The Mount Sinai Center for Stress, Resilience, and Personal Growth will take a multi-disciplinary approach to address the psychosocial effects of COVID-19 on our health care workers.
At the Mount Sinai Health System, we appreciate the toll fighting COVID-19 is taking on our health care workers, including doctors, nurses, trainees, students, chaplains, social workers and support staff. We understand the trauma and grief of losing patients, the anxiety over potentially exposing family members to the virus, and fears of contracting COVID-19 themselves. We know that our staff has been working at an intensity level so stressful that many will likely suffer mental health consequences. We also know that many of the same strengths that our workers have brought to bear in the fight against the coronavirus will help them through this.
As a health system with a medical school, we are well-situated to appreciate the magnitude of COVID-19’s effect on our health care workers. While the full impact of COVID-19 will become more fully known over time, our past experience indicates that the emotional toll will be high. Previous studies of disaster responders indicate that they are at elevated risk for developing post-traumatic stress disorder (PTSD), depression, alcohol misuse, anxiety, and burnout.
The goal of the Center for Stress, Resilience, and Personal Growth is to help our workers recover and even become more resilient, helping to ensure the future of our health care system. The new Center collaborates with and complements other Mount Sinai programs, such as those organized by the Office of Well-Being and Resilience, Human Resources Department, Talent Development and Learning, and the mental health services offered through the Department of Psychiatry. We will focus on outreach, education, and research.
At Mount Sinai, we take care of our own. At the same time, we hope our efforts will serve as a model for institutions and communities around the globe.
Our clinical care goals are to not only address mental health needs, but to attempt to prevent them. Preventive measures will include early intervention and offering resilience training and treatment for every health care worker. In addition, we will provide screening, psychoeducation, support groups, individual assessment, resilience plans, and referrals for mental health services. We will make sure that there will be services available to healthcare workers at all eight hospitals as well as our other clinical sites.
Drawing on our extensive expertise in trauma interventions and resilience research, this program will focus on building resilience and be based on the book, Resilience: The Science of Mastering Life’s Greatest Challenges. The goal is to ensure that our faculty, students, and staff have the tools they need to prevent or mitigate the adverse mental health effects of fighting COVID-19. These trainings will also enable participants to develop their own resilience plans.
We will extend a personal invitation to every worker to be screened for stress and mental health. Screening will include a secure digital assessment of key mental health conditions and as needed in-person exploration of these conditions in greater depth, along with evaluation of new personal, occupational, and family stressors arising since the pandemic onset. The earlier we find any issues, the sooner we can intervene. Studies show that early intervention improves positive outcomes.
Individual Assessments and Wellness Coaching
A Mount Sinai social worker will help with developing resilience plans and, where necessary, developing mental health treatment plans. This may include one or more of the other clinical services at the Center.
We will also offer one-on-one wellness coaching to set and reach mental health and wellbeing personal goals.
Mental Health Treatment Referrals
We will provide referrals to clinical providers experienced in treating trauma-related conditions. These services will assist workers who develop a COVID-19-related mental health condition, such as PTSD, depression, prolonged grief, and/or alcohol misuse. We will utilize a high-quality network of clinical providers who are within the Mount Sinai Health System or outside of it.
Drawing on the resources of the Icahn School of Medicine at Mount Sinai, the Center will collect data, conduct longitudinal analyses, identify psychosocial and biological determinants of risk and resilience, and develop evidence-based interventions and novel treatments. We will offer all Center participants the opportunity to enroll in studies designed to better understand mental health care needs arising from exposure to the COVID-19 pandemic. Researchers will also examine longitudinal data to investigate changes among participants over time and assess the efficacy of the program’s resilience-enhancing interventions by comparing pre- and post-intervention data. Proposed studies include:
Identification of Psychosocial and Biological Determinants of Risk and Resilience
This longitudinal study will look at psychosocial factors associated with risk of and resilience to COVID-19 stress among both Mount Sinai’s health workers and in the New York City community more broadly. Participants will complete a series of detailed, longitudinal surveys collecting information about their exposure to COVID-19-related stress, medical and psychiatric history, psychosocial and lifestyle factors, coping styles, and symptoms. We will focus on symptoms such as anxiety, depression, and post-traumatic stress symptoms at four distinct assessment times. We will also collect blood samples from a subset of study participants to examine peripheral biomarkers (e.g., genomic, inflammatory) of risk and resilience to COVID-19-related stress. Our findings will inform preparedness for future pandemics, natural disasters, and other forms of extreme stress. It will also help us better understand the underlying mechanisms of risk and resilience.
