For the past four months, the COVID-19 virus has disrupted lives in ways few could have imagined prior to the pandemic. The emergence of the coronavirus in the United States — followed by prevention measures being put in place — quickly and dramatically altered daily behavior.
While health departments and media outlets routinely report the number of people infected by the coronavirus and daily death counts, researchers have started to examine the impact this is having on mental health.
According to a study out of the University of Connecticut and published in the Journal of General Internal Medicine, 96 percent of the people it surveyed in April reported that they felt stressed when they read or heard about the contagiousness of the virus, while 88 percent felt stressed because they didn’t know how long quarantine or social distancing requirements would last. Similarly, information collected by the United States Census Bureau found that a third of the people it surveyed in May were experiencing symptoms of anxiety or depression — or both — which is almost double the percentage of people reporting those symptoms in 2014.
During a period when more people than usual are struggling with their mental health, UW–Madison’s Simon Goldberg is leading two different research projects that hold the potential to bring mindfulness and well-being practices to a large number of people via a mobile app.
“As a counseling psychologist, one of the things that I have no doubt about is that human beings have an immense capacity for positive change and growth,” says Goldberg, an assistant professor with the Department of Counseling Psychology and an affiliate faculty member with the university’s Center for Healthy Minds (CHM). “But one of the major bottlenecks is that people simply don’t have access to traditional mental health services — like psychotherapy, medications, or other strategies that can be helpful in promoting well-being. Making mindfulness meditation practices accessible to people around the world via a mobile health app is an incredible opportunity.”
Goldberg is the co-principal investigator on a research project funded by the Chan Zuckerberg Initiative titled, “Supporting Healthy Minds for Teachers During COVID-19.” For this project, Goldberg is working alongside Matt Hirshberg, a 2019 National Academy of Education/Spencer Foundation Postdoctoral Research Fellow at CHM, and Richard Davidson, the world-renowned neuroscientist and founder of the Center for Healthy Minds.
This project is a randomized, controlled trial that will study employees of the Madison Metropolitan School District (MMSD) — and possibly those elsewhere in Wisconsin, as well. Half of the participants will be randomized to receive the Healthy Minds Program. This app-based mindfulness program utilizes decades of research from Davidson and others, building on the premise that personal well-being is a skill that can be learned, not something static and set. The app is designed to help train the mind and rewire the brain to experience less stress, and become more focused and resilient to enhance health.
Hirshberg explains that previous research indicates teachers, along with physicians, consistently report the highest levels of occupational stress and burnout. Even during more normal times, teaching and working in schools can be very challenging. During the coronavirus crisis, educators were loaded with additional tasks, such as training families in the technical skills to make virtual learning possible, providing emotional support for students, and attending to a range of other needs beyond traditional academics.
So while many people are experiencing various levels of stress, anxiety, and loneliness due to the COVID-19 pandemic, the impacts on caring professionals such as teachers is likely even more significant.
“Research shows that teachers who are highly stressed and burned out have less high-quality relationships with students, and that can impact student learning,” says Hirshberg, who earned his PhD from the School of Education’s Department of Educational Psychology.
This new study from Goldberg and his colleagues builds off similar work conducted last year in which researchers piloted an early version of the Healthy Minds Program app. That project, with approximately 80 staff from the Madison Schools, received overwhelmingly positive reviews. The new project aims to recruit 400 MMSD employees to further study the impact of a four-week version of the Healthy Minds Program (HMP) app on anxiety, depression, loneliness, well-being, and social connection.
“There hasn’t been a lot of research on these types of interventions, but in the work that has been done it’s quite clear that it does reduce things like stress, anxiety, and depression,” says Hirshberg, who previously conducted research examining pre-service teachers utilizing similar mindfulness training. “The early evidence on this research is encouraging and we’re trying to build off that work in this project.”
The research team started recruiting participants from MMSD in June, and plans to finish collecting data during the upcoming fall semester.
“We feel a responsibility to use the knowledge gained through decades of research on well-being and strategies that cultivate it to support our community,” Goldberg says of partnering with MMSD on this work. “If we find that this app is successful, it is perfectly designed for widespread dissemination to other communities throughout the country, even across the globe. The hope is that the HMP app will support educators in maintaining their own well-being — allowing them to provide the best care possible to their students.”
Goldberg this spring also received a five-year, K Award from the National Center for Complementary and Integrative Health (NCCIH), which is housed within the National Institutes of Health. This professional development award is to assist Goldberg in his efforts to test the efficacy of the HMP app for people who have clinically elevated symptoms of depression and anxiety.
Goldberg explains that while mindfulness-based interventions have been shown to provide significant help to people with depression and anxiety, access to such interventions is limited. The delivery of mindfulness training via mobile health platforms is a promising approach for increasing access to such interventions. However, for this work to move forward, it is vital to determine the necessary dose of mindfulness practice to produce positive outcomes.
In particular, the K Award provides Goldberg with mentors who will help him get trained and build expertise in new realms. Among those who will be helping Goldberg are Davidson and UW–Madison’s Daniel Bolt, the Nancy C. Hoefs-Bascom Professor of Educational Psychology within the School of Education.
“I’m a psychotherapy researcher with an expertise in meditation, but my experience working in the mobile health area is limited,” says Goldberg. “The K award will help me become trained in mobile health research to support efforts to move the field forward.”
Goldberg says there currently is a gap in research on mobile health programs in terms of dosage — or how often people need to utilize an app and its services to receive a benefit. The K Award project will examine this dosage question via a clinical trial.
“The hope is that over time we can figure out the most effective ways people can utilize these apps. Ultimately, we’d like to develop content and versions designed specifically for under-represented groups or others who otherwise may not access or have access to mental health treatments,” says Goldberg. “The potential for these kinds of mobile interventions to increase access to mindfulness training and their potential to improve well-being at the population level is something I find quite inspiring.”