Addressing the psychological impact of COVID-19 on healthcare workers: learning from a systematic review of early interventions for frontline responders

OBJECTIVES: Protecting healthcare workers from psychological harm is an urgent clinical issue within the current COVID-19 pandemic. Research on early psychological programmes that aim to prevent or reduce mental health symptoms and that have been tested in frontline responders may assist service providers with choosing a suitable intervention for rapid dissemination in healthcare settings. DESIGN AND OUTCOME MEASURES: First, Embase, Web of Science, PsycINFO and Google Scholar were searched through a systematic literature review of early psychological interventions administered to frontline responders in the last 15 years. Interventions were included if they were designed to prevent or reduce psychological impact and had outcome measures of psychological distress (eg, general psychopathology, post-traumatic stress disorder and stress) and/or positive mental health domains (eg, resilience, self-efficacy and life satisfaction). Second, the suitability of these programmes for the healthcare workforce was evaluated according to the criteria of effectiveness, content applicability and feasibility. RESULTS: Of 320 articles retrieved, 12 relevant studies were included that described six early psychological interventions. Although the evidence base is limited, psychological first aid, eye movement desensitisation and reprocessing, and trauma risk management showed effectiveness across at least two studies each with frontline workers. Resilience and coping for the healthcare community; anticipate, plan, and deter; and resilience at work programmes found promising results in single studies. Concerning other suitability criteria, all programmes appear applicable to healthcare settings and have acceptable feasibility for rapid implementation. CONCLUSIONS: Despite the limited evidence, several interventions were identified as potentially suitable and useful for improving psychological functioning of healthcare workers across a variety of disaster situations. Service providers should continue to implement and evaluate early psychological interventions in frontline workers in order to refine best practices for managing the psychological impact of future disasters.