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Rapid studies have highlighted the adverse mental health impact of COVID-19 on health and social care workers (HSCWs). Complementing this work, we report on the psychosocial factors that have helped HSCWs adapt to the adversities associated with COVID-19 and protect staff wellbeing in Scotland. The ENACT study collected data from HSCWs (n= 1364) in Scotland during the third national lockdown. Using a cross-sectional design, participants completed an online survey providing quantitative data and free responses. A multi-method approach to analysis was used. The majority of HSCWs were found to have low wellbeing scores, high levels of COVID-19 stress, worry, burnout and risk perception scores and almost half of HSCWs met the clinical cut off for acute stress. Adaptive coping strategies and increased perceived team resilience helped mitigate against the adverse impact that COVID-19 stressors have on HSCWs’ mental wellbeing. HSCWs were significantly more likely to seek informal support for dealing with personal or emotional problems. Barriers to formal help-seeking were identified including stigma and fears of consequence of disclosure. HSCWs most valued peer support, workplace supports, visible leadership and teamwork. Our findings illuminate the complexity of the effects of the COVID-19 pandemic on HSCWs’ wellbeing and will inform future intervention development to increase positive adaptation amongst staff. Addressing barriers to mental health help-seeking among HSCWs is essential. The implications emphasise the importance of lessons learned across health and social care contexts, planning and preparedness for future pandemics.

Objective: Psychological safety is increasingly recognised as central to mental health, wellbeing and post-traumatic growth. To date, there is no psychometrically supported measure of psychological safety combining psychological, physiological and social components. The current research aimed to develop and establish the neuroception of psychological safety scale (NPSS), informed by Polyvagal Theory. Method: The study comprised of three stages: (1) item generation, (2) item reduction, and (3) assessment of factor structure and internal consistency. Exploratory and confirmatory factor analysis was conducted from two samples who completed a survey online (exploratory n = 342, confirmatory n = 455). Results: Initially, 107 items were generated. Item reduction and exploratory factor analysis resulted in a 29-item NPSS with subscales of compassion, social engagement and body sensations. The NPSS was found to have a consistent factor structure and internal consistency. Conclusion: The NPSS is a novel measure of psychological safety which can be used across a range of health and social care settings. This research provides a platform for further work to support and enhance understandings of the science of safety through the measurement of psychological, relational and physiological components of safety. The NPSS will help shape new approaches to evaluating trauma treatments, relational issues and mental health concerns. Research to establish the convergent, discriminant and concurrent validity of the NPSS and to explore its use with diverse community and clinical populations is underway.