Majority of Health and Social Care Workers Experienced Mental Health Disorder During First COVID-19 Wave

Talya Greene, Ph.D., M.P.H.

On the one-year anniversary of the World Health Organization (WHO) declaring COVID-19 a global pandemic, new data reveal almost 60% of frontline health and social care workers experienced a mental health disorder during the first lockdown.

Many of such workers suffered “very high rates of distress,” according to the study led by researchers at University College London and the University of Haifa, Israel.

Because of the findings, Talya Greene, Ph.D., M.P.H., and colleagues are calling for long-term planning to meet the needs of staff from across health and social care, including specialist trauma services to be set up for such workers.

Greene and the team identified demographic, work-related, and other predictors for clinically significant PTSD, depression, and anxiety during the COVID-19 pandemic in U.K. frontline health and social care workers. They further compared rates of distress across different groups of health and social care workers working in different roles and settings.

The investigators invited frontline health and social care workers to participate in the study through a social media campaign. A questionnaire was administered using online survey methods. The team collected data between May 27, 2020 and July 23, 202 — the post-peak phase of the initial COVID-19 surge in the U.K. The sample included 1,194 individuals.

The survey included demographic and background information such as the participant’s age, gender, income, ethnicity, relationship status, whether they were caring for children at home, and U.K. region of work. Participants were also asked to indicate their job role among a variety of categories: nurse or midwife, carer, clinical support staff, doctor, non-clinical staff working in health and social care settings, allied healthcare professionals, and any other roles. The participants also reported their work setting of either hospital, nursing or care home, and any other community setting. The survey had questions to assess access to PPE; whether they were redeployed into a new team or to a new role as part of the emergency response to the COVID-19 pandemic; whether they had been infected with COVID-19; using alcohol, cigarettes, or other substances more than usual to cope; and whether they could tell their manager or team leader if they were not coping.

PTSD symptoms were assessed using the International Trauma Questionnaire, while depression symptoms were assessed using the Patient Health Questionnaire-9. The Generalized Anxiety Disorder Scale-7 was used to assess anxiety.

More than half of respondents (58%) met the threshold for a clinically significant disorder — 22% for PTSD and 47% each for anxiety and depression. Symptom levels were high across occupational groups and settings.

Use of logistic regression analyses demonstrated participants who were concerned about infecting others, who could not talk with their managers if they were not coping, who reported feeling stigmatized, and who had not had reliable access to PPE were more likely to meet criteria for a clinically significant mental disorder. Those who were redeployed during the pandemic and those who had had COVID-19 had higher odds for PTSD. There were reduced odds for a mental disorder for participants who had higher household income.

Greene and the investigative team suggested examining the role managers can play in reducing staff distress, especially for redeployed staff. They also emphasized the criticality of identifying risk factors for PTSD, depression, and anxiety among health and social care workers and providing treatment when needed.

The study, “Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19,” was published online in the European Journal of Psychotraumatology.