Predictors and rates of PTSD, depression and anxiety in UK frontline health and social care workers during COVID-19

Abstract

Background: Studies have shown that working in frontline healthcare roles during epidemics and pandemics was associated with PTSD, depression, anxiety, and other mental health disorders. Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant PTSD, depression, and anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of distress across different groups of HCSWs working in different roles and settings. Methods: A convenience sample (n = 1194) of frontline UK HCSWs completed an online survey during the first wave of the pandemic (27 May-23 July 2020). Participants worked in UK hospitals, nursing or care homes and other community settings. PTSD was assessed using the International Trauma Questionnaire (ITQ); Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7). Results: Nearly 58% of respondents met the threshold for a clinically significant disorder (PTSD = 22%; anxiety = 47%; depression = 47%), and symptom levels were high across occupational groups and settings. Logistic regression analyses found that participants who were concerned about infecting others, who could not talk with their managers if there were not coping, who reported feeling stigmatized and who had not had reliable access to personal protective equipment (PPE) were more likely to meet criteria for a clinically significant mental disorder. Being redeployed during the pandemic, and having had COVID were associated with higher odds for PTSD. Higher household income was associated with reduced odds for a mental disorder. Conclusions: This study identified predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE and further investigation of barriers to communication between managers and staff.

What support do frontline workers want? A qualitative study of health and social care workers’ experiences and views of psychosocial support during the COVID-19 pandemic

“…This made it particularly difficult for staff who were redeployed during the pandemic, who did not always feel included in their new ingroup but were no longer part of their old ingroup and could be left without clear lines of management support. Other quantitative research [ 3 ] has shown that being redeployed was a significant risk factor for health and social care workers developing PTSD in the context of the pandemic. Additional psychosocial support for redeployed staff is therefore likely to be of paramount importance.…”

“…Early quantitative research emerging from the UK [ 2 – 4 ] and around the world [ 5 , 6 ] has demonstrated a significant mental health burden experienced by frontline workers in response to COVID-19, with elevated rates of depression, anxiety, post-traumatic stress disorder (PTSD) and suicidality reported. In the UK, it has been estimated that 45–58% of the frontline health and social care workforce met criteria for clinically significant levels of anxiety, depression and/or PTSD shortly following the first wave of the pandemic [ 2 , 3 ]. This is amongst a workforce already under considerable strain pre-COVID-19, as evidenced by the growing incidence of stress, burnout, depression, drug and alcohol dependence and suicide across all groups of health professionals, worldwide [ 7 ].…”

Mental health responses to COVID-19 around the world

“…Together, these are likely to produce a sharp increase in a wide range of mental health problems, not limited to the most widely studied symptoms of anxiety and depression (e.g. Alexandra Maftei & Holman, 2021 ; Allan et al, 2020 ; Bareeqa et al, 2020 ; BinDhim et al, 2021 ; Cénat et al, 2021 ; de Pablo et al, 2020 ; Ertan, El-Hage, Thierree, Javelot, & Hingray, 2020 ; Greene et al, 2021 ; Shi et al, 2020 ; Vindegaard & Benros, 2020 ; Wu et al, 2021 ; Xiong et al, 2020 ). Identifying the various mental health consequences of the COVID-19 pandemic is a priority but still frequently neglected or minimized in national and international intervention plans (Brewin, DePierro, Pirard, Vazquez, & Williams, 2020 ).…”

COVID-19: An Urgency to Address Mental Health Consequences

“…Nothing less could be found among the healthcare workers who are dealing with the COVID-19 patients (Allan et al, 2020). For example, in survey of UK doctors in May 2020, 45% reported experiencing depression, anxiety, stress, burnout or other mental health problems during the pandemic (Green et al, 2021).…”