportive and non-judgemental attitude from clinicians - they do have specific needs related to confidentiality and stigma.
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Affiliation(s)
- Samantha K Brooks
- a Department of Psychological Medicine , King's College London, Institute of Psychiatry, Weston Education Centre , London , UK , and
| | - Clare Gerada
- b Practitioner Health Programme, Riverside Medical Centre , Vauxhall , London , UK
| | - Trudie Chalder
- a Department of Psychological Medicine , King's College London, Institute of Psychiatry, Weston Education Centre , London , UK , and
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Brooks SK, Dunn R, Amlôt R, Greenberg N, Rubin GJ. Social and occupational factors associated with psychological distress and disorder among disaster responders: a systematic review. BMC Psychol 2016; 4:18. [PMID: 27114240 PMCID: PMC4845476 DOI: 10.1186/s40359-016-0120-9] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Accepted: 03/29/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND When disasters occur, there are many different occupational groups involved in rescue, recovery and support efforts. This study aimed to conduct a systematic literature review to identify social and occupational factors affecting the psychological impact of disasters on responders. METHODS Four electronic literature databases (MEDLINE®, Embase, PsycINFO® and Web of Science) were searched and hand searches of reference lists were carried out. Papers were screened against specific inclusion criteria (e.g. published in peer-reviewed journal in English; included a quantitative measure of wellbeing; participants were disaster responders). Data was extracted from relevant papers and thematic analysis was used to develop a list of key factors affecting the wellbeing of disaster responders. RESULTS Eighteen thousand five papers were found and 111 included in the review. The psychological impact of disasters on responders appeared associated with pre-disaster factors (occupational factors; specialised training and preparedness; life events and health), during-disaster factors (exposure; duration on site and arrival time; emotional involvement; peri-traumatic distress/dissociation; role-related stressors; perceptions of safety, threat and risk; harm to self or close others; social support; professional support) and post-disaster factors (professional support; impact on life; life events; media; coping strategies). CONCLUSIONS There are steps that can be taken at all stages of a disaster (before, during and after) which may minimise risks to responders and enhance resilience. Preparedness (for the demands of the role and the potential psychological impact) and support (particularly from the organisation) are essential. The findings of this review could potentially be used to develop training workshops for professionals involved in disaster response.
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Affiliation(s)
- Samantha K Brooks
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK.
| | - Rebecca Dunn
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK
| | - Richard Amlôt
- Public Health England, Emergency Response Department Science and Technology, Health Protection and Medical Directorate, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Neil Greenberg
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK
| | - G James Rubin
- King's College London, Department of Psychological Medicine, Cutcombe Road, London, SE5 9RJ, UK
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Brooks SK, Dunn R, Sage CAM, Amlôt R, Greenberg N, Rubin GJ. Risk and resilience factors affecting the psychological wellbeing of individuals deployed in humanitarian relief roles after a disaster. J Ment Health 2015; 24:385-413. [PMID: 26452755 DOI: 10.3109/09638237.2015.1057334] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND When disasters occur, humanitarian relief workers frequently deploy to assist in rescue/recovery efforts. AIMS To conduct a systematic review of factors affecting the psychological wellbeing of disaster relief workers and identify recommendations for interventions. METHOD We searched MEDLINE®, Embase, PsycINFO® and Web of Science for relevant studies, supplemented by hand searches. We performed thematic analysis on their results to identify factors predicting wellbeing. RESULTS Sixty-one publications were included. Key themes were: pre-deployment factors (preparedness/training); peri-deployment factors (deployment length/timing; traumatic exposure; emotional involvement; leadership; inter-agency cooperation; support; role; demands and workload; safety/equipment; self-doubt/guilt; coping strategies) and post-deployment factors (support; media; personal and professional growth). CONCLUSIONS As well as role-specific stressors, many occupational stressors not specific to humanitarian relief (e.g. poor leadership, poor support) present a significant health hazard to relief workers. Humanitarian organisations should prioritise strengthening relationships between team members and supervisors, and dealing effectively with non-role-specific stressors, to improve the psychological resilience of their workforce.
