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UNC and Google partner on mental health app for COVID-19 frontline workers

News & Observer - 7/14/2020

Jul. 14--CHAPEL HILL -- The UNC School of Medicine launched a new app Tuesday that it hopes will help monitor the mental health of COVID-19 health care workers across the country, as the pandemic's surge continues to strain the country's health infrastructure.

The app, called the Heroes Health Initiative, helps first responders and health care workers complete short mental health self-assessments each week. The app, which is available for free on the Apple App Store and Google Play, then displays symptom summaries and tracks trends over time to help workers understand their own mental state during a time of unprecedented stress at many hospitals.

The app would also provide partnering health organizations, like UNC Health, aggregated data to help them identify when and where more worker support is needed.

The initiative was founded by Dr. Samuel McLean, the research vice chair in the school's Department of Anesthesiology as well as an attending physician in the Department of Emergency Medicine.

In an interview, McLean, who contracted COVID-19 in March while treating the first wave of patients, said he's seen first hand the strains many health care workers are facing because of the coronavirus.

Many of them -- whether they are nurses, doctors or other support staff -- face daily the deaths and illnesses of patients hospitalized by the pandemic and are working more hours than usual to keep up.

Like many states across the country, North Carolina has seen a surge in coronavirus cases in recent weeks. On Tuesday, the state hit a record of 1,100 people hospitalized because of the coronavirus, and it saw its highest single-day death toll, The News & Observer reported.

The state's hospitals are getting closer to capacity, with 78% of the state's intensive-care beds now occupied.

On top of their concern for patients, health workers live with the fear that they may contract the virus themselves or bring it home to their loved ones, as McLean did earlier this year, when two members of his family got sick. As a result, many health care workers are separating themselves from their family and friends to protect them.

"This virus isolates us all in many ways," McLean said in a phone interview, "and isolation is one of the parts that makes this so much worse."

An analysis of multiple studies of health care workers during COVID-19 found that "a high proportion" are facing "significant levels of anxiety, depression and insomnia." That analysis found that prevalence rates of anxiety and depression among health care workers during COVID-19 were 23.2% and 22.8% respectively.

In the United States, a doctor based in New York City died by suicide after contracting the coronavirus and going back to work after recuperating. In an interview with The New York Times, the doctor's father said the sheer amount of devastation inside of hospitals had taken a toll on her.

McLean said the prevalence of anxiety and depression among health care workers gave UNC a sense of urgency to build the app.

"These are people that need to be helped," he said. "It needs to be addressed. We are a community under stress."

How it works

UNC was able to launch the app quickly with the help of volunteers from Google parent company Alphabet, specifically from its moonshot-focused subsidiary X.

The app was also supported by the nonprofit One Mind, The Rockefeller Foundation and Bank of America, and received input from researchers at UNC, Harvard University, Brown University and Cooper University Health.

Each week, the app sends a notification to workers to answer questions about key checkpoints like sleep, stress, anxiety and feelings of sadness.

The app provides links for crisis support and other mental health resources around improving sleep and stress. McLean said, for example, a health worker could begin a text conversation with a crisis counselor from one click within the app.

For the organizations partnering with Heroes Health, the app provides anonymous summaries and trends about their workers, giving them a potential heads up on which units and floors might need more support.

For many hospitals, McLean noted, they just don't have any data about the mental health of their workers.

"For example, Miami is getting (overwhelmed) right now" by the coronavirus, he said. "If you went to a Miami hospital and asked, 'How are you nurses doing?' They couldn't tell you. They don't have the data."

McLean said he has been encouraged that more people seem willing to talk about the mental health of health workers. For a long time, he said, the issue has been stigmatized.

He's hopeful that the pandemic is creating an opportunity for conversations about mental health to become more standard, like discussing blood pressure.

And with hospitals getting slammed across the country, workers who may have had a lot of energy to face the issue at the beginning of the pandemic could begin to wear down.

"As it goes on and on, it can feel like there's no end in sight," McLean said. "It is harder than it was when there was an initial wave, but we thought we could lock it down. Now everyone has a much more grim or uncertain feeling of what is the next year going to look like."

This story was produced with financial support from a coalition of partners led by Innovate Raleigh as part of an independent journalism fellowship program. The N&O maintains full editorial control of the work. Learn more; go to bit.ly/newsinnovate

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