As New York City became the epicenter of the coronavirus disease (COVID-19) pandemic in March 2020, healthcare workers and their families began to experience potentially harmful levels of stress. At NYU Langone, the Department of Child and Adolescent Psychiatry played a key role in efforts to provide the care and resources they needed.
Creating a Wide Range of Online Resources
When COVID-19 caseloads began climbing, the first task for the department was to shift primarily to a virtual platform for consultations in the KiDS Emergency Department at Hassenfeld Children’s Hospital at NYU Langone and its inpatient and Pediatric Intensive Care Unit. At the same time, the medical center’s inpatient pediatric units began treating the influx of adult patients with coronavirus.
From the beginning, it was clear that faculty, trainees, nurses, and support staff across NYU Langone Health’s system would need help coping with the mental health impacts of the crisis—arising not only from the demands of caring for these critically ill patients, but also from the danger of becoming infected or infecting others. A cross-departmental, interdisciplinary Frontline Staff Support Task Force was launched to address pandemic-related issues, including difficulties with sleep, anxiety, stress, and juggling work and family responsibilities. This task force included representatives of the Department of Psychiatry and the Department of Child and Adolescent Psychiatry from all of NYU Langone’s locations, as well as the affiliated VA NY Harbor Healthcare System and NYC Health + Hospitals/Bellevue.
Ron-Li Liaw, MD, clinical associate professor of child and adolescent psychiatry, chief of service in the Department of Child and Adolescent Psychiatry at Tisch Hospital and Hassenfeld Children’s Hospital, and director of the Center for Child and Family Resilience at the Sala Institute for Child and Family Centered Care, co-led an initiative with Rachel Podbury, senior project manager at the WonderLab (the department’s digital innovation laboratory), and child psychology clinical instructor Nikhil A. Patel, MD, to create online resources for healthcare workers and their loved ones. In collaboration with the departments of psychiatry, social work, spiritual care, and integrative health, the team created an internal website for employees and an outward-facing site for family members, offering pathways for mental health services as well as webinars, Facebook Live events, articles, tip sheets, and infographics on coping strategies.
In order to promote staff awareness and utilization, the team designed posters and postcards publicizing the intranet site and featuring a QR code to facilitate access via mobile phone. These materials were displayed in high-traffic areas on each unit and distributed in-person during breaks and shift changes by an interdisciplinary staff support team. In addition, presentations on staff support resources were delivered at administrative and nursing leadership meetings, department grand rounds and town halls, and interdisciplinary team meetings and were promoted through a daily, enterprise-wide COVID-19 email. In the first 25 days after the launch of the website, its landing page had 7,423 hits and 2,425 unique users.
“The ability of our organization to collaborate across boundaries in an efficient and nimble way was crucial to our success,” Dr. Liaw says. “That’s a good lesson to remember as we continue to navigate through this crisis together.”
Offering Support Groups and Connections to Individual Counseling
Dr. Liaw also led an effort to create virtual support groups for healthcare workers and their families and to adapt existing groups (such as Project Safe Space, a program promoting resiliency for emergency medicine residents) to focus on the challenges of COVID-19.
Nearly 40 support groups were provided for faculty, nurses, staff, and medical students across the health system. They met weekly, offering opportunities for reflection, grief, community, psychoeducation, and self-care. A team of psychiatrists, psychologists, social workers, nurse practitioners, psychiatry residents and fellows, and chaplaincy staff volunteered to lead sessions. A guidebook was produced by Randi D. Pochtar, PhD, clinical assistant professor of child and adolescent psychiatry, to provide a framework for group leaders across disciplines and settings. The guidebook adapted material from Psychological First Aid, an evidence-informed intervention developed by the National Child Traumatic Stress Center and the National Center for PTSD to help individuals following a disaster or crisis.
Access to individual counseling was expanded as well. The Department of Child and Adolescent Psychiatry and the adult NYU Langone Psychiatry Associates collaborated to provide frontline healthcare workers with expedited triage and linkage to individual care via telehealth on the day of outreach. In addition, inpatient psychiatric nurses from the Department of Psychiatry were redeployed to the Consultation–Liaison Psychiatry team, where they acted as mental health “medics,” delivering Psychological First Aid to frontline clinical staff wherever it was needed.
“The rapid deployment of all these programs was fueled by an urgency to care for colleagues at a time of crisis, and sustained through a remarkable degree of coordination across departments and disciplines,” says Helen L. Egger, MD, the Arnold Simon Professor of Child and Adolescent Psychiatry at NYU Grossman School of Medicine and chair of the Department of Child and Adolescent Psychiatry at NYU Langone. “And it provides valuable lessons for public health emergencies to come.”
Adds Dr. Liaw: “One thing this pandemic has really highlighted is that we have to take care of our healthcare workforce—now and through the long road of healing ahead.”