The COVID-19 pandemic has worsened mental health among health workers around the world. With a projected global shortage of 10.2 million health workers by 2030, further exacerbated by COVID-19, taking action to support health worker mental health needs to be an integral component of investments to overcome this gap and build resiliency of systems for the future. Health workers are functioning in highly stressful environments at great personal risk to provide services that improve quality of life and save lives. To reduce burnout and early exits from the workforce, health workers must be protected and equipped to work in supportive environments, manage stress, and access mental health services when needed. This article explores the impact of COVID-19 on health worker mental health and proposes actions for health systems and workplaces to support health workers which draw on available evidence and examples of USAID-supported partner activities.

Community-based psychosocial interventions are key elements of mental health and psychosocial support; yet evidence regarding their effectiveness and implementation in humanitarian settings is limited. This study aimed to assess the appropriateness, acceptability, feasibility and safety of conducting a cluster randomized trial evaluating two versions of a group psychosocial intervention. Nine community clusters in Ecuador and Panamá were randomized to receive the standard version of the Entre Nosotras intervention, a community-based group psychosocial intervention co-designed with community members, or an enhanced version of Entre Nosotras that integrated a stress management component. In a sample of 225 refugees, migrants and host community women, we found that both versions were safe, acceptable and appropriate. Training lay facilitators to deliver the intervention was feasible. Challenges included slow recruitment related to delays caused by the COVID-19 pandemic, high attrition due to population mobility and other competing priorities, and mixed psychometric performance of psychosocial outcome measures. Although the intervention appeared promising, a definitive cluster randomized comparative effectiveness trial requires further adaptations to the research protocol. Within this pilot study we identified strategies to overcome these challenges that may inform adaptations. This comparative effectiveness design may be a model for identifying effective components of psychosocial interventions.

Healthcare personnel who deal with COVID-19 experience stigma. There is a lack of national-level representative qualitative data to study COVID-19-related stigma among healthcare workers in India. The present study explores factors associated with stigma and manifestations experienced by Indian healthcare workers involved in COVID-19 management. We conducted in-depth interviews across 10 centres in India, which were analysed using NVivo software version 12. Thematic and sentiment analysis was performed to gain deep insights into the complex phenomenon by categorising the qualitative data into meaningful and related categories. Healthcare workers (HCW) usually addressed the stigma they encountered when doing their COVID duties under the superordinate theme of stigma. Among them, 77.42% said they had been stigmatised in some way. Analyses revealed seven interrelated themes surrounding stigma among healthcare workers. It can be seen that the majority of the stigma and coping sentiments fall into the mixed category, followed by the negative sentiment category. This study contributes to our understanding of stigma and discrimination in low- and middle-income settings. Our data show that the emergence of fear of the virus has quickly turned into a stigma against healthcare workers.

The current study aimed to test whether social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideation among Palestinians. The study sample consisted of 520 Palestinian adults selected using online tools. The findings of the study revealed that posttraumatic stress symptoms positively correlated with suicidal ideations (r = .32, p < .01), and negatively correlated with social support (r = −.34, p < .01), spirituality (r = −.16, p < .05) and mindfulness (r = −.72, p < .01), whereas suicidal ideations negatively correlated with social support (r = −.46, p < .01), spirituality(r = −.27, p < .01) and mindfulness (r = −.72, p < .01). Results of the path analysis showed that social support, spirituality and mindfulness mediated the association between posttraumatic stress symptoms and suicidal ideations. Developing intervention programs to enhance social support, mindfulness and spirituality to mitigate the effect of ongoing traumatic experiences among Palestinians is crucial to reducing suicidal ideations. Further studies are also recommended to investigate the role of potentially protective factors that may reduce suicidal ideations and appropriate techniques to deal effectively with traumatic and stressful events.

ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD have been understudied in the older population. The study focused on the associations between traumatic exposure before the pandemic, COVID-19 worries, depression, and loneliness with current PTSD and CPTSD among older adults. A random sample of five hundred and twelve Israeli older adults (Mage = 72.67 ± 3.81, range 68–87) was recruited using a Web-based survey company (Ipanel, Israel). Participants completed questionnaires of demographic details, self-rated health, COVID-19 worries, trauma exposure, depressive symptoms, level of loneliness, PTSD, and CPTSD. Univariate logistic regression revealed that trauma exposure, COVID-19 worries, depression, and loneliness were associated with PTSD. Multinomial regression revealed that only trauma exposure was associated with PTSD among older adults with PTSD compared with those not reaching the PTSD cutoff level. In the comparison between older adults suffering from CPTSD with those not reaching the PTSD cutoff level, being married, higher levels of trauma exposure, COVID-19 worries, depression, and loneliness were associated with a higher risk of CPTSD. Results suggest that specific factors may be significant psychological correlates of CPTSD symptoms among older adults during the COVID-19 pandemic. Identifying these factors could assist practitioners in tailoring more effective interventions.

