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

Background 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.

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Socioeconomic gradients and mental health: implications for public health

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.147280 ◽

2015 ◽

Vol 206 (6) ◽

pp. 461-465 ◽

Cited By ~ 38

Author(s):

Sarah Stewart-Brown ◽

Preshila Chandimali Samaraweera ◽

Frances Taggart ◽

Ngianga-Bakwin Kandala ◽

Saverio Stranges

Keyword(s):

Mental Health ◽

Mental Illness ◽

Employment Status ◽

Linear Trend ◽

Well Being ◽

Odds Ratios ◽

Factors Associated ◽

Middle Range ◽

The Unemployed ◽

Mental Well Being

BackgroundResearch on mental well-being is relatively new and studies of its determinants are rare.AimsTo investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness.MethodUsing logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England.ResultsIndependent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01–2.10) and those aged 35–54 years (OR = 1.58, 95% CI 1.35–1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62–0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23–1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09–1.69); education where there was no association; and equivalised income for which the association was non-linear.ConclusionsOdds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.

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Nursing Staff Members Mental’s Health and Factors Associated with the Work Process: An Integrative Review

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017901612010167 ◽

2016 ◽

Vol 12 (1) ◽

pp. 167-176 ◽

Cited By ~ 1

Author(s):

Selene Cordeiro Vasconcelos ◽

Sandra Lopes de Souza ◽

Everton Botelho Sougey ◽

Elayne Cristina de Oliveira Ribeiro ◽

José Jailson Costa do Nascimento ◽

...

Keyword(s):

Mental Health ◽

Nursing Staff ◽

Mental Health Problems ◽

Integrative Review ◽

Post Traumatic Stress ◽

Work Process ◽

Related Factors ◽

Factors Associated ◽

Staff Members ◽

Mesh Terms

Background: The mental health of nursing staff members influences the work process outcomes. Objective: Identify the work related factors that harms the nursing team’s mental health. Methods: Databases PubMed, Scopus, CINAHL and MEDLINE, by mating between the indexed descriptors in MeSH terms “mental health” and “occupational health nursing”. 783 articles were rescued to give a final sample of 18 articles. Integrative review in order to identify factors associated with the work process of the nursing staff that negatively affects mental health. Results: The main associated factors were work demands, psychological demands, violence, aggression, poor relationships with administrators, accidents involving the risk of exposure to HIV, stress and errors in the execution of labor activities. The main findings regarding the nursing staff’s mental health were post-traumatic stress disorder, depression, stress, major depressive episode and generalized anxiety disorder. Conclusion: Occupational nurses need to understand the complexities of mental health problems and substance use among nursing staff members to recognize, identify and care for workers at risk and offer adequate mental health care. Although the researches interests in this theme have increased, proving that all these factors contribute to the risk to mental health of nursing professionals, the protective measures and care are being neglected by managers in both private and public network . The health of nursing workers in question here is one more challenge for a profession that takes care of others in need, therefore, requires some caring with their own health.

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NHS CHECK: protocol for a cohort study investigating the psychosocial impact of the COVID-19 pandemic on healthcare workers

10.1101/2021.06.08.21258551 ◽

2021 ◽

Author(s):

Danielle Lamb ◽

Neil Greenberg ◽

Matthew Hotopf ◽

Rosalind Raine ◽

Reza Razavi ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Healthcare Workers ◽

Online Survey ◽

Qualitative Interviews ◽

Well Being ◽

Poor Mental Health ◽

Baseline Survey ◽

Post Traumatic Stress ◽

Academic Publications

Introduction The COVID-19 pandemic has had profound effects on the working lives of healthcare workers (HCWs), but the extent to which their well-being and mental health have been affected remains unclear. This longitudinal cohort study aims to recruit a cohort of NHS healthcare workers, conducting surveys at regular intervals to provide evidence about the prevalence of symptoms of mental disorders, investigate associated factors such as occupational contexts and support interventions available. Methods and Analysis All staff, students, and volunteers working in each of the 18 participating NHS Trusts in England will be sent emails inviting them to complete a survey at baseline, with email invitations for the follow up surveys being sent 6 and 12 months later. Opening in late April 2020, the baseline survey collects data on demographics, occupational and organisational factors, experiences of COVID-19, a number of validated measures of symptoms of poor mental health (e.g. depression, anxiety, post-traumatic stress disorder; PTSD), and measures of constructs such as resilience and moral injury. These regular surveys will be complemented by in-depth psychiatric interviews with a select sample of healthcare workers. Qualitative interviews will also be conducted, to gain deeper understanding of the support programmes used or desired by staff, and facilitators and barriers to accessing such programmes. Ethics and Dissemination Ethical approval for the study was granted by the Health Research Authority (reference: 20/HRA/210, IRAS: 282686) and local Trust Research and Development approval. Cohort data are being collected via Qualtrics online survey software, are pseudonymised and held on secure University servers. Participants are aware that they can withdraw from the study at any time, and there is signposting to support services for any participant who feels they need it. Only those consenting to be contacted about further research will be invited to participate in the psychiatric and qualitative interview components of the study. Findings will be rapidly shared with NHS Trusts to enable better support of staff during the pandemic, and via academic publications in due course.

