Research reveals mental health impact of Covid-19 on hospital healthcare workers

Hospital healthcare workers reported higher rates of clinically significant mental health symptoms following the initial Covid-19 pandemic peak in the UK, new research led by the University of Birmingham has revealed.

A study, published in BJPsych Open, found around a third of hospital healthcare workers reported clinically significant symptoms of anxiety (34.3%) and depression (31.2%), while almost a quarter (24.5%) reported clinically significant post-traumatic stress disorder (PTSD) symptoms.

Over 2,600 healthcare workers employed by 10 NHS hospital trusts across the West Midlands took part in a survey between June 5th 2020 and July 31st 2020, in a study aimed at gauging the mental health consequences of the immediate aftermath of the initial Covid-19 pandemic peak in the UK.

The survey found:

• Those with a history of mental health conditions had at least two-fold increased odds of clinically significant symptoms of PTSD, depression and anxiety.
• Women, those with a history of physical illness, smokers, staff based on in-patient wards, emergency departments, and intensive therapy units, had an increased likelihood of clinically significant PTSD symptoms.
• Younger participants, women, and those who had either themselves or a close family member or friend been admitted to hospital with COVID-19, were around 50% more likely to report anxiety symptoms.
• There was an almost two-fold increase in odds of healthcare workers having symptoms of depression when they were based in an acute general hospital, compared with a mental health setting.
• Smokers were 50% more likely to report symptoms of depression and PTSD, but not anxiety.
• Those who reported adequate availability of personal protection equipment (PPE) and well-being support, and no ‘morally uncomfortable’ changes in working practices, were up to 50% less likely to have anxiety, depression or PTSD symptoms.
• Doctors and nurses were 20% less likely to report anxiety or PTSD compared with other hospital healthcare workers.

Just over half (55%) of those surveyed reported that adequate PPE was available at their workplace, while 30.8% said this was not the case. The majority (78.2%) were aware of well-being measures implemented by their employer, however only 15.4% accessed any form of psychological support during the study period.

A third (33.1%) were redeployed as a result of the pandemic and 38.5% reported increased working hours. In addition, 51.2% reported ‘morally uncomfortable’ changes in the way they worked.

A total 720 (27.3%) were diagnosed with COVID-19 during the survey period, while 522 (19.8%) also reported a cohabitant had developed COVID-19. Also, 452 (17.1%) either themselves, or a close family member or friend, were admitted to hospital due to COVID-19.

The research team included Dr Kasun Wanigasooriya, Professor Andrew Beggs, and Dr Tariq Ismail.

First author Dr Kasun Wanigasooriya, a Junior Doctor and a PhD student at the University of Birmingham, said: “The pandemic has stretched the limits of healthcare systems to beyond capacity.

“Healthcare workers have been exposed to numerous stressors including a rapid escalation in workload; sudden changes in roles and responsibilities including critical decision-making; witnessing higher than the usual number of deaths; and contracting the virus themselves.

“It is essential that we ensure adequate access to both PPE and well-being support for all of our workforce on the frontline, particularly for those who may be at greater risk.”

Author Professor Andrew Beggs, of the University of Birmingham, said: “Our findings show the vast majority of healthcare workers are aware of well-being support but very few access it.

“We hope that our research will highlight this important issue and will lead to more healthcare workers accessing the support they need.”

Professor Neil Greenberg, from the Royal College of Psychiatrists, said: “Experiences of 'moral injury', a term for distress as a result of violating one's moral principles, limited wellbeing support and lack of PPE are associated with higher levels of anxiety, depression and PTSD symptoms in hospital staff.

“These findings are concerning and must be addressed, especially during this current wave. Adverse symptoms not only have serious consequences for the workforce’s mental health but can make it difficult to deliver high quality care.

“While more research is needed to understand the impact of the pandemic on the workforce’s mental health, it’s essential that all NHS staff can access evidence-based psychological support, and in cases of mental illness, the right psychiatric treatment when they need it.”

There were 2,638 eligible participants who completed the survey, which collected self-reported data on 24 independent variables, including sociodemographic, lifestyle and employment factors, and impacts on professional and personal lives.

Notes to Editors

• For more information, please contact Emma McKinney, Communications Manager, University of Birmingham, on +44 7815607157. Alternatively, contact the Press Office out of hours on +44 (0)7789 921165.
• Wanigasooriya et al (Dec, 2020). ‘Mental health symptoms in a cohort of hospital healthcare workers following the first peak of the COVID-19 pandemic in the UK’. BJPsych Open. DOI: 10.1192/bjo.2020.150
• The University of Birmingham is ranked amongst the world’s top 100 institutions, and its work brings people from across the world to Birmingham, including researchers and teachers and more than 6,500 international students from nearly 150 countries.