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Affiliation(s)
- Samantha K Brooks
- a Department of Psychological Medicine , King's College London , London , UK and
| | - Rebecca Dunn
- a Department of Psychological Medicine , King's College London , London , UK and
| | - Clara A M Sage
- a Department of Psychological Medicine , King's College London , London , UK and
| | - Richard Amlôt
- b Emergency Response Department, Health Protection Directorate, Public Health England, Microbial Risk Assessment and Behavioural Science, Porton Down , Salisbury , Wilts , UK
| | - Neil Greenberg
- a Department of Psychological Medicine , King's College London , London , UK and
| | - G James Rubin
- a Department of Psychological Medicine , King's College London , London , UK and
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Brooks SK, Del Busso L, Chalder T, Harvey SB, Hatch SL, Hotopf M, Madan I, Henderson M. 'You feel you've been bad, not ill': Sick doctors' experiences of interactions with the General Medical Council. BMJ Open 2014; 4:e005537. [PMID: 25034631 PMCID: PMC4120406 DOI: 10.1136/bmjopen-2014-005537] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To explore the views of sick doctors on their experiences with the General Medical Council (GMC) and their perception of the impact of GMC involvement on return to work. DESIGN Qualitative study. SETTING UK PARTICIPANTS Doctors who had been away from work for at least 6 months with physical or mental health problems, drug or alcohol problems, GMC involvement or any combination of these, were eligible for inclusion into the study. Eligible doctors were recruited in conjunction with the Royal Medical Benevolent Fund, the GMC and the Practitioner Health Programme. These organisations approached 77 doctors; 19 participated. Each doctor completed an in-depth semistructured interview. We used a constant comparison method to identify and agree on the coding of data and the identification of central themes. RESULTS 18 of the 19 participants had a mental health, addiction or substance misuse problem. 14 of the 19 had interacted with the GMC. 4 main themes were identified: perceptions of the GMC as a whole; perceptions of GMC processes; perceived health impacts and suggested improvements. Participants described the GMC processes they experienced as necessary, and some elements as supportive. However, many described contact with the GMC as daunting, confusing and anxiety provoking. Some were unclear about the role of the GMC and felt that GMC communication was unhelpful, particularly the language used in correspondence. Improvements suggested by participants included having separate pathways for doctors with purely health issues, less use of legalistic language, and a more personal approach with for example individualised undertakings or conditions. CONCLUSIONS While participants recognised the need for a regulator, the processes employed by the GMC and the communication style used were often distressing, confusing and perceived to have impacted negatively on their mental health and ability to return to work.
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Affiliation(s)
- Samantha K Brooks
- Institute of Psychiatry – Psychological Medicine, Kings College London, London, UK
| | - Lilliana Del Busso
- Faculty of Health & Social Science, Ostfold University College, Ostfold, Norway
| | - Trudie Chalder
- Institute of Psychiatry – Psychological Medicine, Kings College London, London, UK
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Black Dog Institute Hospital Road Randwick, Sydney, New South Wales, Australia
| | - Stephani L Hatch
- Institute of Psychiatry – Psychological Medicine, Kings College London, London, UK
| | - Matthew Hotopf
- Institute of Psychiatry – Psychological Medicine, Kings College London, London, UK
| | - Ira Madan
- Occupational Health, St Thomas Hospital, London, UK
| | - Max Henderson
- Institute of Psychiatry – Psychological Medicine, Kings College London, London, UK
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Brooks SK, Hachmoller W. P2.157 The Experience of Implementing Point-Of-Care HIV Testing in GP Practices in the United Kingdom. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Brooks SK, Gerada C, Chalder T. Doctors and dentists with mental ill health and addictions: outcomes of treatment from the Practitioner Health Programme. J Ment Health 2013; 22:237-45. [PMID: 23323773 DOI: 10.3109/09638237.2012.734647] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Practitioner Health Programme (PHP) was developed to provide expert assessment and support to practitioners (doctors and dentists) with mental and physical health problems affecting their ability to work. AIMS This paper examines the treatment outcomes of the practitioner-patients utilising PHP. METHOD We assessed outcomes on consecutive patients using the PHP. The Clinical Outcomes in Routine Evaluation Outcome Measure and the Work and Social Adjustment Scale were completed at initial assessment, 8- and 26-week follow-up. We also report the percentages of practitioner-patients off work at each interval, and examine global improvement and satisfaction scores for both follow-up intervals. RESULTS Two hundred practitioner-patients entered PHP due to a mental health or substance abuse problem and subsequently completed questionnaires at baseline; 102 patients returned questionnaires after 8 weeks and 95 returned questionnaires after 26 weeks. Results suggested that patients reported less distress and less impairment of functioning at 8 and 26 weeks. Scores for satisfaction and global improvement were consistently high. CONCLUSIONS The PHP is providing a valuable service to practitioner-patients, significantly helping to decrease levels of distress and improve work and social functioning.
