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1. Crisis Response and Suicidal Behaviors of Essential Workers and Children of Essential Workers During the COVID-19 Pandemic

   https://doi.org/10.1177/00333549221148177  

   Sugg, Margaret_M; Runkle, Jennifer_D; Ryan, Sophia_C; Singh, Devyani; Green, Shannon; Thompson, Martie (January 2023, Public Health Reports®)

   Objective:The COVID-19 pandemic has put unprecedented stress on essential workers and their children. Limited cross-sectional research has found increases in mental health conditions from workload, reduced income, and isolation among essential workers. Less research has been conducted on children of essential workers. We examined trends in the crisis response of essential workers and their children from April 2020 through August 2021. Methods:We investigated the impact during 3 periods of the pandemic on workers and their children using anonymized data from the Crisis Text Line on crisis help-seeking texts for thoughts of suicide or active suicidal ideation (desire, intent, capability, time frame), abuse (emotional, physical, sexual, unspecified), anxiety/stress, grief, depression, isolation, bullying, eating or body image, gender/sexual identity, self-harm, and substance use. We used generalized estimating equations to study the longitudinal change in crisis response across the later stages of the pandemic using adjusted odds ratios (aORs) for worker status and crisis outcomes. Results:Results demonstrated higher odds of crisis outcomes for thoughts of suicide (aOR = 1.06; 95% CI, 1.00-1.12) and suicide capability (aOR = 1.14; 95% CI, 1.02-1.27) among essential workers than among nonessential workers. Children of essential workers had higher odds of substance use than children of nonessential workers (aOR = 1.33; 95% CI, 1.08-1.65), particularly for Indigenous American children (aOR = 2.76; 95% CI, 1.35-5.36). Essential workers (aOR = 1.17; 95% CI, 1.07-1.27) and their children (aOR = 1.18; 95% CI, 1.07-1.30) had higher odds of grief than nonessential workers and their children. Conclusion:Essential workers and their children had elevated crisis outcomes. Immediate and low-cost psychologically supportive interventions are needed to mitigate the mental health impacts of the COVID-19 pandemic on these populations. 

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2. Cultivating community-based participatory research (CBPR) to respond to the COVID-19 pandemic: an illustrative example of partnership and topic prioritization in the food services industry

   https://doi.org/10.1186/s12889-023-16787-1  

   Hoerger, Michael; Kim, Seowoo; Mossman, Brenna; Alonzi, Sarah; Xu, Kenneth; Coward, John C; Whalen, Kathleen; Nauman, Elizabeth; Miller, Jonice; De_La_Cerda, Tracey; et al (December 2023, BMC Public Health)

   Abstract BackgroundAs an illustrative example of COVID-19 pandemic community-based participatory research (CBPR), we describe a community-academic partnership to prioritize future research most important to people experiencing high occupational exposure to COVID-19 – food service workers. Food service workers face key challenges surrounding (1) health and safety precautions, (2) stress and mental health, and (3) the long-term pandemic impact. MethodUsing CBPR methodologies, academic scientists partnered with community stakeholders to develop the research aims, methods, and measures, and interpret and disseminate results. We conducted a survey, three focus groups, and a rapid qualitative assessment to understand the three areas of concern and prioritize future research. ResultsThe survey showed that food service employers mainly supported basic droplet protections (soap, hand sanitizer, gloves), rather than comprehensive airborne protections (high-quality masks, air quality monitoring, air cleaning). Food service workers faced challenging decisions surrounding isolation, quarantine, testing, masking, vaccines, and in-home transmission, described anxiety, depression, and substance use as top mental health concerns, and described long-term physical and financial concerns. Focus groups provided qualitative examples of concerns experienced by food service workers and narrowed topic prioritization. The rapid qualitative assessment identified key needs and opportunities, with help reducing in-home COVID-19 transmission identified as a top priority. COVID-19 mitigation scientists offered recommendations for reducing in-home transmission. ConclusionsThe COVID-19 pandemic has forced food service workers to experience complex decisions about health and safety, stress and mental health concerns, and longer-term concerns. Challenging health decisions included attempting to avoid an airborne infectious illness when employers were mainly only concerned with droplet precautions and trying to decide protocols for testing and isolation without clear guidance, free tests, or paid sick leave. Key mental health concerns were anxiety, depression, and substance use. Longer-term challenges included Long COVID, lack of mental healthcare access, and financial instability. Food service workers suggest the need for more research aimed at reducing in-home COVID-19 transmission and supporting long-term mental health, physical health, and financial concerns. This research provides an illustrative example of how to cultivate community-based partnerships to respond to immediate and critical issues affecting populations most burdened by public health crises. 

