Objectives: The objectives of this study were to identify demographic, work-related and other predictors for clinically significant psychological distress, including PTSD, depression, and/or anxiety during the COVID-19 pandemic in UK frontline health and social care workers (HSCWs), and to compare rates of PTSD, depression and anxiety across different groups of HCSWs.
Design: An online survey was conducted in the weeks following the initial peak in cases (27 May to 23 July 2020).
Setting: The participants worked in a variety of healthcare roles UK hospitals, nursing or care homes and community settings.
Participants: A convenience sample (n=1194) of frontline UK health and social care workers completed the survey (including allied healthcare professionals, carers, clinical support staff, nurses and midwives, and other health and social care roles).
Main outcome measures: PTSD was assessed using the PTSD subscale of the International Trauma Questionnaire (ITQ); Depression assessed using the Patient Health Questionnaire-9 (PHQ-9); Anxiety was assessed using the Generalized Anxiety Disorder Scale (GAD-7).
Results: Logistic regression analyses examined predictors for depression, anxiety and PTSD separately, and also investigated the predictors of meeting the criteria for at least one of the three conditions. Over 57% of respondents met the threshold for clinically significant PTSD, anxiety or depression, and symptom levels were reasonably high and comparable across occupational groups. Participants who were more concerned about infecting others, who felt they could not talk with their managers, who reported feeling stigmatised due to their role 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 a higher likelihood of meeting criteria for PTSD. Higher household income was associated with reduced odds for a mental disorder.
Conclusions: This study identifies predictors of clinically significant distress during COVID-19 and highlights the need for reliable access to PPE. Further research should investigate mental disorders in under-represented HSCW groups and examine barriers to communication between managers and staff. Identifying risk factors for PTSD, depression and anxiety among HSCWs, and providing treatment for those who need it, is critical given that subsequent waves of COVID-19 and other healthcare crises are inevitable.