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Mental health and well-being of healthcare workers during the COVID-19 pandemic in the UK: contrasting guidelines with experiences in practice

BJPsych Open ◽

10.1192/bjo.2020.148 ◽

2020 ◽

Vol 7 (1) ◽

Author(s):

Norha Vera San Juan ◽

David Aceituno ◽

Nehla Djellouli ◽

Kirsi Sumray ◽

Nina Regenold ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Well Being ◽

Evidence Base ◽

Rapid Review ◽

Front Line ◽

Contextual Characteristics ◽

Definition Of ◽

The Uk

Background Substantial evidence has highlighted the importance of considering the mental health of healthcare workers during the COVID-19 pandemic, and several organisations have issued guidelines with recommendations. However, the definition of well-being and the evidence base behind such guidelines remain unclear. Aims The aims of the study are to assess the applicability of well-being guidelines in practice, identify unaddressed healthcare workers’ needs and provide recommendations for supporting front-line staff during the current and future pandemics. Method This paper discusses the findings of a qualitative study based on interviews with front-line healthcare workers in the UK (n = 33), and examines them in relation to a rapid review of well-being guidelines developed in response to the COVID-19 pandemic (n = 14). Results The guidelines placed greater emphasis on individual mental health and psychological support, whereas healthcare workers placed greater emphasis on structural conditions at work, responsibilities outside the hospital and the invaluable support of the community. The well-being support interventions proposed in the guidelines did not always respond to the lived experiences of staff, as some reported not being able to participate in these interventions because of understaffing, exhaustion or clashing schedules. Conclusions Healthcare workers expressed well-being needs that aligned with socio-ecological conceptualisations of well-being related to quality of life. This approach to well-being has been highlighted in literature on support of healthcare workers in previous health emergencies, but it has not been monitored during this pandemic. Well-being guidelines should explore the needs of healthcare workers, and contextual characteristics affecting the implementation of recommendations.

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NHS CHECK: protocol for a cohort study investigating the psychosocial impact of the COVID-19 pandemic on healthcare workers

BMJ Open ◽

10.1136/bmjopen-2021-051687 ◽

2021 ◽

Vol 11 (6) ◽

pp. e051687

Author(s):

Danielle Lamb ◽

Neil Greenberg ◽

Matthew Hotopf ◽

Rosalind Raine ◽

Reza Razavi ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

Healthcare Workers ◽

Online Survey ◽

Qualitative Interviews ◽

Well Being ◽

Poor Mental Health ◽

Baseline Survey ◽

Post Traumatic Stress ◽

Academic Publications

IntroductionThe COVID-19 pandemic has had profound effects on the working lives of healthcare workers (HCWs), but the extent to which their well-being and mental health have been affected remains unclear. This longitudinal cohort study aims to recruit a cohort of National Health Service (NHS) HCWs, conducting surveys at regular intervals to provide evidence about the prevalence of symptoms of mental disorders, and investigate associated factors such as occupational contexts and support interventions available.Methods and analysisAll staff, students and volunteers working in the 18 participating NHS Trusts in England will be sent emails inviting them to complete a survey at baseline, with email invitations for the follow-up surveys sent 6 months and 12 months later. Opening in late April 2020, the baseline survey collects data on demographics, occupational/organisational factors, experiences of COVID-19, validated measures of symptoms of poor mental health (eg, depression, anxiety, post-traumatic stress disorder), and constructs such as resilience and moral injury. These surveys will be complemented by in-depth psychiatric interviews with a sample of HCWs. Qualitative interviews will also be conducted, to gain deeper understanding of the support programmes used or desired by staff, and facilitators and barriers to accessing such programmes.Ethics and disseminationEthical approval for the study was granted by the Health Research Authority (reference: 20/HRA/210, IRAS: 282686) and local Trust Research and Development approval. Cohort data are collected via Qualtrics online survey software, pseudonymised and held on secure university servers. Participants are aware that they can withdraw from the study at any time, and there is signposting to support services if participants feel they need it. Only those consenting to be contacted about further research will be invited to participate in further components. Findings will be rapidly shared with NHS Trusts, and via academic publications in due course.

