The COVID-19 Impact on the Mental Health of Healthcare Workers

Background and Purpose: Recent reports have found that the COVID-19 pandemic has had an adverse impact on the mental health of healthcare workers (HCWs). A Kaiser Family Foundation/Washington Post survey (Kirzinger et al., 2021) found that over 60% of healthcare workers reported the stress associated with COVID-19 had impacted their mental health and 55% felt burned out. Other studies using psychiatric screens have reported a high prevalence of anxiety, depressive symptoms, and traumatic stress among HCWs (Benfante et al., 2020; Pappa et al., 2020). In this study, we describe the impact of COVID-19 on a number of psychiatric conditions including depression, suicidal ideation, generalized anxiety, PTSD, and vicarious trauma as well as burnout in a sample of HWCs employed in hospital settings.

Methods: This descriptive cross-sectional online survey was conducted in April 2021. This convenience sample includes unionized HCWs at four area hospitals belonging to the same health network. Participants were recruited by email and by Hustle, a peer-to-peer text messaging system; 275 medical HCWs (nurses) and 174 non-medical HCWs (service/clerical/technical workers). Mental health measures included commonly used screens for depression (PHQ-2), suicidal ideation (Question 9 from PHQ-9), generalized anxiety disorder (GAD-7), posttraumatic stress disorder (PTSD-5), and vicarious trauma (Vicarious Trauma Scale). Furthermore, items related to employment burnout (Copenhagen Burnout Inventory) were included. Descriptive statistics were used to report the percentage of respondents with a positive screen and chi-square was used to compare medical and non-medical HCWs on these screens.

Results: HCWs were primarily female (87%) and White (86%). Their average age was 38.6±13.8 years old and had been working in a hospital setting for 12.2±12.3 years. Almost half (48%) had bachelor's degree and higher. Overall, 47% of the workers had at least one current positive mental health screen; 47% of medical HCWs and 48% of non-medical HCWs. Specific positive screens included depression (overall 26%; medical HCWs 26%; non-medical HCWs 27%), suicidal ideation (11%; 11%; 12%), generalized anxiety disorder (27%; 29%; 24%), and PTSD (29%; 31%; 26%). Significant differences were found in vicarious trauma and employment burnout. The prevalence of vicarious trauma and work-related burnout was statistically significantly higher for medical HCWs. Among all HCWs, 66% reported moderate to high levels of vicarious trauma; 77% of medical HCWs and 48% of non-medical HCWs. Additionally, 21% of all HCWs indicated moderate to high levels of employment burnout; 24% of medical HCWs and 16% non-medical HCWs.

Conclusions and Implications: Consistent with the national surveys (Young et al., 2020; Kirzinger et al., 2021), most HCWs in our sample reported serious psychiatric symptoms. Such a high rate of psychiatric symptoms highlights the magnitude of the current mental health needs among both medical and non-medical HCWs. The hospitals where these HCWs are employed need to examine the current organizational culture, adopt strategies to better address their employees’ mental health conditions, and modify policies and procedures to respond to trauma victims at all levels of the organization.