Title: The Resilience Hubs: A multi-site, mixed-methods evaluation of an NHS Outreach, Screening and Support Navigation service model to address the mental health needs of key workers affected by the COVID-19 pandemic
Funder: Department of Health and Social Care

Abstract: BACKGROUND: Many nurses, doctors, ambulance workers and other professional carers are developing mental health problems because of the very stressful circumstances they have to deal with during the COVID-19 pandemic. The mental health of many of these ‘key workers’ will improve over time but some will need help to prevent long-term problems such as anxiety, depression and Post-Traumatic Stress Disorder. Mental health experts agree that we need urgent research on how we can reach key workers who need psychological support and help them to access the support they need._x000D_ _x000D_ AIMS: We will evaluate new NHS services, called ‘Resilience Hubs’, that are being set up in several regions in the UK to help key workers who are struggling with mental health issues brought about by the pandemic. These services offer mental health screening to NHS, social care and emergency services workers, and help those with mental health issues to get the right support as quickly and early as possible, before their problems become even worse. This type of service has helped people affected by major incidents like terrorist attacks in the past, but we do not know how well these services work in response to the COVID-19 pandemic, how helpful key workers find them or the best way of setting up new Hubs in regions where this kind of support did not exist before. It is vital to learn as much as possible from the process of setting up and using these new services so that we could ensure that key workers get the best service response, both throughout the COVID-19 pandemic and also in future crises._x000D_ _x000D_ METHODS: We will work with 4 Resilience Hubs for 20 months to: _x000D_ _x000D_ 1) See how many key workers need mental health support after registering with the Hubs, and whether certain groups need more support than others or might find it more difficult to access mental health services after registering with the Hubs; _x000D_ _x000D_ 2) Ask key workers about what services they have accessed with the support of the Hubs, and how useful they found the help they received from the Hubs; _x000D_ _x000D_ 3) Understand what resources are needed to set-up and manage the Hubs and check the ‘value for money’ of these new services; _x000D_ _x000D_ 4) Interview key workers who received Hub support, key workers that did not register with the Hubs (for example, because they felt it was not right for them) and professionals who work at the Hubs. These interviews will allow us to understand if the Hubs are fit-for-purpose and useful for all the different key workers they are supposed to help, and how the Hubs’ support could be improved and modified to suit the needs of different UK regions who might require a service of this kind in the future._x000D_ _x000D_ PPI: We will receive regular advice from a group of representatives of key workers with diverse backgrounds. We will also meet, at key stages of the project, with a wider range of different key workers to make sure that our research is meaningful and helpful to them._x000D_ _x000D_ DISSEMINATION: We will share findings widely, including with NHS and social care organisations, local authorities and commissioners that are already establishing new Resilience Hubs, or might do so in the future. In addition to publications in scientific journals and conference talks, we will make sure that people will know about our work by advertising our progress throughout the project on websites and social media outlets of the organisations we work with, and through webinars and newsletters that we will publicise widely.

Lay abstract: BACKGROUND: A healthy and resilient NHS and social care workforce is essential to ensure an optimal response to both the current pandemic and future large-scale crises. Research indicates that key workers are at high risk for both acute and long-lasting mental health issues as a result of the adversities faced during the pandemic. The NHS Clinical Leaders Network (2020) has issued an urgent call for action to ensure that NHS organisations prioritise initiatives to enhance mental health resilience and support provision for key workers during this time. The Lancet Psychiatry’s immediate research priorities for the COVID-19 pandemic (Holmes et al. 2020) include monitoring mental health issues and determining the best ways of signposting and delivering mental health services for vulnerable groups, including key workers, and to identify and provide interventions to promote mental wellbeing in key workers exposed to stress and trauma that can be delivered now and at scale._x000D_ _x000D_ RESEARCH AIMS: This research will evaluate the Resilience Hub model in four UK sites. The Resilience Hub is a service model originally developed in response to the 2017 Manchester Arena bombing. It has been adapted and repurposed in Greater Manchester to provide mental health screening and facilitation of access to evidence-based psychosocial support for NHS, social care and emergency response key workers throughout the COVID-19 pandemic. The model is being replicated to support mental health needs of key workers in other UK regions._x000D_ _x000D_ METHODS: The research will take 20 months. We will produce mixed method case studies for three study sites, triangulating findings from 1) quantitative analyses of routine mental health screening data collected at the three Hubs; 2) health economic analyses conducted using Hub clients’ service use and health status data; 3) in-depth interviews with Hub providers (recovery workers; therapists; service managers; commissioners), and key workers who did and did not register with the Hubs. Further quantitative data will be included for a fourth study site. The project will deliver crucial data and evidence-based recommendations for ensuring the ‘transactability’ of the Hub approach (i.e. how it can be scaled up and replicated in other sites in the UK) and inform evidence-based commissioning both in the short-term (in response to the ongoing pandemic) and longer term (in response to future large-scale crises). These include: i) data relevant to the identification of subgroups of key workers with higher support needs and/or lower support uptake, to guide effective targeted outreach and model service demand; ii) recommendations for maximising mental health screening uptake and psychosocial support access and uptake following screening; iii) guidance on resolving systemic and organisational barriers to accessing onward psychosocial support; iv) economic data to inform future commissioning decisions.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MENTAL HEALTH