Occupational Disruptions during the COVID-19 Pandemic and Their Association with Healthcare Workers' Mental Health

Abstract

Background: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic.

Methods: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout.

Results: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19.

Conclusions: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.

Keywords: COVID-19; communication; healthcare services; leadership; mental health.

Figure 1

Bars are indicative of odds ratio and 95% confidence intervals. Colour key represents predictors for each validated scale outcome: Anxiety (Generalised Anxiety Disorder Scale); Depression (Patient Health Questionnaire); PTSD (post-traumatic stress disorder; Impact of Events Scale); Burnout (Maslach Burnout Inventory; DP = Depersonalisations; EE = Emotional Exhaustion; PA = Personal Accomplishment). Lower odds ratio for PA indicates poorer outcomes. Reference categories—satisfied with organisational support vs. neutral, satisfied with workplace communications vs. neutral, no change to working hours vs. change, increased unpaid hours vs. negative response, redeployed vs. negative response, role change vs. negative response, confident to care vs. neutral, needs training vs. negative response.