Resilience and Mental Wellbeing of the Health and Care Workforce

This topic aims at supporting activities that are enabling or contributing to one or several expected impacts of destination 4 “Ensuring access to innovative, sustainable and high-quality health care”. To that end, proposals under this topic should aim for delivering results that are directed, tailored towards and contributing to several of the following expected outcomes:

• Health and care workers receive support (including mental health support), access to tools and guidance that enhances their wellbeing and ability to adapt to changing working conditions, as a result of new technologies, new work models or unexpected adverse events, including during public health emergencies and when under ethical stress.
• Decision- and policymakers, employers and social partners in the health and care sectors^[1] have knowledge of the specific risks for the resilience, mental health and well-being of health and care professionals and informal carers. They have access to solutions (regulatory, organisational, technological, educational, HR, health services) to prevent and manage them, based on the integrated development of work processes and wellbeing at work and on the study of effects of clustered work stressors on work ability and recovery from work.
• Funders of health and care provision have access to evidence, novel approaches and cost-effective recommendations for interventions supporting the mental health and well-being of health and care workers at individual, organisation and sector levels.
• Policymakers cooperate with relevant stakeholders, including health and care professionals associations and social partners to foster specific solutions to improve resilience and well-being of health workers and carers including informal carers^[2], and fight the accumulation of stressors.

A resilient workforce in the health and care sectors is essential for the sustainability and prosperity of our societies. However, careers in the health and care sector can be physically and mentally taxing by submitting health professionals and carers to psychosocial risks (for example heavy workload, stressful working conditions, risk of exposure to infectious agents, precariousness, ethical stress etc.). Many health professionals and carers also commute to work or have migrated to work in a new country. This adds to the struggle of health and care systems to attract new people to their workforce, but also to maintain the ones already working. A combination of factors such as changes in work organisation, budgetary and administrative pressures faced by health and care systems, systemic shortages of health professionals, precarious working conditions, structural inequalities and leaps in technological innovation may leave health and care workers with feelings of helplessness, physical or mental vulnerability or moral injury.

Technological innovations (including digitisation, big data and artificial intelligence applications) provide opportunities for a more efficient provision of health and care services, and for lightening the workload of health and care workers. However, they also create new risks, potentially affecting the mental wellbeing of the workforce. For example, new skills, requirements, new organisational models, performance monitoring by algorithms, lack of control or accountability in workplace decisions, ethical questions, are elements that can increase stress and hamper the ability of health and care workers to function in their jobs on a daily basis.

The COVID-19 pandemic has put a strain on health and care workers’ resilience and exacerbated mental health issues that were already a problem pre-pandemic, ranging from anxiety due to increased workload to burnout and post-traumatic stress disorder. Informal carers suffer from similar stress, potentially caused by different factors, such as the need to provide care which keeps them away from employment and puts them at an increased risk of poverty. Lack of acknowledgement that one’s mental health is deteriorating, barriers to seeking help or the stigma that still surrounds mental illness may impede people from addressing such problems early enough. Different socio-economic groups are affected to different extents: in emerging virus outbreaks prior to the COVID-19 pandemic lower educational level among other things was associated with higher risk for adverse psychological outcomes among health workers^[3].

Successful proposals should address several of the following activities:

• Collect and analyse new evidence and data generation – on occupation-specific factors building the resilience, mental health well-being of health and care workers, or informal carers. Where appropriate, evidence should be gathered and analysed on the interplay of such factors with non-occupation specific factors (e.g. genetic, social etc.). Where relevant, such evidence should be target-group specific, considering variation of challenges for professionals working in various settings (primary care, hospitals, residential care institutions, disadvantaged geographic locations).
• Develop action-oriented recommendations to policymakers, employers, social partners and relevant civil society organisations at the appropriate levels (EU, national, regional, local) based on evidence generated by the proposed action. Such recommendations should suggest (cost-)effective policy interventions or elements for further research aiming to promote the resilience, mental health and well-being of health and care workers. They should be based on cost-benefit studies and ex-ante evaluations of proposed interventions.
• Develop, or identify, innovative solutions (including digitally enabled ones), organisational models and management approaches to support health policymakers, employers and formal or informal health and care workers in promoting resilience, mental health and well-being in the workplace.
• Develop financing and resource allocation models to ensure access to support and mental health services for health and care workers and informal carers.
• Carry out testing and validation activities for new or improved solutions^[4] improving conditions for health and care workers or informal carers according to specific factors influencing their mental well-being.

Proposals can identify one or more worker groups or informal carers as target of R&I activities, based on credible scientific criteria.

This topic requires the effective contribution of social sciences and humanities (SSH) disciplines and the involvement of SSH experts, institutions as well as the inclusion of relevant SSH expertise, health and care professionals associations and (informal) carers associations, in order to produce meaningful and significant effects enhancing the societal impact of the related research activities.

All projects funded under this topic are strongly encouraged to participate in networking and joint activities, as appropriate. Therefore, proposals should include a budget for the attendance to regular joint meetings and may consider covering the costs of any other potential joint activities without the prerequisite to detail concrete joint activities at this stage. The details of these joint activities will be defined during the grant agreement preparation phase.

With women making up over 70% of EU health care professionals and employees in the care sector and a great part of informal carers, an appropriate gender approach is essential in research and policy interventions, to prevent or mitigate workplace inequalities and imbalances. Researchers and policymakers should also take into account the inclusion dimension, as a significant share of health professionals or care workers typically come from minority groups, whether through declared or undeclared work.

Proposals should consider potential synergies and avoid overlaps with ongoing calls or actions funded under EU or national programmes for example the future cofunded partnership on Transforming Health and Care Systems (THCS).

Proposals are encouraged to take into account, when relevant, the EU Strategic Framework on Health and Safety at Work (2021-2027)^[5], the report on mental health^[6] and most importantly, the recommendations and analysis presented in the Expert Panel on effective ways of investing in health (EXPH) opinion on supporting the mental health of the health workforce and of other essential workers.

Applicants envisaging to include clinical studies should provide details of their clinical studies in the dedicated annex using the template provided in the submission system. See definition of clinical studies in the introduction to this work programme part.

[1] “Health and care systems” implies a broader notion than “health systems” or “healthcare systems” notably encompassing all parts of health systems and health related parts of social care systems.

[2] OECD definition: “Informal carers are defined as people providing any help to older family members, friends and people in their social network, living inside or outside of their household, who require help with everyday tasks.”

[3] https://ec.europa.eu/health/system/files/2021-10/028_mental-health_workforce_en_0.pdf

[4]Practices can be shared via the Best Practice Portal (pb-portal (europa.eu). Examples of interventions that were initiated to tackle the mental health impact of the pandemic are also available on the pages of the dedicated web space on that topic on the Health Policy Platform https://webgate.ec.europa.eu/hpf/

[5] https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:52021DC0323&from=EN

[6]https://health.ec.europa.eu/system/files/2021-05/ev_20210510_mi_en_0.pdf