Healthcare workers experience mental health problems during and after pandemics

Mental health problems such as Post-Traumatic Stress Disorder, anxiety and depression are common among healthcare staff during and immediately after pandemics – according to new research from the University of East Anglia.

Researchers investigated how treating patients in past pandemics such as SARS and MERS affected the mental health of front-line staff.

They found that almost a quarter of health-care workers (23.4 per cent) experienced PTSD symptoms during the most intense ‘acute’ phase of previous pandemic outbreaks – with 11.9 per cent of carers still experiencing symptoms a year on.

They also looked at data about elevated levels of mental distress and found that more than a third of health workers (34.1 per cent) experienced symptoms such as anxiety or depression during the acute phase, dropping to 17.9 per cent after six months. This figure however increased again to 29.3 per cent after 12 months or longer.

The team hope that their work will help highlight the impact that the Covid-19 pandemic could be having on the mental health of doctors and nurses around the world.

We know that Covid-19 poses unprecedented challenges to the NHS and to healthcare staff worldwide. Nurses, doctors, allied health professionals and all support staff based in hospitals where patients with Covid-19 are treated are facing considerable pressure, over a sustained period. In addition to the challenge of treating a large volume of severely unwell patients, front line staff also have to contend with threats to their own physical health through infection, particularly as they have had to face shortages of essential personal protective equipment. The media has reported that healthcare workers treating coronavirus patients will face a ‘tsunami’ of mental health problems as a result of their work. We wanted to examine this by looking closely at the existing data from previous pandemics to better understand the potential impact of Covid-19. We estimated the prevalence of common mental health disorders in health care workers based in pandemic-affected hospitals. And we hope our work will help inform hospital managers of the level of resources required to support staff through these difficult times.”

Prof Richard Meiser-Stedman, Norwich Medical School, UEA

A team of trainee clinical psychologists - Sophie Allan, Rebecca Bealey, Jennifer Birch, Toby Cushing, Sheryl Parke and Georgina Sergi - all from UEA’s Norwich Medical School, investigated how previous pandemics affected healthcare workers’ mental health, with support from Prof Meiser-Stedman and Dr Michael Bloomfield, University College London.

They looked at 19 studies which included data predominantly from the SARS outbreak in Asia and Canada, and which tended to focus on the acute stage of the pandemic - during and up to around six weeks after the pandemic.

We found that post-traumatic stress symptoms were elevated during the acute phase of a pandemic and at 12 months post-pandemic. There is some evidence that some mental health symptoms such as Post Traumatic Stress symptoms get better naturally over time but we cannot be sure about this. The studies we looked at had very different methods - for example they used different questionnaires about mental health - so we need to be cautious about the results. We didn’t find any differences between doctors and nurses experiencing PTSD or other psychiatric conditions, but the available data was limited and more research is needed to explore this. Overall there are not enough studies examining the impact of pandemics on the mental health of healthcare staff. More research is needed that focuses on Covid-19 specifically and looks at the mental health of healthcare workers longer-term.”

Sophie Allan, Norwich Medical School, UEA

‘The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis’ is published in the European Journal of Psychotraumatology on October 16, 2020.