Supportive supervision has been shown to improve mental health outcomes and job retention for mental health and psychosocial support (MHPSS) workers in humanitarian contexts. However, the impact of gender on supervision practices has been poorly evaluated and documented in international guidelines to date. To address this gap, qualitative interviews were conducted with 12 MHPSS staff working in diverse humanitarian contexts to identify key gender considerations in supportive supervision. Results show that gender in supervision is influenced by the context of MHPSS work; with culture, religion and gender roles identified as key elements. Participants discuss recruitment mechanisms, highlighting the unequal gender distribution and inequitable opportunities within MHPSS programming. The importance of addressing power dynamics impacted by gender and of ensuring the safety of women within supervision is also highlighted. Finally, participants discuss the gender differences across the various supervisory formats. Altogether, results indicate that gender has the potential to influence supportive supervision within MHPSS, and it is recommended that international guidelines account for nuances of gender in supportive supervision within humanitarian contexts.

COVID-19 has led to an increase in mental health problems for adolescents. In this study, we examined the factors related to the eHealth literacy of adolescents and how that impacted their pursuit of health information and mental health information online during the COVID-19 pandemic. We analyzed data from the 2020 Taiwan Communication Survey, which involved a total of 1,250 national representative adolescents who completed an online questionnaire. The results showed that two-thirds of adolescents reported searching for health information online, and about half of them reported searching for mental health information online during the COVID-19 pandemic. Multivariate analysis results indicated that adolescents who spent more time learning online, had higher levels of bonding social capital and self-determination, and had higher levels of parental active internet mediation were more likely to have higher levels of eHealth literacy. In addition, multivariate analysis results showed that adolescents who had higher levels of eHealth literacy and had higher depression and anxiety were more likely to seek health information and mental health information online. In conclusion, the levels of eHealth literacy and psychological distress of adolescents played a crucial role in their pursuit of health information and mental health information online during the COVID-19 pandemic.

The COVID-19 pandemic had significant impacts on mental health. We examined factors associated with symptoms of depression and anxiety during the COVID-19 pandemic in Kazakhstan. We surveyed 991 adults in Kazakhstan in July 2021 using multistage stratified sampling. Depression and anxiety were measured with the Patient Health Questionnaire-4. We conducted logistic regression to assess associations between depression and anxiety and sociobehavioral factors. Overall, 12.01% reported depressive symptoms and 8.38% anxiety. Higher likelihood of depression was associated with being female (AOR: 1.64; 95% CI [1.05, 2.55]), having experience with COVID-19 in the social environment (AOR: 1.85; 95% CI [1.1–3.14]), experiencing food insecurity (AOR: 1.80; 95% CI [1.11–2.89]), increased family conflict (AOR: 2.43; 95% CI [1.32–4.48]) and impaired healthcare access (AOR: 2.41; 95% CI [1.32–4.41]). Higher likelihood of anxiety was associated with being female (AOR: 3.43; 95% CI [1.91–6.15]), increased family conflict (AOR: 2.22; 95% CI [1.11–4.44]) and impaired healthcare access (AOR: 2.63; 95% CI [1.36–5.12]). Multiple factors were associated with mental health in Kazakhstan during the COVID-19 pandemic. Further research is needed to determine the extent to which these factors and their associated mental health outcomes may persist.

The outbreak of COVID-19 has caused widespread fear among people around the world, particularly those with underlying health conditions such as type-2 diabetes. This study aimed to investigate COVID-19 fear and its associated potential factors among type-2 diabetes patients in Bangladesh. A total of 1,036 type-2 diabetes patients residing in the Jashore district of Bangladesh were interviewed using the COVID-19 Fear Scale in Bengali language. A pre-validated questionnaire was used to collect data on sociodemographic, lifestyle-related characteristics, and COVID-19-related information. Logistic regression was performed to identify factors associated with perceived fear of COVID-19. The mean score of the COVID-19 fear was 18.1 ± 5.6. Approximately 45 and 39% were most afraid and uncomfortable thinking about COVID-19, respectively. Regression analysis revealed that gender, age, occupation, residence, physical activity, smoking, and dietary diversity score were associated with fear. Additionally, respondents who had limited self-care practice, unaffordable medicine, medicine shortages, a close friend or family member diagnosed with COVID-19, and financial problems during COVID-19 were significant predictors of COVID-19 fear. Healthcare providers should implement interventions, including appropriate education and counseling, to address the psychological impact of the COVID-19 pandemic on type-2 diabetes patients in Bangladesh.

Identifying women with depressive symptoms is the first step to reducing the risk of the short-term and long-term consequences of antenatal depression. Task shifting by training primary healthcare workers may help to reduce the burden in low-resource settings. Twenty health workers in a primary healthcare center in urban Bengaluru were trained to screen and identify antenatal depression. The training had two components: knowledge-based, using the depression module in the Mental Health Gap Action Program; and skills-based hands-on training, using the Patient Health Questionnaire-9. Knowledge about antenatal depression in the health workers improved by three units after training (p < 0.001). Their perceived skills and self-efficacy also improved by one unit each (p = 0.032 and p = 0.036, respectively). Following the training, 25% of the pregnant women who underwent screening by health workers reported depressive symptoms, as compared to no positive screening before training. Training was found to improve the knowledge, perceived skills and self-efficacy of nurses, junior health assistants and Accredited Social Health Activists (ASHAs), and was found to increase the screening rate of depression in an antenatal clinic in urban India. Incorporating screening for depressive symptoms into regular antenatal care is feasible in low-resource settings.