Social Work Research Expands on Behavioral Health Impact of COVID-19
Researchers at the USC Suzanne Dworak-Peck School of Social Work are rising up to meet the challenges of the COVID-19 pandemic and understand how the public health crisis is impacting behavioral health.
In the past eight months, the school’s faculty have partnered with other schools at USC, as well as outside organizations, to respond to the disease. They aim to advance knowledge of the disease’s impact on the health care system and individual well-being, and develop strategies for recovery.
Coping with the uncertainty of COVID-19
Lawrence Palinkas, the Albert G. and Frances Lomas Feldman Professor of Social Policy and Health at the USC Suzanne Dworak-Peck School of Social Work, has three research projects aimed at advancing understanding of the impacts of COVID-19 on health care service delivery, especially mental health services.
When the first cases of COVID-19 started emerging in the State of Washington in February 2020, Palinkas was already conducting research in Seattle area trauma centers. As initially designed, the research project aimed to introduce interventions for the treatment of PTSD symptoms and other conditions in patients who showed up at emergency rooms, usually with some kind of physical injury. A portion of the project focused on training trauma care providers on how to collect ethnographic information about their patients.
As the first few COVID-19 cases grew into a pandemic, Palinkas and his research team kept their framework for data collection but rapidly shifted their focus to the impact of the disease on delivery of trauma services and the health and well-being of the service providers. The study was one of the first of its kind to be conducted in the United States examining the still-unfolding infectious disease pandemic in a health care setting that was often the first point of entry for COVID-19 positive patients. Its findings, published in BMJ Open in October 2020, document significant changes in acute care clinical procedures as well as in the behaviors of patients and providers as a result of the outbreak.
Since that study, Palinkas and his fellow researchers have used a very similar technique in two other studies. One study examined how community-based organizations in New Orleans and southern Louisiana were preparing for hurricanes and natural disasters during the COVID-19 pandemic. The other, part of an NIMH-funded research center, investigated how the pandemic is affecting delivery of mental health services to children and adolescents across the country.
“In all three studies, we see many similarities in the challenges that people experience but also in the ingenuity that people exercise in overcoming these challenges,” Palinkas said. Many of the changes occurring now, such as the shift to telehealth, are likely to have significant long-term benefits and will reshape future service delivery. “As difficult as things are right now, we’re hearing reports that teenagers greatly prefer working with mental health providers via telehealth,” he said. It’s an encouraging sign.
For Palinkas, conducting research with those working on the front lines of health care delivery during a pandemic has been a privilege that has broadened his understanding of how people are really coping. The isolation that everyone is experiencing as they stay at home limits any individual’s perspective, and accounts in the media can also provide a limited view.
Palinkas knows something about isolation: his previous research includes the effects of isolation on people working at the International Space Station and Antarctica. “They cope because they know when the period of isolation will end,” he said. “We’re not quite there yet with the pandemic, as we’re facing what people are describing as a winter of discontent. As long as that uncertainty persists, there will be a need for professionals and nonprofessionals trained in psychological first aid and other forms of mental health services to help the population cope with this pandemic.”
COVID-19 impact on California’s rural hospitals
Underserved communities in rural areas face intense challenges while preventing and treating COVID-19 as well as other ongoing medical conditions in their patients. Shinyi Wu, associate professor at the USC Suzanne Dworak-Peck School of Social Work and the USC Viterbi School of Engineering, joined USC Viterbi Adjunct Professor David Belson to conduct a survey this summer examining how 30-plus critical access hospitals in California coped with the real-time unfolding of the global health crisis. Together they examined the repercussions of COVID-19 through their research interests: Wu in improving health care services for disadvantaged populations with chronic illnesses, and Belson in helping hospitals improve processes, reduce costs and increase productivity.
Their findings were crystal clear: fear of contracting coronavirus kept many chronically ill patients from seeking routine medical care. This meant less money coming into the rural hospitals, many of which were already struggling. It also meant that the doctors and nurses did not know how their patients with underlying conditions were faring, because they were not coming in for routine care. But the hospital staff proved to be quite adaptive and resilient during this time, shifting to telephone and video calls for consultations and in some cases, sending ambulances out to check on patients who were reluctant to come to the hospital in-person.
That adaptability was a bright spot in their findings, Wu and Belson said, and could have long-lasting and positive impacts on population health management as well as hospital operations. However, they don’t yet know the degree to which regulations and financial support will accommodate these changes.
“Now we know the technology works and that people accept different modalities for doctor visits,” Wu said. “Patients seem to like it and we may see more people have better access to health care through these different means.” She hopes that an outcome of the pandemic may be implementation of population health management systems that can identify patients at high risk and provide them with proactive health care services to prevent catastrophic events.
Belson, who is also the program director of USC Viterbi’s Health Systems Management Engineering master’s program, said, “The disruption and difficult challenges of COVID-19 has also brought an opportunity for us to rethink how health care systems work. We don’t know all the impacts yet, but one thing we do know is that it is going to change a lot of things in health care.”
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