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Pandemic and mental health of the front-line healthcare workers: a review and implications in the Indian context amidst COVID-19

General Psychiatry ◽

10.1136/gpsych-2020-100284 ◽

2020 ◽

Vol 33 (5) ◽

pp. e100284

Author(s):

Snehil Gupta ◽

Swapnajeet Sahoo

Keyword(s):

Mental Health ◽

Psychological Health ◽

Healthcare Workers ◽

Mental Health Problems ◽

Psychological Impact ◽

Well Being ◽

Health Problems ◽

Front Line ◽

Digital Platforms ◽

Indian Context

Pandemic, being unprecedented, leads to several mental health problems, especially among the front-line healthcare workers (HCW). Front-line HCWs often suffer from anxiety, depression, burnout, insomnia and stress-related disorders. This is mediated to a large extent by the biopsychological vulnerabilities of the individuals; socioenvironmental factors such as the risk of exposure to infection, effective risk communication to HCWs, availability of personal protective equipment, job-related stress, perceived stigma and psychological impact of the isolation/quarantine and interpersonal distancing also play the major roles. Despite the huge magnitude of mental health problems among the front-line HCWs, their psychological health is often overlooked. Some of the potential measures to reduce the mental health problems of the front-line HCWs are effective communication, tangible support from the administration/seniors, mental health problem screening—and interventional—facilities, making quarantine/isolation less restrictive and ensuring interpersonal communication through the various digital platforms, proactively curtailing the misinformation/rumour spread by the media and strict legal measures against violence/ill treatment with the HCWs, and so on. India, along with other countries who lately got affected by the COVID-19, must learn from the experiences of the other countries and also from the previous pandemics as to how to address the mental health needs of their front-line HCWs and ensure HCWs’ mental well-being, thereby improving their productivity. Current review attempts to highlight the mental health aspects of the pandemic on the front-line HCWs, discusses some of the contentious issues and provides future directions particularly concerning COVID-19 in the Indian context and other low-resource countries.

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The impact of the COVID-19 pandemic on the mental health and wellbeing of UK healthcare workers

10.1101/2020.10.23.20218396 ◽

2020 ◽

Author(s):

James Gilleen ◽

Aida Santaolalla ◽

Lorena Valdearenas ◽

Clara Salice ◽

Montserrat Fusté

Keyword(s):

Mental Health ◽

Protective Factors ◽

Healthcare Workers ◽

Risk And Protective Factors ◽

Mental Wellbeing ◽

Factors Associated ◽

Increased Risk ◽

Controllable Factors ◽

The Uk ◽

The Impact

AbstractBackgroundThere is an urgent need to understand the psychological impact the COVID-19 pandemic has had on UK healthcare workers (HCW).AimsTo reveal risk and protective factors associated with poor mental wellbeing of HCW working during the COVID-19 pandemic in the UK.Method2773 UK HCWs completed a survey between 22ndApril and 10th May 2020 containing scales measuring anxiety, depression, PTSD, and stress, and questions about roles and COVID-19-related factors including workplace preparation and risk management. Respondents were classified as high or low symptomatic on each mental health scale and logistic regression revealed risk and protective factors associated with each outcome. Change in wellbeing from pre to during COVID-19 was also quantified.ResultsA large proportion of UK HCW had high mental health symptoms. ‘Fixed’ risk factors of poor mental health included being female, being ‘frontline’, pre-existing mental health diagnoses, and experience of stressful/traumatic events. An additional set of ‘controllable’ factors also significantly increased risk: PPE availability, workload, lack of COVID-19 preparation and training, and insufficient communication of clinical procedures. Resilience and sharing stress reduced risk, as did ethical support for those making treatment decisions. Allied HCW and managers were at elevated risk of high symptoms particularly PTSD. Wellbeing, especially of frontline workers, had significantly worsened compared to before COVID-19.ConclusionsPoor mental wellbeing was prevalent in HCW during the UK COVID-19 response. A number of controllable factors should be targeted, and protective factors promoted, to reduce the detrimental effect of COVID-19 and other pandemics on HCW mental health.