Longitudinal Study of COVID-19-related Memories
Building on research on ‘memory reconsolidation,’ or the flexibility of emotional memories, researchers will conduct a pilot longitudinal study to examine how COVID-19-related memories change over time. This will include a pilot neuroimaging component to understand the neural mechanisms underlying emotional control and flexibility. By comparing the emotional processing in the brain of resilient COVID-19-exposed individuals and COVID-19-exposed individuals who developed PTSD, we will be able to develop innovative treatment approaches for individuals with trauma-related mental health conditions.
High Resolution Neuroimaging of the Threat Response System in Individuals Exposed to COVID-19
Using a Mount Sinai-developed ultra-high field 7-Tesla (7T) MRI platform for imaging the structure and function of the locus coeruleus (LC)–a structure that is critically implicated in the human response to threat and stress–researchers will examine the LC threat system among individuals who have experienced COVID-19-related stress. The goal is to better understand the biological responses that are associated with the development of PTSD versus resilience to stress. By clarifying the role of the LC threat system, our findings will pave the way to more effectively treat it.
Efficacy of Neuropeptide Y in Response to Extreme Stress
This study will build on findings about the potential role of neuropeptide Y (NPY) as a ‘pro-resilience’ molecule in the human brain. We will study the effect of administering NPY in brain systems that mediate threat response among individuals who have suffered COVID-19-related stress. This work could result in novel therapeutic approaches for patients experiencing extreme stress.
Combining Ketamine with Brief Psychotherapy for Faster, More Effective PTSD Treatment
Ketamine, which acts as a selective NMDA receptor antagonist, has shown tremendous promise as a therapeutic agent for treating depression. This pilot clinical trial will explore the effects of combining ketamine administration with evidence-based brief trauma-focused psychotherapy adapted for COVID-19 survivors to treat severe PTSD.
Meet Our Team
Our team will be led by experts in the field.
Deborah B. Marin, MD, the George and Marion Sokolik Blumenthal Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, will serve as Director. Dr. Marin specializes in geriatric psychiatry and Alzheimer’s disease. She will retain her roles as Director of the Center for Spirituality and Heath and Director of the Ombuds Office within the School. A member of the Mount Sinai faculty since 1992, Dr. Marin has held many important executive positions in the Department of Psychiatry, including Chief, Division of Geriatric Psychiatry; Director, Geriatric Psychiatry Fellowship Program; Medical Director; and Vice Chair for Education. During her career, she also served as Executive Vice President for Strategic Development and Chief Medical Officer for The Mount Sinai Hospital.
Jonathan M. DePierro, PhD, an Assistant Professor of Psychiatry, is a clinical psychologist in the Mount Sinai World Trade Center (WTC) Mental Health Program, where he provides direct clinical care, supervises trainees, and conducts research. He has published on novel treatment approaches for PTSD, mental health service needs in WTC responders, and cognition-emotion interactions in individuals with chronic trauma exposure.
Adriana Feder, MD, is an Associate Professor of Psychiatry, Director of the Trauma and Resilience Program, Associate Director for Research at the WTC Mental Health Program, and an investigator in the Depression and Anxiety Center for Discovery and Treatment at the Icahn School of Medicine at Mount Sinai. Dr. Feder’s clinical, epidemiological, and translational research has focused on resilience and stress-related disorders such as PTSD, depression, and anxiety disorders in trauma-exposed populations.
Craig L. Katz, MD, Clinical Professor of Psychiatry, Medical Education, and System Design and Global Health, founded and directs Mount Sinai’s Program in Global Mental Health. He organized the psychiatric response to 9/11 in New York City through an organization he co-founded, Disaster Psychiatry Outreach, including founding and directing the World Trade Center Mental Health Screening and Treatment Program for 9/11 responders. Dr. Katz has also written and co-edited books and papers in the fields of disaster psychiatry and global psychiatry.