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Affiliation(s)
- Samantha K Brooks
- Academic Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK
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Henderson M, Brooks SK, del Busso L, Chalder T, Harvey SB, Hotopf M, Madan I, Hatch S. Shame! Self-stigmatisation as an obstacle to sick doctors returning to work: a qualitative study. BMJ Open 2012; 2:bmjopen-2012-001776. [PMID: 23069770 PMCID: PMC3488732 DOI: 10.1136/bmjopen-2012-001776] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To explore the views of sick doctors on the obstacles preventing them returning to work. DESIGN Qualitative study. SETTING Single participating centre recruiting doctors from all over the UK. PARTICIPANTS Doctors who had been away from work for at least 6 months with physical or mental health problems, drug or alcohol problems, General Medical Council involvement or any combination of these, were eligible. Eligible doctors were recruited in conjunction with the Royal Medical Benevolent Fund, the General Medical Council and the Practitioner Health Programme. These organisations approached 77 doctors; 19 participated. Each doctor completed an in-depth semistructured interview. We used a constant comparison method to identify and agree on the coding of the data and the identification of a number of central themes. RESULTS The doctors described that being away from work left them isolated and sad. Many experienced negative reactions from their family and some deliberately concealed their problems. Doctors described a lack of support from colleagues and feared a negative response when returning to work. Self-stigmatisation was central to the participants' accounts; several described themselves as failures and appeared to have internalised the negative views of others. CONCLUSIONS Self-stigmatising views, which possibly emerge from the belief that 'doctors are invincible', represent a major obstacle to doctors returning to work. From medical school onwards cultural change is necessary to allow doctors to recognise their vulnerabilities so they can more easily generate strategies to manage if they become unwell.
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Affiliation(s)
- Max Henderson
- Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
| | - Samantha K Brooks
- Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
| | | | - Trudie Chalder
- Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
| | - Samuel B Harvey
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Matthew Hotopf
- Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
| | - Ira Madan
- Guys and St Thomas’ Hospital NHS Foundation Trust, London, UK
| | - Stephani Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Kings College London, London, UK
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Brooks SK, Chalder T, Gerada C. Doctors vulnerable to psychological distress and addictions: treatment from the Practitioner Health Programme. J Ment Health 2011; 20:157-64. [PMID: 21542716 DOI: 10.3109/09638237.2011.556168] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The Practitioner Health Programme (PHP) is a service set up to provide expert assessment and support to health professionals with mental and physical health problems affecting their ability to work. AIMS The aim of this article is to examine the demographic and clinical characteristics of doctor-patients utilising PHP. METHOD We report on scores for the CORE-OM, the Work and Social Adjustment Scale and the FAST for the first 200 patients seen by PHP. RESULTS Prevalent conditions included depression and alcohol dependence. Patients with co-morbid disorders showed severe distress and impairment of functioning. Ages ranged between 24 and 67, with 33.5% of the cohort aged between 30 and 39. Patients aged below 50 showed greater impairment of social functioning. CONCLUSIONS The needs of doctors are profound, with young doctors particularly vulnerable. Measures should be put in place to ensure that doctors at an early stage of their careers are aware of help available to them. The results highlight the importance of a service such as PHP.
