The mental health of staff working in intensive care during COVID-19

  1. Neil Greenberg
  2. Dale Weston
  3. Charlotte Hall
  4. Tristan Caulfield
  5. Victoria Williamson
  6. Kevin Fong
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Abstract

Background

Intensive Care Unit (ICU), anaesthetic and theatres staff have faced significant challenges during the COVID-19 pandemic which have the potential to adversely affect their mental health

Aims

To identify the rates of probable mental health disorder in ICU and anaesthetic staff in six English hospitals during June and July 2020

Methods

An anonymised brief web-based survey comprising standardised questionnaires examining depression, anxiety symptoms, symptoms of Post Traumatic Stress Disorder (PTSD), wellbeing and alcohol use was administered to staff.

Results

709 participants completed the surveys comprising 291 (41%) doctors, 344 (48.5%) nurses, and 74 (10.4%) other healthcare staff. Over half (58.8%) reported good wellbeing, however 45.4% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6.3%), PTSD (39.5%), severe anxiety (11.3%) or problem drinking (7.2%). 13.4% of respondents reported frequent thoughts of being better off dead, or of hurting themselves in the past two weeks. We found that doctors consistently reported better mental health than nurses.

Conclusions

We found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. These results indicate the need for a national strategy to protect the mental health, and decrease the risk of functional impairment, of ICU staff whilst they carry out their essential work during COVID-19.

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What is already known about this subject

  • Intensive care unit (ICU) staff are regularly exposed to traumatic situations as part of their job

  • Previous studies have shown them to be at risk of psychological and moral distress

  • Little is known about the mental health of ICU staff during the current pandemic

What this study adds

  • Almost half of ICU staff report symptoms consistent with a probable diagnosis of post traumatic stress disorder, severe depression or anxiety or problem drinking

  • Around 1 in 7 ICU staff report recent thoughts of self-harm or of wanting to be better off dead

  • Nursing staff are more likely to report higher levels of distress than doctors or other clinical staff

What impact this may have on practice or policy

  • Healthcare managers need to prioritise staff mental health support and timely access to evidence based treatments for ICU staff

  • Supervisors and managers should be aware that a substantial proportion of ICU staff may perform less well because of their current poor state of mental health

  • More work is needed to understand whether the high levels of mental health symptoms identified in this study are truly indicative of high levels of clinical need for mental healthcare

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