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The Mental Health Impact of Pandemics for Front Line Health Care Staff

Frontline. Inspired by images of exhausted doctors and nurses. Image created by Kevin Kobsic. Submitted for United Nations Global Call Out To Creatives - help stop the spread of COVID-19.

New research estimates the high prevalence of common mental health disorders in health care workers based in pandemic-affected hospitals, aiming to inform hospital managers of the level of resources required to support staff through and after the unprecedented COVID-19 response.

Research from the University of East Anglia outlines the prevalence of mental health problems such as Post-Traumatic Stress Disorder, anxiety and depression among healthcare staff during and immediately after pandemics.

The team hope that their work will help highlight the impact that the Covid-19 pandemic could be having on the mental health of doctors, nurses and care givers around the world.

The researchers investigated how treating patients in past pandemics such as SARS and MERS affected the mental health of front-line staff and found that almost a quarter of health-care workers (23.4 per cent) experienced PTSD symptoms during the most intense ‘acute’ phase of previous pandemic outbreaks – with 11.9 per cent of carers still experiencing symptoms a year on.

They also looked at data about elevated levels of mental distress and found that more than a third of health workers (34.1 per cent) experienced symptoms such as anxiety or depression during the acute phase, dropping to 17.9 per cent after six months. This figure however increased again to 29.3 per cent after 12 months or longer.

“Nurses, doctors, allied health professionals and all support staff based in hospitals where patients with Covid-19 are treated are facing considerable pressure, over a sustained period,” said Prof Richard Meiser-Stedman, from UEA’s Norwich Medical School. “In addition to the challenge of treating a large volume of severely unwell patients, front line staff also have to contend with threats to their own physical health through infection, particularly as they have had to face shortages of essential personal protective equipment.”

The team looked at 19 studies which included data predominantly from the SARS outbreak in Asia and Canada. They found that post-traumatic stress symptoms were elevated during the acute phase of a pandemic and at 12 months post-pandemic.

“There is some evidence that some mental health symptoms such as Post Traumatic Stress symptoms get better naturally over time but we cannot be sure about this. The studies we looked at had very different methods – for example they used different questionnaires about mental health – so we need to be cautious about the results,” noted team member Sophie Allan of UEA’s Norwich Medical School.

“We didn’t find any differences between doctors and nurses experiencing PTSD or other psychiatric conditions, but the available data was limited and more research is needed to explore this. Overall there are not enough studies examining the impact of pandemics on the mental health of healthcare staff. More research is needed that focusses on Covid-19 specifically and looks at the mental health of healthcare workers longer-term,” she added.

The prevalence of common and stress-related mental health disorders in healthcare workers based in pandemic-affected hospitals: a rapid systematic review and meta-analysis. European Journal of Psychotraumatology, October 16, 2020.

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