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Affiliation(s)
- Samantha K Brooks
- Academic Department of Psychological Medicine, King's College London, Weston Education Centre, London SE5 9RJ, UK
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Abstract
BACKGROUND Mental ill health is common among doctors. Fast, efficient diagnosis and treatment are needed as mentally ill doctors pose a safety risk to the public, yet they are often reluctant to seek help. AIMS To review literature regarding risk factors and potential barriers to help-seeking unique to doctors; to consider the success of interventions by specialist services for doctors. METHOD Key phrases regarding the 'mental health of doctors' were entered into internet searches and journal databases to identify relevant research. When key authors were identified, author-specific searches were carried out. FINDINGS There are contradictory reports about the prevalence of mental ill health in doctors but it is generally agreed that doctors face a large number of risk factors, both occupational and individual; and help-seeking is difficult due to complexities surrounding a doctor becoming a patient. Specialist services developed specifically for interventions for doctors with mental health problems tend to show promising results but further research is needed. CONCLUSIONS The unique and complex situation of a doctor becoming a patient benefits from specialist services; such services should focus on early intervention and raising awareness.
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Affiliation(s)
- Samantha K Brooks
- Academic Department of Psychological Medicine, Weston Education Centre, King's College London, London SE5 9RJ, UK
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Akeson AL, Brooks SK, Thompson FY, Greenberg JM. In vitro model for developmental progression from vasculogenesis to angiogenesis with a murine endothelial precursor cell line, MFLM-4. Microvasc Res 2001; 61:75-86. [PMID: 11162198 DOI: 10.1006/mvre.2000.2257] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In the embryo, vascular networks are developed through both vasculogenesis, the assembly of vessels from endothelial progenitor cells or hemangioblasts, and angiogenesis, the sprouting of vessels from preexisting capillaries. Cell culture models using endothelial cells (EC) and various extracellular matrix components have been useful in understanding the cellular and molecular factors involved in angiogenesis. However, there are few models of vasculogenesis. Using a murine endothelial precursor cell line, MFLM-4, derived from e14.5 lung mesenchyme, we have developed a culture system that not only recapitulates many of the characteristics of vasculogenesis but also progresses into angiogenesis. By 8 h, MFLM-4 cultured on the basement membrane preparation Matrigel invade the matrix, coalesce, and assemble into large clusters of cells resembling blood islands. During vascular development, blood islands are the focal areas for coalescence of endothelial precursors. For MFLM-4, this phase of in vitro vasculogenic clustering does not require proliferation. If proliferation is not blocked, MFLM-4 progresses into an angiogenic phase with the clusters forming multicell angiogenic sprouts. Through 3 days of culture, lumens form within the clusters, adjacent clusters are connected with tube-like structures, and eventually an extensive network or plexus of clusters connected by capillary-like tubes is formed. MFLM-4 cultured on Matrigel provides an in vitro system for analysis of the multistage, concurrent processes of vasculogenesis and angiogenesis.
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Affiliation(s)
- A L Akeson
- Division of Pulmonary Biology, The Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA
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Abstract
During development, the lung mesenchyme has a dynamic relationship with the branching airway. Embryonic lung mesenchyme is loosely packed and composed of indistinguishable cells, yet it is the source of vascular progenitors that will become endothelial cells, smooth muscle cells and fibroblasts. In the lung, vessel development in the periphery proceeds first through vasculogenesis, the migration and assembly of cells into a primitive network, and subsequently, through angiogenesis, the sprouting of vessels from this network. As a way to assess the cellular and molecular mechanisms of lung vascularization, we have isolated and cloned cell lines from mouse fetal lung mesenchyme (MFLM). Two of these MFLM cell lines, MFLM-4 and MFLM-91U, display characteristics of an endothelial lineage. RNA analysis demonstrates transcripts for the vascular endothelial growth factor receptors R1 and R2, the receptor tyrosine kinases, Tie-1 and Tie-2, as well as the Tie-2 ligands, Ang-1 and -2. The MFLM cell lines form extensive networks of capillary-like structures with lumens when cultured on a reconstituted basement membrane. In vivo, following blastocyst injection, the MFLM cells chimerize endothelium of the lung and areas of the heart vasculature. The results from these studies suggest that MFLM-4 and MFLM-91U, derived from embryonic lung mesenchyme, can function in vitro and in vivo as endothelial precursors and as models of cardiopulmonary vascularization. Dev Dyn 2000;217:11-23.
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Affiliation(s)
- A L Akeson
- Children's Hospital Medical Center, Division of Pulmonary Biology, Cincinnati, OH 45229-3039, USA.
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Brooks SK. Restricting the sale of ammunition. N Engl J Med 1994; 331:1238; author reply 1239. [PMID: 7935678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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