The Essential Network (TEN): Protocol for an implementation study of a digital-first mental health solution for Australian healthcare workers during COVID-19 (Preprint)

Abstract

The COVID-19 pandemic has placed healthcare workers (HCWs) under severe stress, compounded by barriers to seeking mental health support among HCWs. The Essential Network (TEN) is a blend of digital and person-to-person (blended care) mental health support services for HCWs, funded by the Australian Federal Department of Health as part of their national COVID-19 response strategy. TEN is designed as both a preventative and treatment for common mental health problems faced by HCWs. New blended services need to demonstrate improvements in mental health symptoms and test acceptability in their target audience, as well as review implementation strategies to improve engagement.

The primary objective of this implementation study is to design and test an implementation strategy to improve uptake of TEN. The secondary objectives are examining the acceptability of TEN among HCWs, changes in mental health outcomes associated with use of TEN, as well as reductions in mental health stigma among HCWs following use of TEN.

The implementation study contains three components: a consultation study with up to 39 stakeholders or researchers with implementation experience to design an implementation strategy; a longitudinal observational study of at least 105 healthcare workers to examine the acceptability of TEN and the effectiveness of TEN at one and six months in improving mental health (as assessed by Distress Questionnaire (DQ-5), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7), Oldenburg Burnout Inventory (OBI-16), and Work and Social Adjustment Scale (WSAS)) and reducing mental health stigma (Endorsed and Anticipated Stigma Inventory (EASI)); and an implementation study where TEN service uptake analytics will be examined for three months before and after the introduction of the implementation strategy.

The implementation strategy, designed with input from the consultation and observational studies, is expected to lead to an increased number of unique visits to the TEN Website in the three months following the introduction of the implementation strategy. The observational study is expected to observe high service acceptability. Moderate improvements to general mental health (DQ-5, WSAS) and a reduction in workplace- and treatment-related mental health stigma (EASI) between the baseline and 1-month timepoints.

TEN is a first-of-kind blended mental health service available to Australian HCWs. The results of this project have the potential to inform the implementation and development of blended care mental health services, as well as how such services can be effectively implemented during crisis.