Stories from Chile: Providing mental health and psychosocial support during COVID-19

Care for health teams fighting coronavirus

This initiative arises from the need to provide tools to health workers to allow them to face the current crisis in the best possible way. 3-5 minute long videos or audio messages are recorded and distributed through the Graneros Hospital's WhatsApp account in order to reach as many staff as possible. They address the thoughts, feelings and actions that could be affecting us or that do us harm in relation to the crisis and its forms and how to combat them. They also cover exercises based on interpersonal therapy and awareness-raising material with regards to managing relations during these difficult times.

The aim of these actions is for each staff member to be able to explore and identify their own personal and emotional resources and strengths in order to improve their ability to manage the crisis.

Continuing mental health services during the pandemic

Providing mental health services to the general population and COVID-19 response teams through telephone-based interventions.

Remote mental health care and outreach plan

This initiative looks to develop a complete platform of innovative activities to address mental health needs and provide support to the population during the COVID-19 outbreak. The intervention consists of a Remote Care Plan that includes monitoring strategies, flexibility for clinicians  through teleworking and shorter working shifts.

The following are the initiatives implemented:

• Creation of a protocol for the implementation of the Remote Care Plan of the community mental health center in the town of Pirque
• Daily planning meetings (daily target or contingency approach) through teleworking platforms
• Weekly team meetings through teleworking platforms
• Use of personal telephones for consultation and monitoring
• Adaptation of clinical models suitable to account for the new teleworking arrangements
• Creation of a Facebook page for dissemination purposes of topics of community interest, by the community mental health center in the town of Pirque

Modified care in ambulatory unit for children and adolescents in times of crisis

New practices such as teleworking and videoconferencing have been established to adapt to the new context, as well as strengthening intersectoral work and connections between colleagues in different departments.

Emotional support and psychoeducation for health workers

Psychosocial Care via video call is provided to staff who are emotionally and mentally overwhelmed by the situation; educational audiovisual messages promoting psychosocial wellbeing during the pandemic are disseminated through social media.

Continuation of holistic mental health services in times of COVID-19

Ensuring the continuation of mental Health and psychosocial support (MHPSS) for new and returning patients through remote means, including:

• Ensuring continuation of care for patients following psychotropic treatment;
• Awareness-raising through social media;
• Use of technology to coordinate mental health teams;
• Working with parents via WhatsApp to provide psychosocial support to 5-9yr old children ;
• Collaboration with social workers to care for people with substance use disorders;
• Collaborating with midwives to support mothers in peri- and postnatal periods.

Remote Family Therapy

Originally conceived as a home-based intervention to prevent depression and promote wellbeing in mothers/fathers/carers through a family-based approach. Since the beginning of the pandemic they offer different means of remote communication to cater for different families’ needs.

• Use of technology to share informational material;
• Use of muscle relaxation techniques remotely;
• Promotion of positive emotions by bringing patients to remember more positive times;
• Supporting families gain agency over their wellbeing (e.g. organizing family meetings to solve problems and support each other).

Mental Health in resident care homes

Focus on resident care homes for people with mental health disorders called “protected homes” (PH).  Since the beginning of the pandemic Psychological First Aid training was carried out to all care home workers, who have also been supported in planning and managing services and with who a WhatsApp group has been created for continuous emotional and technical support., An occupational therapist has been also been deployed to support the care home’s activities.

Mental health care as a survival tool in times of crisis

Holistic mental health services provided through:

• A mental health telephone hotline;
• An email address to which people can write to ask mental health-related questions;
• Awareness-raising video messages and radio programme;
• Continuation of psychotropic treatment through home delivery through collaboration with medical teams;
• Caring for healthcare workers both face-to-face and remotely;
• Establishment of a buddying system to support field workers;
• Presence of psychologists in other state services.

Using the pandemic as an opportunity to strengthen mental health services

Using this crisis as a way to promote the enhancement of community-based, person-centered services:

• Promoting continuous communication with field teams;
• Development of quick and standardised guidelines across the catchment area;
• Improving the health information system to take managerial decisions at the micro and macro level;
• Strengthening of specialised outpatient services;
• Enhanced management and delivery of psychotropic medication;
• Use of tele-MHPSS to reach patients and establishing care for healthcare workers.