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The Essential Network (TEN): rapid development and implementation of a digital-first mental health solution for Australian healthcare workers during COVID-19
  1. Peter Andrew Baldwin1,2,
  2. Melissa Jane Black1,3,
  3. Jill M Newby1,3,
  4. Lyndsay Brown1,
  5. Nicole Scott1,
  6. Tanya Shrestha1,
  7. Nicole Cockayne1,
  8. Jonathan Tennant1,
  9. Samuel B Harvey1,2,
  10. Helen Christensen1,2
  1. 1 Black Dog Institute, Randwick, New South Wales, Australia
  2. 2 School of Medicine, UNSW, Sydney, New South Wales, Australia
  3. 3 School of Psychology, UNSW, Sydney, New South Wales, Australia
  1. Correspondence to Dr Peter Andrew Baldwin, Black Dog Institute, Randwick, NSW 2031, Australia; p.baldwin{at}

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Summary box

What are the new findings?

  • Healthcare workers (HCWs) urgently need mental health support, but face many barriers to accessing care.

  • We developed and implemented Australia’s first blended mental healthcare service created by and for HCWs.

  • Agile development, cross-discipline support and iterative consumer consultation were key drivers of service design and boosting uptake.

How might it impact on healthcare in the future?

  • Our project demonstrates how others can rapidly deploy digital-first services that deliver personalised, evidence-based mental healthcare at scale during a crisis.

  • Such services could transform the global effort to protect and empower our healthcare workforce through COVID-19 and beyond.


The COVID-19 pandemic has presented healthcare workers (HCWs) with extraordinary, unabating stress.1 International data suggest that front-line HCWs are at increased risk of poor mental health,2 with post-traumatic stress disorder (PTSD) a significant concern.3–5 Early mental health treatment can lower the risk of HCWs developing more chronic and potentially disabling difficulties;2 however, many HCWs avoid seeking help due to concerns about stigma,2 6 confidentiality and negative impacts on their employment.7 8 HCWs urgently need accessible and effective mental health services that sidestep these systemic barriers.

HCW-specific services must address the unique challenges of healthcare. During a pandemic, HCWs encounter unique stressors, such as fear of infecting their families or watching colleagues die,9 10 and differ greatly in how they react to stress.11 Therefore, HCWs need a responsive, tailored mental health service that can address a range of concerns, from acute distress to moral injury12 and psychiatric disorders like PTSD.3 4 Another challenge is delivering such personalised services at the required scale in the context of an ongoing pandemic. With tens of millions of HCWs across the globe,13 researchers have called for self-guided mental health tools for HCWs than can be rapidly scaled.14 Existing national healthcare-focused services have recommended streamlined triage for HCWs …

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  • PAB and MJB are joint first authors.

  • Contributors PAB was responsible for the initial draft of the manuscript. PAB, MJB, JMN, LB, NS, TS, NC, JT, SBH and HC provided input on subsequent drafts of the manuscript and were responsible for the development and delivery of The Essential Network.

  • Funding This project was funded by the Australian Government Department of Health (grant number: not available).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.