Psychological support in times of COVID-19: the Essen community-based CoPE concept.

The SARS CoV-2-virus (COVID-19) pandemic is pushing national and international structures to their limits. Little is known about treatment options to combat the novel virus, but the same applies to the effects of COVID-19 on people's mental health. In Germany, as in many other countries, governmental actions impact peoples' individual freedom. These highly necessary actions to slow down the spread of the virus, however, are a burden to the community. We established a structured concept to support psychological burdened people in Essen, which is located in the Ruhr area, a metropolitan region with more than 5.1 million inhabitants in the heart of the federal state North Rhine Westphalia. The psychological burden following the spread of the virus and individual restrictions should not be neglected.

To the Editor

Since the first cases of the SARS CoV-2-virus (COVID-19) in Wuhan, China, in December 2019, the World Health Organization (WHO) officially classified the spread of the virus as the first pandemic since H1N1 in 2009/2010., So far, little is known about treatment options and potential vaccinations to effectively combat COVID-19. However, the same applies for the impact of COVID-19 on people’s mental health. In Germany, as in many other countries, the government determined social distancing, restricted personal lives and put thousands of people under private quarantine. These highly relevant actions to ‘flatten the curve’, however, are a burden to the community. A recent work about the psychological impact of quarantine indicates the psychological strain on those who are not allowed or unable to participate in social life. Besides necessary government regulations in order to slow down the rapid spread of the virus, a COVID-19 crisis strategy to face the increased psychological burden of the community has not been defined yet. We established a structured concept to support psychological burdened people in Essen, which is located in the Ruhr area, a metropolitan region with more than 5.1 million inhabitants in the heart of the federal state North Rhine Westphalia (NRW). NRW is the most populated state and total numbers of COVID-19 infections are the highest in Germany. Given these circumstances, community-based mental health support and interventions are highly needed, but also challenging. ‘Coping with Corona: Extended Psychosomatic care in Essen’ (CoPE) comprises telephone and videoconferencing calls with experts, as well as web contents and online interventions. CoPE is an integrated part of the community emergency action plan and includes a stepped procedure of assessment, indication, counseling and intervention (Fig. 1). The initial contact point is the corona specific hotline of the community of Essen (‘Bürgertelefon’), where citizens can get information about virus specific topics or express COVID-19-related burdens (e.g. distress, worries) [Step 1]. If the latter applies, medical assistants will do further psychological diagnostics (phone-based ‘CoPE hotline’) in order to distinguish the need and appropriate intervention [Step 2]. After triaging by the medical assistants, the citizen is directed to the required expert, i.e. psychologists, physicians (experts in psychosomatic medicine and psychiatry), qualified nursing staff and social workers. The telephone and videoconferencing calls compromise a semi-structured interview, individually need-based content, i.e. the activation of resources, relaxing techniques and support in social law [Step 3]. Aftercare is provided in the form of repeated telephone or videos contacts or by the use of the developed CoPE webpage offering psycho-educational information materials about resources, relaxing techniques and mental health. Additionally, an online intervention ‘CoPE It’ is provided [Step 4]. ‘CoPE It’ consists of four structured modules including psycho-education, mindfulness and cognitive behavioral skills training. During the COVID-19 crisis, implementing structured community-based concepts to support psychological burdened citizens is crucial. Furthermore, authorities and policymakers should be aware of the psychological impact of fear caused by the rapid outbreak of COVID-19 as well as decreed behavioral rules to decelerate the spreading.

Fig. 1

Flow chart of the CoPE concept.

Conflict of interest

We declare no competing interests.

Funding

Not applicable.