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 stress. At NYU Langone, the Child and Adolescent Psychiatry Department played a key role in efforts to provide the care and resources needed.

Create a wide range of online resources

As the number of COVID-19 cases began to rise, the department’s first task was to move primarily to a virtual platform for consultations in the KiDS emergency room of NYU Langone’s Hassenfeld Children’s Hospital 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.

It was clear from the start that faculties, trainees, nurses, and support staff across NYU Langone Health’s system would need help managing the psychological effects of the crisis – not just because of the demands on caring for these critically ill patients, but also before the risk of infection or infection of others. A cross-departmental, interdisciplinary taskline to support frontline workers has been created to resolve pandemic-related issues including sleep disorders, anxiety, stress, and work-life balance. This task force included representatives from the Department of Psychiatry and the Department of Child and Adolescent Psychiatry from all NYU Langone 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, Head of Service in the Department of Child and Adolescent Psychiatry at Tisch Hospital and at Hassenfeld Children’s Hospital, and Director of the Center for Child and Family Resilience at the Sala Institute for Child and Family Centered Care, along with Rachel Podbury, Senior Project Manager at WonderLab (the division’s digital innovation laboratory), and Child Psychology Clinical Trainer Dr. Nikhil A. Patel, an initiative to create online resources for health care workers and their employee loved ones. Working with the Psychiatry, Social Work, Spiritual Care, and Inclusive Health Departments, the team created an internal website for staff and an outward-facing website for family members that provides pathways for mental health services, as well as webinars and live Facebook events, articles, tips and Coping skills infographics.

To promote awareness and use among employees, the team designed posters and postcards that advertise the intranet site and contain a QR code to make it easier to access via mobile phone. These materials were displayed in high-traffic areas of each unit and distributed personally by an interdisciplinary employee support team during breaks and shift changes. In addition, presentations on resources for employee support at administrative and care management meetings, large departmental rounds and town halls as well as interdisciplinary team meetings were given and promoted by a daily company-wide COVID-19 email. In the first 25 days after starting the website, the target page had 7,423 hits and 2,425 unique users.

“The ability of our organization to work together efficiently and quickly across borders was critical to our success,” says Dr. Liaw. “This is a good lesson to remember as we continue to navigate this crisis together.”

Offer of self-help groups and connections for individual advice

Dr. Liaw also made efforts to set up virtual support groups for health care workers and their families, and to adapt existing groups (such as Project Safe Space, a resilience program for emergency medicine residents) to focus on the challenges of COVID-19.

Almost 40 support groups have been provided for faculties, nurses, staff, and medical students across the healthcare system. They met weekly and offered opportunities for reflection, grief, community, psycho-education and self-care. A team of psychiatrists, psychologists, social workers, nurses, residents, and scholarship holders from psychiatry and pastoral workers volunteered to lead meetings. Randi D. Pochtar, PhD, clinical assistant professor of child and adolescent psychiatry, created a guide to provide a framework for group leaders in various disciplines and settings. The guide adapted material from Psychological First Aid, an evidence-based intervention developed by the National Center for Traumatic Stress in Children and the National Center for PTSD to help people after a disaster or crisis.

Access to individual advice has also been expanded. The Child and Adolescent Psychiatry Department and NYU Adult Langone Psychiatry Associates worked together to provide expedited triage and connection to individual care via telemedicine on first line health care workers on contact day. In addition, inpatient psychiatric nurses were transferred from the Department of Psychiatry to the Consultation-Liaison Psychiatry team, where they acted as mental health “medics” and provided frontline psychological first aid to clinical staff wherever needed.

“The rapid deployment of all these programs was driven by the urgency of looking after colleagues in times of crisis and sustained by a remarkable level of coordination between departments and disciplines,” says Dr. Helen L. Egger, Arnold Simon Professor of Child and Adolescent Psychiatry at NYU’s Grossman School of Medicine and Chair of the Department of Child and Adolescent Psychiatry at NYU Langone. “And it offers valuable lessons for future public health emergencies.”

Dr. Liaw adds, “One thing that really highlighted this pandemic is that we need to take care of our healthcare workers – now and on the long path to recovery.”