Mental Health Among Healthcare Workers During COVID-19

More than a year ago, the global healthcare community entered an unprecedented period of turmoil. With the COVID-19 pandemic still claiming thousands of lives daily, the mental health of healthcare workers (HCWs) remains threatened. Posttraumatic stress disorder (PTSD), anxiety, depression, and even suicidal ideation are worryingly common [1]. HCWs from various demographics across several countries report having experienced troubling mental health conditions during the pandemic. Accordingly, health authorities must familiarize themselves with the tell-tale signs of psychological difficulties and act with urgency to prevent their workers from suffering in silence [2]. 

Among the most common psychological conditions exhibited by HCWs are anxiety, depression, and stress. A review of English-language cross-sectional studies sought to gauge the prevalence of these three conditions among HCWs [3]. The highest reported prevalences were 67.55%, 55.89%, and 62.99%, respectively [3]. In a national survey of 1,685 HCWs, 31% of respondents reported mild anxiety, 33% meaningful anxiety, 29% mild depressive symptoms, and 17% moderate-severe depressive symptoms [4]. 5% of respondents also reported suicidal ideation, while 14% experienced symptoms consistent with PTSD [4]. While these percentages may not be representative of all HCWs, they are concerning. 

Studies have identified some demographic patterns across HCWs experiencing mental health difficulties. On average, nurses experience more worrying mental health symptoms than doctors, as do intermediate and junior HCWs compared to their senior counterparts, and less-educated workers compared to those with college or graduate-level degrees [3, 5]. Additionally, women are more likely to be depressed than men [3, 5]. Interestingly, frontline nurses reported fewer mental illness symptoms than their non-frontline colleagues, which researchers speculate may be due to their specialized training in high-stress situations [4].  

It follows that a major reason for this mental health crisis is that the health system was generally unprepared for the impact of COVID-19 [6]. A variety of unfamiliar situations sprouted due to the pandemic. Resource shortages in hospitals forced HCWs to have to choose which patients to treat [6]. Lockdown restrictions compelled HCWs to step in as their patients’ emotional support, even at the cost of their safety [6]. And the fear of being infected and transmitting the disease to others further heightens the sense of instability experienced by HCWs [6]. Other elements of this crisis, such as political discord and moral injury, contribute to the mental battle that persists even after HCWs’ shifts are over [1, 6]. 

There are several actions that health authorities can take to counter HCWs’ deteriorating mental health. For one, staff should be told about the challenges that may arise from their work treating COVID-19 patients beforehand [1]. Detailed instruction should be provided in plain language without any euphemisms [1]. Additionally, facilitated discussions should occur regularly to help HCWs debrief experiences and voice any emotional and social difficulties they may be facing [1]. Authorities should make an effort to reach out to nonparticipative HCWs, especially since avoidance is a central symptom of trauma [1]. HCWs experiencing trauma may benefit from eye movement desensitization and reprocessing therapy (EMDR) [6]. Group therapy can also be administered to help HCWs manage feelings of detachment and numbness [6]. The administrations of health organizations must step in to implement these initiatives. As has been the case in Boston and New York City, multiagency collaboration has helped regularize and monitor interventions to pronounced success [6].  

During the COVID-19 pandemic, health care workers have been at unique risk for anxiety, depression, trauma, and other serious mental health concerns. Taking active steps to check in with workers, lend them space and time to voice their problems, and provide them with as much preparation as possible is crucial in the fight to prevent and manage mental illness. 

References 

[1] N. Greenberg et al., “Managing mental health challenges faced by healthcare workers during COVID-19 pandemic,” British Medical Journal, vol. 368, p. 1-4, March 2020. [Online]. Available: https://doi.org/10.1136/bmj.m1211. 

[2] M. S. Spoorthy, S. K. Pratapa, and S. Mahant., “Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review,” Asian Journal of Psychiatry, vol. 51, p. 1-4, June 2020. [Online]. Available: https://doi.org/10.1016/j.ajp.2020.102119. 

[3] M. Vizheh et al., “The mental health of healthcare workers in the COVID-19 pandemic: A systematic review,” Journal of Diabetes and Metabolic Disorders, vol. 19, no. 2, p. 1967-1978, December 2020. [Online]. Available: https://doi.org/10.1002/cncy.22347. 

[4] K. P. Young et al., “Health Care Workers’ Mental Health and Quality of Life During COVID-19: Results From a Mid-Pandemic, National Survey,” Psychiatric Services, vol. 72, no. 2, p. 122-128, December 2020. [Online]. Available: https://doi.org/10.1176/appi.ps.202000424. 

[5] X. H. Fang et al., “Mental health problems and social supports in the COVID-19 healthcare workers: a Chinese explanatory study,” BMC Psychiatry, vol. 21, no. 34, p. 1-8, January 2021. [Online]. Available: https://doi.org/10.1186/s12888-020-02998-7. 

[6] B. Nelson and D. B. Kaminsky, “COVID‐19’s crushing mental health toll on health care workers,” Cancer Cytopathology, vol. 128, no. 9, p. 597-598, September 2020. [Online]. Available: https://doi.org/10.1002/cncy.22347.