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The Three “R”s-Rights, Roles and Responsibilities of Healthcare Workers During COVID-19 Outbreak in India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/48651:15074 ◽

2021 ◽

Author(s):

Monalisa Biswas ◽

Vijetha Shenoy Belle

Keyword(s):

Healthcare Workers ◽

Well Being ◽

Public Health Emergency ◽

Front Line ◽

Roles And Responsibilities ◽

Medical Supplies ◽

The Family ◽

Burn Out ◽

Pandemic Threat ◽

Mental Well Being

This article addresses the rights, roles and responsibilities of Healthcare Workers (HCW) who are front line warriors in any pandemic outbreak. Coronaviruses 2019 (COVID-19) pandemic has emerged as international public health emergency in March 2020, and exposed the weak/failed health care system preparedness to respond to the pandemic threat and controlling the community spread. In India, huge population, poor economic growth and unacceptable doctor to patient ratio made swift response to emergence of pandemic, safeguarding HCWs, ability to provide care without mental and physical burn out challenging. This review emphasises the need for safety of HCW and patients, infection control, security to the family, psychosocial and mental well-being, proper allocation of medical supplies, medical ethics and communication.

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Mental health disorders among healthcare workers during the COVID-19 pandemic: a cross-sectional survey from three major hospitals in Kenya

BMJ Open ◽

10.1136/bmjopen-2021-050316 ◽

2021 ◽

Vol 11 (6) ◽

pp. e050316

Author(s):

Jasmit Shah ◽

Aliza Monroe-Wise ◽

Zohray Talib ◽

Alphonse Nabiswa ◽

Mohammed Said ◽

...

Keyword(s):

Mental Health ◽

Healthcare Workers ◽

Well Being ◽

Mental Health Disorders ◽

Sub Saharan Africa ◽

Front Line ◽

Mental Health Symptoms ◽

Cross Sectional ◽

Health Symptoms ◽

Health Disorders

BackgroundCOVID-19 is an international global health emergency and has posed a great challenge to mental well-being and resilience. Little is known about the mental health impact of COVID-19 among healthcare workers (HCWs) in sub-Saharan Africa or other low-resource settings.MethodsWe conducted a cross-sectional study between August and November 2020 among HCWs recruited from three major hospitals in Kenya. The survey questionnaire consisted of six components: demographic and work title characteristics; information regarding care of patients with COVID-19; and symptoms of depression, anxiety, insomnia, distress and burnout, measured using standardised questionnaires. Multivariable logistic regression analysis was performed to identify factors associated with mental health disorders.ResultsA total of 433 (65.2% response rate) individuals participated in the survey. Median age was 32.75 years, 58.4% were females and 68.8% were front-line workers. Depression, anxiety, insomnia, distress and burnout were reported in 53.6%, 44.3%, 41.1%, 31.0% and 45.8% of all participants, respectively. Front-line HCWs, females and doctors were at higher risk of mental health symptoms. Nearly half of participants reported inadequate resources or training to care for patients with COVID-19, and those in the government hospital were more likely to report mental health symptoms.ConclusionsThis is among the first studies examining mental health outcomes among HCWs during the COVID-19 pandemic in Kenya. Similar to other studies from around the world, HCWs directly involved with patients with COVID-19 reported higher rates of mental health symptoms. Mitigating strategies specific to Kenyan HCWs are urgently needed to help them cope with mental health symptoms during the pandemic.

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Vulnerability to rumors during the COVID-19 pandemic: Results of a national survey

10.1101/2020.10.01.20205187 ◽

2020 ◽

Author(s):

Victoria Jane En Long ◽

Wei Shien Koh ◽

Young Ern Saw ◽

Jean CJ Liu

Keyword(s):

Mental Health ◽

Higher Education ◽

Protective Factor ◽

Community Sample ◽

Well Being ◽

Poor Mental Health ◽

List Type ◽

Factors Associated ◽

Nation Wide Survey ◽

Mental Well Being

AbstractAmidst the COVID-19 pandemic, many rumors have emerged. Given prior research linking rumor exposure to mental well-being, we conducted a nation-wide survey to document the base rate of rumor exposure and factors associated with rumor vulnerability. Between March to July 2020, 1237 participants were surveyed on 5 widely-disseminated COVID-19 rumors (that drinking water frequently could be preventive, that eating garlic could be preventive, that the outbreak arose because of bat soup consumption, that the virus was created in an American lab, and that the virus was created in a Chinese lab). For each rumor, participants reported whether they had heard, shared or believed each rumor. Although most participants had been exposed to COVID-19 rumors, few shared or believed these. Sharing behaviors sometimes occurred in the absence of belief; however, education emerged as a protective factor for both sharing and belief. Together, our results suggest that campaigns targeting skills associated with higher education (e.g. epistemology) may prove more effective than counter-rumor messages.HighlightsPrior studies linked exposure to COVID-19 rumors with poor mental health.In a community sample, most participants reported having heard rumors.Few participants shared or believed rumors.Sharing sometimes occurred in the absence of belief.More educated individuals believed and shared fewer rumors.

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