(PS5-B47) The Impact of Message Based Care on Frontline Workers During the COVID-19 Pandemic

Introduction: 

The COVID-19 pandemic presented unprecedented stress for frontline workers, especially healthcare workers (HCWs). HCW hours and responsibilities rapidly expanded 9 due to shortages in staff, personal protective equipment, and available beds for sick patients. HCWs were already at risk for burnout, stress, anxiety, and depression.  Response to previous epidemics has shown that workplace interventions to support basic needs and psychosocial support buffer against the development of psychopathology. As the use of telehealth became more acceptable with the onset of COVID-19, mobile technologies offered opportunities to address the unpredictable schedules and erratic hours HCWs were facing.  Previous studies have shown HCWs are reluctant to seek out psychiatric help but will utilize a support network that is built into their environment. Many of the existing digital health platforms are either synchronous care or utilize self-guided, mindfulness techniques which do not have the same therapeutic benefits as care directed by a licensed practitioner. 

Aim: The current study explored the feasibility of connecting HCWs with licensed therapists through an asynchronous messaging platform designed to enhance the accessibility and flexibility of receiving professional care. We examined the clinical outcomes (PHQ-9 and GAD-7) for a large sample of HCWs receiving one month of treatment during the first US wave of the COVID-19 pandemic.

Methods:  Data was collected on a sample of 820 self-referred US HCWs seeking telepsychiatry services between March and June 2020. One month of no-cost mental healthcare treatment was donated to HCWs by a telehealth platform (Talkspace) to help frontline workers. HCWs were defined as healthcare and medical providers (e.g., physicians, nurses, residents, emergency medical service providers, social workers, etc.) with an active National Provider Identifier (NPI) profile at the time of treatment. A cognitive behavioral therapy based talk therapy intervention was performed.

Results:  The baseline anxiety score (GAD-7) for HCWs was 14.56 (3.76), with 68.55% of the HCWs having moderate to severe anxiety.  Baseline depression (PHQ-9) was 11.21 (5.46), with 43.90% of HCWs having moderate to severe depression.  Thirty-five percent (35.2%) of HCWs reported being in treatment for the first time.  Measures at Week 3 showed that 57.31% of HCWs reported clinically significant change (defined as symptom scores below 10 and a change of 5 points or more)  for depression and 42.93% of HCWs for anxiety.
Conclusions: These results suggest that message-based care is a promising route of care for frontline responders, especially amidst disasters. Asynchronous messaging shows promise for increasing accessible and flexible care at scale while conferring clinical benefit offering frontline workers access to resources to help build resilience and defend against the stress and demands of their jobs.