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. 2021 Nov;78(11):801-808.
doi: 10.1136/oemed-2020-107276. Epub 2021 Jun 28.

Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

Danielle Lamb  1 , Sam Gnanapragasam  2 , Neil Greenberg  3 , Rupa Bhundia  4 , Ewan Carr  5 , Matthew Hotopf  2   6 , Reza Razavi  7 , Rosalind Raine  8 , Sean Cross  4 , Amy Dewar  9 , Mary Docherty  4 , Sarah Dorrington  10 , Stephani Hatch  10 , Charlotte Wilson-Jones  10 , Daniel Leightley  3   4 , Ira Madan  9 , Sally Marlow  10 , Isabel McMullen  4 , Anne-Marie Rafferty  11 , Martin Parsons  12 , Catherine Polling  10 , Danai Serfioti  3 , Helen Gaunt  13 , Peter Aitken  14 , Joanna Morris-Bone  15 , Chloe Simela  9 , Veronica French  16 , Rachel Harris  17 , Sharon A M Stevelink  3   4 , Simon Wessely  4
Affiliations

Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: initial baseline data from a cohort study collected during the first wave of the pandemic

Danielle Lamb et al. Occup Environ Med. 2021 Nov.

Abstract

Objectives: This study reports preliminary findings on the prevalence of, and factors associated with, mental health and well-being outcomes of healthcare workers during the early months (April-June) of the COVID-19 pandemic in the UK.

Methods: Preliminary cross-sectional data were analysed from a cohort study (n=4378). Clinical and non-clinical staff of three London-based NHS Trusts, including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire. Secondary outcomes are probable anxiety (seven-item Generalised Anxiety Disorder), depression (nine-item Patient Health Questionnaire), post-traumatic stress disorder (PTSD) (six-item Post-Traumatic Stress Disorder checklist), suicidal ideation (Clinical Interview Schedule) and alcohol use (Alcohol Use Disorder Identification Test). Moral injury is measured using the Moray Injury Event Scale.

Results: Analyses showed substantial levels of probable CMDs (58.9%, 95% CI 58.1 to 60.8) and of PTSD (30.2%, 95% CI 28.1 to 32.5) with lower levels of depression (27.3%, 95% CI 25.3 to 29.4), anxiety (23.2%, 95% CI 21.3 to 25.3) and alcohol misuse (10.5%, 95% CI 9.2 to 11.9). Women, younger staff and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one's moral code) was strongly associated with increased levels of probable CMDs, anxiety, depression, PTSD symptoms and alcohol misuse.

Conclusions: Our findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.

Keywords: health personnel; mental health; post-traumatic; psychiatry; psychology; stress disorders.

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Conflict of interest statement

Competing interests: RoR reports grants from DHSC/UKRI/ESRC COVID-19 Rapid Response Call, grants from Rosetrees Trust, grants from King’s Together rapid response call, grants from UCL (Wellcome Trust) rapid response call, during the conduct of the study; grants from Innovative Medicines Initiative and EFPIA, RADAR-CNS consortium, grants from MRC, grants from NIHR, outside the submitted work. SH reports grants from NIHR, grants from Wellcome Trust, grants from ESRC, grants from Guy’s and St. Thomas’ Charity, grants from MRC, grants from UKRI, outside the submitted work; and a member of the following advisory groups: The Health Foundation – COVID-19 Research Programme Panel, NHS England and NHS Improvement – Patient and Carers Race Equalities Framework (PCREF) Steering Group, NHS England and NHS Improvement – Advancing Mental Health Equalities Taskforce, Health Education England – Mental Health Workforce Equalities Subgroup, Maudsley Learning – Maudsley Learning Advisory Board, South London and Maudsley NHS Foundation Trust (SLaM) – Independent Advisory Groups, the SLaM Partnership Group, Lambeth Public Health – Serious Youth Violence Public Health Task and Finish Group, NHS England – Workforce Race Equality Standard Advisory Group, Thrive London – Thrive London Advisory Board, Black Thrive – Black Thrive Advisory Board. Commissions: Welsh Government’s Race Equality Plan; contribution to the evidence review for Health and Social Care and Employment and Income policy areas. SAMS reports grants from UKRI/ESRC/DHSC, grants from UCL, grants from UKRI/MRC/DHSC, grants from Rosetrees Trust, grants from King’s Together Fund, during the conduct of the study. NG reports a potential COI with NHSEI, during the conduct of the study; and the managing director of March on Stress Ltd, which has provided training for a number of NHS organisations although NG is not clear if the company has delivered training to any of the participating trusts or not as NG does not get directly involved in commissioning specific pieces of work.

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