COVID-19: NHS staff show signs of mild depression

Tawfiq Choudhury

According to a survey published in the Journal of Occupational and Environmental Medicine, NHS staff working during the pandemic are showing signs of mild depression. The survey also indicates that a large majority (81%) of workers fear contracting COVID-19 and only 19% feel confident that they will not experience burnout if the pandemic continues. Authors Tawfiq Choudhury (Blackpool Victoria Hospital, Blackpool, UK) and colleagues report that these findings “highlight the presence of psychological distress amongst healthcare workers and the risk of burnout”.

In a letter to the Journal of Occupational and Environmental Medicine, Choudhury et al note that the “NHS, along with other health services around the world, faces unprecedented pressures to deal with the COVID-19 pandemic”. They add that these pressures not only relate to “resource and financial constraints” but also to “physical and psychological wellbeing”.  Therefore, the authors sent two surveys to staff at their tertiary cardiac centre in the UK to assess the psychological burden of COVID-19. The surveys featured questions on depression, stress, and anxiety.

Of 65 responses to the survey about depression/stress, the median Patient Health Questionnaire (PHQ-9) was five. Choudhury et al report that this indicates mild depression and that there were no significant differences in this score between those with pre-existing depression/anxiety compared with those without. There were also no differences in depression scores among the different professions of the respondents (clinicians versus nurses/allied healthcare professionals). However, those with pre-existing depression/anxiety had significantly higher stress scores those without. The median stress score was seven.

The anxiety survey found that the median General Anxiety Disorder-7 (GAD-7) score was five (total respondents 41), with mild anxiety occurring in 27% of respondents, moderate anxiety in 12%, and severe in 22%. The authors note: “There was no significant difference in anxiety score based on occupation, direct exposure to patients, age, or length of NHS experience. Furthermore, there was no significant difference in GAD-7 score in respondents with and without pre-existing depression/anxiety.”

No respondents reported symptoms of burnout. However, according to Choudhury et al, only 19% felt “confident they would not experience burnout if the pandemic was prolonged until the second half of this year”. Additionally, 81% said that they were “scared of contracting COVID-19”.

“The results of the survey show a prevalence, at this current point in time [April 2020], of mild depression, increased levels of stress, and mild anxiety amongst healthcare workers working during the current COVID-19 pandemic,” the authors state. They add that interpersonal isolation, fear of contagion, and concern for family are potential contributing factors for these findings.

Choudhury et al write that the results of the survey “raise the need for early intervention to mitigate the immediate and longer-term consequences of the psychological stress amongst our NHS workers”. “Getting through these difficult times will require early and persistent psychological support, addressing the above factors and with extra attention to the vulnerable, high-risk groups. Individual and organisational resilience are key,” they comment.

They conclude: “Early recognition of signs of psychological distress, setting up adequate support services and long-term aftercare for our healthcare workers are of paramount importance.”

Choudhury told Cardiovascular News: “Similar to the SARS outbreak, the COVID-19 pandemic is likely to have a longer-term effect on the psychological well-being of healthcare workers. Early recognition of psychological distress in healthcare workers and institution of immediate and longer-term support is extremely important to mitigate the impact of Covid-19 on the mental health of the NHS workforce.”


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