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Examining How the Pandemic Has Affected the Mental Health of Frontline Workers
A recently published study found that health care workers directly involved with the early days of the COVID-19 pandemic experienced mental health problems comparable to those during previous large-scale disasters, and faced more mental health risks than workers in previous viral outbreaks did. In this Q&A, researchers Andrew J. Smith, PhD, Brandon J. Griffin, PhD, and Charles C. Benight, PhD, discuss the details of their findings, how workers’ mental health needs can be addressed as the pandemic continues, and initial findings from a larger, follow-up study.
Q: What do you see as the most significant results of your study, and why?
A: More than half of the emergency and hospital workers we assessed screened positive for 1 or more of 5 mental health problems including traumatic stress, depression, anxiety, insomnia, and hazardous alcohol use. The rates we observed are similar to prevalence of mental health problems among frontline personnel who responded to previous disasters such as the 9/11 attacks and Hurricane Katrina.
Q: What factors made workers more likely to be experiencing mental health problems?
A: Medically vulnerable employees who reported having a weakened immune system were more likely to screen positive for clinically significant stress, depression, and anxiety symptoms. Also, managers were more likely to report hazardous alcohol use and insufficient sleep.
Q: Were any of your findings surprising or unexpected?
A: The survey was open for several weeks between April and May of 2020. Surprisingly, those who completed the survey closer to May—when there were several thousand confirmed COVID-19 cases in the geographic area—were less likely to screen positive for a mental health problem than those who completed the survey in April, when only a couple hundred cases were confirmed. It is possible that we captured a phase of crisis response that happens soon after disasters occur in which community cohesion is high, resources are available, and people are optimistic about a quick return to normal.
It is also possible that this finding resulted from selection bias in our sampling, which we will explore more fully in our follow up longitudinal analyses. Regardless, additional research is needed to assess frontline personnel’s well-being over time as people become more disillusioned and exhausted while the number of confirmed COVID-19 cases, hospitalizations, and deaths continues to climb.
Q: Are there any systemic or institutional initiatives you feel are needed to address the mental health needs of frontline workers going forward?
A: We know from studies of frontline personnel following other disasters that resilient workforce communities cohere around a shared purpose, collaborative leadership, open and clear communication, and opportunities for positive coping. To that end, efforts to promote resilience among individual employees must include a focus on providing a transparent, supportive, and flexible organizational climate.
Q: Can you describe the study you conducted in late 2020, and any initial findings?
A: In a follow-up study that has not yet undergone peer review, we assessed more than 2000 health care workers. Similar to our initial study, we found that more than half of the respondents screened positive for at least 1 of 5 mental health problems (ie, traumatic stress, depression, anxiety, problematic alcohol use, insomnia). In addition to the 15% of respondents who reported having an immunocompromising medical condition, 22% of health care workers reported living with someone with a weakened immune system. Clinical providers with an immunocompromised household member were notably more likely to report psychological distress and insufficient sleep.
This highlights the difficult circumstances that many health care workers are navigating as they seek to balance commitments at work and home during the pandemic. Those who identified as women, younger, and a racial minority were also more likely to report a mental health problem, highlighting impacts of the health crisis and its secondary effects (eg, economic instability) that disproportionately affect some groups.
Reference
Andrew J. Smith, PhD, is founder and director of the University of Utah Occupational Trauma Program, Huntsman Mental Health Institute, Salt Lake City. Brandon J. Griffin, PhD, is Assistant Professor of Psychiatry, University of Arkansas for Medical Sciences and Staff Psychologist, Veterans Health Administration, Little Rock, Arkansas. Charles C. Benight, PhD, is a Professor of Psychology and director of the National Institute for Human Resilience at the University of Colorado at Colorado Springs.
