Almost 60% of frontline health and social care workers (HSCWs) experienced a mental health disorder during the first COVID-19 lockdown, with many suffering "very high rates of distress", suggests a new study led by researchers at UCL and the University of Haifa, Israel.
Given the significantly high levels of mental health disorders across all HSCWs, the researchers (part of the UCL-led COVID Trauma Response Working Group*), are now 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 healthcare workers, similar to the specialist commissioned NHS psychological trauma services for military veterans.
The 'Frontline-COVID study', published in the European Journal of Psychotraumatology, surveyed 1,194 HSCWs, who worked in UK hospitals, nursing or care homes and other community settings, to identify and compare the rates of mental health disorder across different job roles and places of work.
The study, carried out just after the first wave of COVID in the UK between 27 May and 23 July, 2020, found that 58% of HSCWs met the threshold for any mental health disorder; 22% met criteria for post-traumatic stress disorder (PTSD); 47% had clinically significant anxiety and 47% had depression. Symptom levels were high across all job roles and settings.
Importantly, the study found that it was not just doctors and nurses who were experiencing clinically significant distress, but all staff from across health and care.
Furthermore, the research also identified some specific mental health risk factors, principally: concern about infecting others with COVID; being unable to talk with their managers about how they were coping; feeling stigmatised (about their role); and not having had reliable access to personal protective equipment (PPE). Key predictors for PTSD included staff being redeployed to other teams and having had COVID themselves.
The research was conducted by the COVID Trauma Response Working Group, formed by UCL psychiatrists and psychologists, who are calling for immediate additional mental health support for HSCWs. This is the first UK study to assess mental health disorders across all health and social care settings during COVID-19.
Lead author, Dr Talya Greene (UCL Psychiatry and University of Haifa), said: "Our study shows that more than half of health and social care staff surveyed met criteria for a mental disorder following the first wave of COVID-19 in the UK. Importantly, we found that rates of distress were high, not only among doctors and nurses, but across a wide range of health and social care roles, such as allied health professionals, ambulance workers, hospital porters, pharmacists, and care home staff.
"Let's be clear: we may be on the verge of a mental health crisis across the health and social care sector. So we need to make sure that specialist help is offered and accessible across all the different roles and settings.
"It is important that this support (for those that need it) is planned for the long-term. Our findings highlight the urgency for immediate long-term funding for specialist mental health services for health and social care workers."
Co-author, Dr Jo Billings (UCL Psychiatry), said: "A really important finding from our study is that it showed that, in addition to doctors and nurses, all staff across the health and social care sector need to be offered help. This study also highlights the need for reliable access to PPE for all staff working in health and social care roles, and further investigation of barriers to communication between managers and staff. Our findings also highlight that staff redeployed into new frontline roles are at particular risk of being traumatised and are likely to require additional support during redeployment."
Co-author, Dr Michael Bloomfield (UCL Psychiatry), added: "Our colleagues in acute hospitals are doing fantastic work under very difficult circumstances. At the same time we know that many mental health clinicians are doing great work in supporting frontline colleagues in need. Whilst our study is based on self-report, and so needs to be interpreted with caution, our findings nonetheless add to a growing body of research on the toll of the pandemic on health and social care workers. Importantly, our study has identified risk factors that might help in better supporting staff. It's important that staff across the health and social care sector are offered this support."
European Journal of Psychotraumatology