COVID-19 | Mental Health | Medicine
The Mental Health Pandemic Among COVID-19 Healthcare Workers
A quarter of healthcare workers during the COVID-19 pandemic suffer depression and anxiety, and over half are at risk for developing these and other mental health problems.
Jeff Notar is an intensive care unit nurse at St. Patrick Hospital in Missoula, Montana. “There’s a higher degree of burnout now than there’s ever been,” he says in an interview with the Missoulian.
“Dealing with the ICU, we’re seeing the worst responders to the virus out of all patients,” explains Notar. “If that’s all you see, then you think ‘if I get this, that’s going to happen to me.’ Am I going to end up on a ventilator? My mental health is tenuous. A lot of us are feeling tenuous.”
To get through a day you have to expend two times the units of work. Some days it’s three or four units of work. But we’re getting the same time off, the same amount of vacation, the same amount of sick pay. The total amount of work is higher and the stress is higher. And I would say the repercussions for failure are higher, too. Then you want to throw in the interaction with family members of patients.
Notar’s account is by no means rare. Two new research studies highlight the prevalence of mental health problems and the risk of developing them for frontline healthcare workers during the COVID-19 pandemic.
A Quarter of Global Healthcare Workers Suffer Depression and Anxiety During COVID-19 Pandemic
In the January 18th issue of Progress in Neuropsychopharmacology and Biological Psychiatry, researchers reported the results of an umbrella review of global research on the prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic.
Umbrella reviews are reviews of previously published systematic reviews or meta-analyses and are becoming increasingly influential in biomedical literature for their ability to provide one of the highest levels of evidence synthesis.
The investigators searched the literature for relevant studies, ultimately basing their umbrella review on 7 reviews and meta-analyses that encompassed 108 articles and 433,800 healthcare workers around the world.
The umbrella review showed that the overall prevalence of anxiety and depression among healthcare workers from January to October 2020 was 24.94% and 24.83%, respectively.
Factors cited as contributing to these levels of anxiety and depression included increased workload, burnout, inadequate PPE, the risk of contracting the disease, and the challenge of making difficult moral decisions about care priorities during the pandemic.
The researchers also noted that nurses in particular have poorer outcomes when it comes to mental health issues compared to other healthcare workers, potentially due to the fact that they spend the most time directly caring for patients.
Over Half of U.S. COVID-19 Health Care Workers At Risk for Mental Health Problems
In another recent study, this time published January 12th in the Journal of Psychiatric Research, researchers reported that more than half of U.S. doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for developing one or more mental health problems.
As described above, these mental health problems include anxiety and depression, but also include acute traumatic stress, problematic alcohol use, and insomnia.
Researchers found that the risk was elevated compared to rates observed during the 2004 Severe acute respiratory syndrome (SARS) outbreak but were comparable to those observed during 9/11 and Hurricane Katrina.
According to Andrew J. Smith, Ph.D., director of the University of Utah Health Occupational Trauma Program and the study’s corresponding author:
Although the majority of health care professionals and emergency responders aren’t necessarily going to develop PTSD, they are working under severe duress, day after day, with a lot of unknowns. Some will be susceptible to a host of stress-related mental health consequences. By studying both resilient and pathological trajectories, we can build a scaffold for constructing evidence-based interventions for both individuals and public health systems.
Of the 571 health care workers surveyed, 56% of the respondents screened positive for at least one mental health disorder. Healthcare workers in the study included emergency responders such as firefighters, police, and EMTs, as well as hospital staff such as doctors and nurses.
In particular, about 36% of health care workers in the study reported risky alcohol use. In contrast, estimates of alcohol abuse in normal circumstances are less than 21% of physicians and 23% of emergency responders. According to the researchers, those in supervisory positions and caregivers who provided direct patient care were at the greatest risk.
Charles C. Benight, Ph.D., co-author of the study and a professor of psychology at the University of Colorado, Colorado Springs says that frontline healthcare workers are exhausted from trying to cope both at work and at home. He notes, “They’re trying to make sure that their families are safe [and] they’re frustrated over not having the pandemic under control. Those things create the sort of burnout, trauma, and stress that lead to the mental health challenges we’re seeing among these caregivers.”
Because the study was limited to healthcare workers in the Mountain West region in the late spring of 2020, the researchers are in the final stages of a similar but larger study conducted in late 2020.
According to Smith, as horrible as the pandemic is, it provides the opportunity to better understand the extraordinary mental stress that healthcare workers face right now. Smith says, “With that understanding, perhaps we can develop ways to mitigate these problems and help health care workers and emergency responders better cope with these sorts of challenges in the future.”