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3. Teens’ Social Media Engagement during the COVID-19 Pandemic: A Time Series Examination of Posting and Emotion on Reddit

   https://doi.org/10.3390/ijerph181910079  

   Zhang, Saijun; Liu, Meirong; Li, Yeefay; Chung, Jae Eun (October 2021, International Journal of Environmental Research and Public Health)

   Research has rarely examined how the COVID-19 pandemic may affect teens’ social media engagement and psychological wellbeing, and even less research has compared the difference between teens with and without mental health concerns. We collected and analyzed weekly data from January to December 2020 from teens in four Reddit communities (subreddits), including teens in r/Teenagers and teens who participated in three mental health subreddits (r/Depression, r/Anxiety, and r/SuicideWatch). The results showed that teens’ weekly subreddit participation, posting/commenting frequency, and emotion expression were related to significant pandemic events. Teen Redditors on r/Teenagers had a higher posting/commenting frequency but lower negative emotion than teen Redditors on the three mental health subreddits. When comparing posts/comments on r/Teenagers, teens who ever visited one of the three mental health subreddits posted/commented twice as frequently as teens who did not, but their emotion expression was similar. The results from the Interrupted Time Series Analysis (ITSA) indicated that both teens with and without mental health concerns reversed the trend in posting frequency and negative emotion from declining to increasing right after the pandemic outbreak, and teens with mental health concerns had a more rapidly increasing trend in posting/commenting. The findings suggest that teens’ social media engagement and emotion expression reflect the pandemic evolution. Teens with mental health concerns are more likely to reveal their emotions on specialized mental health subreddits rather than on the general r/Teenagers subreddit. In addition, the findings indicated that teens with mental health concerns had a strong social interaction desire that various barriers in the real world may inhibit. The findings call for more attention to understand the pandemic’s influence on teens by monitoring and analyzing social media data and offering adequate support to teens regarding their mental health wellbeing. 

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4. Predictors of mental health during the Covid-19 pandemic in the US: Role of economic concerns, health worries and social distancing

   https://doi.org/10.1371/journal.pone.0241895  

   Kämpfen, Fabrice; Kohler, Iliana V.; Ciancio, Alberto; Bruine de Bruin, Wändi; Maurer, Jürgen; Kohler, Hans-Peter (November 2020, PLOS ONE)

   Kwon, Young Dae (Ed.)

   Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative “Understanding America Study” (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents’ own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response. 

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5. Crisis response among essential workers and their children during the COVID-19 pandemic

   https://doi.org/10.1016/j.ypmed.2021.106852  

   Sugg, M.M. (February 2022, Preventive medicine)

   Limited research has been conducted on the mental health concerns of frontline and essential workers and their children during the COVID-19 pandemic in the United States (U.S.). This study examined the association between working on the frontlines in the U.S. during the COVID-19 pandemic (March to July 2020) and personal crisis text concerns (e.g., self-harm, suicidal thoughts, anxiety/stress, and substance abuse) for frontline essential workers and the children of frontline workers. We used a novel data set from a crisis texting service, Crisis Text Line (CTL), that is widely used throughout the U.S. Generalized Estimating Equations examined the individual association between eight specific crisis types (Depression, Stress/Anxiety, Self-Harm, Suicidal Thoughts, Substance Abuse, Isolation, Relationship Issues, and Abuse) and being in frontline work or being a child of a frontline worker during the early phase of the pandemic. Using CTL concerns as a proxy for the prevalence of mental health issues, we found that children of workers, specifically the youngest demographic (13 years and under), females, and non-conforming youth had a higher risk of specific crisis events during the COVID-19 pandemic. Additionally, Hispanic children of workers reported higher rates of stress/anxiety, whereas African American children of workers had higher rates of abuse and depression. Frontline workers had a higher risk of suicidal thoughts, and the risk of crisis events was generally highest for non-binary, transgender, and male users. Increases in CTL usage among frontline workers were noted across 7–28 days after spikes in local COVID-19 cases. The research to date has focused on the mental health of frontline essential workers, but our study highlights troubling trends in psychological stress among children of these workers. Supportive interventions and mental health resources are needed not only for frontline essential workers but for their children too. 

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