Impact of the COVID-19 pandemic on the mental health and well-being of UK healthcare workers

  1. James Gilleen
  2. Aida Santaolalla
  3. Lorena Valdearenas
  4. Clara Salice
  5. Montserrat Fusté

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on healthcare workers (HCWs).

Aims

There is an urgent need to understand the risk and protective factors associated with poor mental well-being of UK HCWs working during the COVID-19 pandemic.

Method

Shortly after the April 2020 UK COVID-19 peak 2773 HCWs completed a survey containing measures of anxiety, depression, post-traumatic stress disorder and stress, as well as questions around potential predictors such as roles, COVID-19 risk perception and workplace-related factors. Respondents were classified as high or low symptomatic on each scale and logistic regression revealed factors associated with severe psychiatric symptoms. Change in well-being from pre- to during COVID-19 was also quantified.

Results

Nearlya third of HCWs reported moderate to severe levels of anxiety and depression, and the number reporting very high symptoms was more than quadruple that pre-COVID-19. Several controllable factors were associated with the most severe level of psychiatric symptoms: insufficient personal protective equipment availability, workplace preparation, training and communication, and higher workload. Being female, ‘front line’, previous psychiatric diagnoses, traumatic events, and being an allied HCW or manager were also significantly associated with severe psychiatric symptoms. Sharing stress, resilience and ethical support for treatment decisions were significantly associated with low psychiatric symptoms. Front-line workers showed greater worsening of mental health compared with non-front-line HCWs.

Conclusions

Poor mental well-being was prevalent during the COVID-19 response, however, controllable factors associated with severe psychiatric symptoms are available to be targeted to reduce the detrimental impact of COVID-19 and other pandemics on HCW mental health.

Article activity feed

  1. Version published to 10.1192/bjo.2021.42
  2. ScreenIT

    SciScore for 10.1101/2020.10.23.20218396: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: All procedures involving human subjects/patients were approved by the University of Roehampton Ethics Committee (REF: PSYCH 20/361) and the UK Health Research Authority.
    Consent: Written informed consent was obtained from all subjects.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Analyses were conducted in SAS 9.4 (SAS Institute Inc.) and SPSS v25 (IBM Corp., Armonk, N.Y., USA).
    SAS Institute
    suggested: (Statistical Analysis System, RRID:SCR_008567)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The study has several strengths and limitations. We recruited a large sample, near the peak of the COVID-19 UK outbreak, and the study provides the most comprehensive picture to date of the negative psychological impact of HCW to COVID-19 in the UK and associated risk factors. Participation in online surveys involves self-selection and respondents may not be fully representative. However, this approach permitted a rapid response around a critical period very close to the COVID-19 peak. The survey was de facto open to all HCW in the UK, and a significant proportion of all UK NHS sites (N=52) recruited staff to the study, providing very wide geographical coverage and a large sample size. That the sample characteristics are similar to the wider NHS workforce in terms of female:male ratio (85%, NHS=77%) and BAME proportion (13% vs NHS 19%) indicates that the data are broadly representative. Pre-COVID-19 wellbeing scores derived from ratings which may not be fully accurate as they were retrospective, however, evidence suggests that ratings of past events in depressed individuals are reliable(32). If low mood resulted in more negative past ratings(33), this would only increase the effect sizes of worsening suggesting these effects are robust. Mood scores indicated that the cohort were not a particularly anxious or worrisome group per se and the majority of respondents reported only low or mild symptoms of anxiety and depression and low worry levels before COVID-19. Mental illness d...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

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  3. Version published to 10.1101/2020.10.23.20218396 on medRxiv