Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Healthcare Workers during the COVID-19 Pandemic.

The outbreak of the coronavirus disease 2019 (COVID-19) and its rapid global spread have created unprecedented challenges to healthcare systems. Significant and sustained efforts have focused on mobilization of personal protective equipment, intensive care beds, and medical equipment, while substantially less attention has focused on preserving the psychological health of the medical workforce tasked with addressing the challenges of the pandemic. And yet, similar to battlefield conditions, healthcare workers are being confronted with ongoing uncertainty about resources, capacities, and risks; as well as exposure to suffering, death, and threats to their own safety. These conditions are engendering high levels of fear and anxiety in the short-term, and place individuals at risk for persistent stress-exposure syndromes, sub-clinical mental health symptoms, and professional burnout in the long-term. Given the potentially wide-ranging mental health impact of COVID-19, protecting healthcare workers from adverse psychological effects of the pandemic is critical.Therefore, we present an overview of the potential psychological stress responses to the COVID-19 crisis in medical providers and describe pre-emptive resilience-promoting strategies at the organizational and personal level. We then describe a rapidly deployable Psychological Resilience Intervention founded on a peer-support model (Battle Buddies) developed by the United States Army. This intervention-- the product of a multidisciplinary collaboration between the Departments of Anesthesiology and Psychiatry & Behavioral Sciences at the University of Minnesota Medical Center-- also incorporates evidence-informed "stress inoculation" methods developed for managing psychological stress exposure in providers deployed to disasters. Our multi-level, resource-efficient, and scalable approach places two key tools directly in the hands of providers: 1) A peer-support Battle Buddy; and 2) A designated mental health consultant who can facilitate training in stress inoculation methods, provide additional support, or coordinate referral for external professional consultation. In parallel, we have instituted a voluntary research data-collection component that will enable us to evaluate the intervention's effectiveness while also identifying the most salient resilience factors for future iterations. It is our hope that these elements will provide guidance to other organizations seeking to protect the well-being of their medical workforce during the pandemic. Given the remarkable adaptability of human beings, we believe that, by promoting resilience, our diverse healthcare workforce can emerge from this monumental challenge with new skills, closer relationships, and greater confidence in the power of community.