Spillover effects of violent attacks and COVID-19 exposure on mental health of health professionals: A two-phase quasi-natural experiments study in Northwest China

Abstract

The aims of this study were to examine the spillover effects of violent attacks, coronavirus disease-2019 (COVID-19) exposure, and their interactions on health professionals' mental health, and the role of organizational support in their relationships in China. A two-phase survey data (n = 10,901) before and after the first outbreak of COVID-19 was integrated with regional macro data on the number of lawsuit cases of violent attacks and COVID-19 cases. Three studies were designed to isolate the general spillover impact of violent attacks on the mental health of health professionals, how COVID-19 affects the mental health of health professionals, and whether organizational support moderates the relationship between violent attacks and mental health through econometric regressions. Violent attacks and COVID-19 are negatively associated with the mental health of health professionals, and the outbreak of COVID-19 adversely deteriorates the spillover effects of violent attacks. Physicians, not nurses, are the most affected group. Better perceived support from hospitals can significantly mitigate the adverse effects of COVID-19, violent attacks, and their interactions on the mental health of health professionals. COVID-19 deteriorates the adverse effects of violent attacks on the mental health of health professionals, while better organizational support is helpful to mitigate these effects. Impact statementsTo the best of our knowledge, this study is the first use of micro-macro data systematically estimating the spillover effects of violent attacks, coronavirus disease-2019 (COVID-19) cases, and their interaction, on the mental health of health professionals in China. It also documents the importance of hospital support in mitigating mental health deterioration in workplaces. Using data from one of the least developed provinces in China, we provide empirical evidence of adverse spillover effects of violent attacks, COVID-19, and their interaction on the mental health of health professionals in China, where support from hospitals is crucial. Most importantly, we estimate a bottom-line situation in China, and then a worse national situation can be speculated. Our findings support studies discussing the adverse effects of violent attacks or COVID-19 on the mental health of health professionals. Particularly, we empirically evidence that COVID-19 can deteriorate the adverse effects of violent attacks, where the adverse effects can spill but are not limited to those who bear the damage. In mitigating and recovering from the adverse spillover effects on the mental health of health professionals incurred by violent attacks or COVID-19 and their interaction, support from hospitals is another crucial channel other than individual-level interventions. Our experience from one of the least developed provinces of China may be nationally or even globally generalized.