Covid-19 Anxiety, Stress and Trauma in Healthcare Workers:

There's been a lot in the news and media about the impact of the current wave of Covid-19 on hospitals and the healthcare system. Hospitals are busier than during the first peak, non Covid-19 procedures are being postponed and there are increasing delays with being able to access NHS help. 

It certainly supports the message that we should all be staying at home and reducing contact with others as much as we are able to. It's not just to help reduce the number of people getting ill and dying from Covid-19, it's not just to try and help those who are suffering with other issues that need treatment, it's not even only to support our wonderful NHS. We should all take action to support each and every individual doctor, nurse and healthcare professional who is giving their all right now (the very same people who are there for us and our loved ones when we need them).

When I talk to my clients who are healthcare workers, they all tell me of the harrowing scenes and challenges throughout this pandemic. There was everything we all saw and heard about way back in the first wave, and for many of these doctors, nurses and healthcare staff, there has been no let up in the demands upon them week after week, and month after month, during this pandemic.

All of the research and evidence shows that the mental health of healthcare workers is being impacted upon and that they now not only need mental health resources and support to be made available effectively, they also need the rest of us to do all we can so that they can continue helping people now and into the coming months.

Mental Health of Healthcare Workers

I've written many articles during this pandemic about how it has affected mental health, with anxiety, stress and worry about contracting the virus, impacts on work, education and finances, and the social restrictions and limitations that have been in place. All of the research points towards the negative impact on mental health.

I've also covered other aspects such as substance abuse, impact on sleeping and dreaming, and how it has led to increased levels of  negative body image.

Back in May 2020, I wrote an article that included research about the impact of Covid-19 on the mental health of healthcare workers (Covid-19 & Easing Lockdown: A Ticking Mental Health Timebomb?). 

Even back then the impact on the mental health of healthcare workers was present. 

Pappa et al (Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 2020) carried out a review to analyse existing evidence on the prevalence of depression, anxiety and insomnia among health care workers during the Covid-19 outbreak. Thirteen studies were included in the analysis with a combined total of 33,062 participants.

They found evidence that a high proportion of healthcare professionals had experienced significant levels of anxiety, depression and insomnia during the Covid-19 pandemic.  

And Sasangohar et al (Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit, 2020) have talked about the emotional and physical toll on healthcare workers. In making recommendations for lessons to be learned from the pandemic they write, "Limited resources, longer shifts, disruptions to sleep and to work-life balance, and occupational hazards associated with exposure to COVID-19 have contributed to physical and mental fatigue, stress and anxiety, and burnout." They highlighted the need to find feasible and practical methods to asses health care workers' fatigue and burnout.

 

Pandemic Related Mental Health 

As well as that research highlighting the impact of the pandemic on the mental health of health care workers, we also have some more recent evidence.

In November 2020,  Wright et al (Pandemic-related mental health risk among front line personnel. Journal of Psychiatric Research. 2020) reported on their study that assessed risks for mental health problems (traumatic stress, depression, anxiety, alcohol use, insomnia) in a sample of 571 emergency and hospital personnel in the USA.

Their overall findings suggest that a sizable proportion of front-line responders during the Covid-19 pandemic are at risk of mental health issues. They likened the levels as being similar to disasters such as 9/11 and Hurricane Katrina (although here the pandemic is not limited so much by geography or area).

"The global nature of this disaster means that many more frontline responders and hospital personnel are being affected simultaneously by this event than any event in modern history. The currently available mental health service offerings and access for frontline responders are inadequate."

And here in the UK, we have very recent research (published January 2021) about the impact of Covid-19 on the mental health of staff working in intensive care.

Greenberg et al (The mental health of staff working in intensive care during COVID-19. 2020) set out to identify the rates of probable mental health disorder in staff working in ICUs in nine English hospitals during June and July 2020 (looking at depression, anxiety symptoms, symptoms of post-traumatic stress disorder (PTSD), well-being and alcohol use).

Based upon a sample of seven hundred and nine doctors, nurses and other healthcare staff, they found that over half reported good well-being but 45% met the threshold for probable clinical significance on at least one of the following measures: severe depression, PTSD , severe anxiety or problem drinking.

In conclusion, they wrote, "We found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. Whilst further work is needed to better understand the real level of clinical need amongst ICU staff, 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."

I think we all need to be concerned by these results. ICU staff have a vital role to play during this pandemic, as well as during more normal times. Their mental health and well-being needs attention and support.

Almost half of intensive care unit staff who participated in this study report symptoms consistent with a probable diagnosis of post-traumatic stress disorder, severe depression or anxiety or problem drinking, and  around one in seven intensive care unit staff in this study report recent thoughts of self-harm or of wanting to be better off dead. Nurses were more likely to report higher levels of distress.

 

Covid-19 Anxiety, Stress and Trauma in Healthcare Workers

Back in March 2020, I wrote that what remains to be seen is how the ongoing psychological distress of healthcare workers translates into the next stages of the pandemic and any ongoing prevalence of PTSD, anxiety and depression. This research suggests that the mental health of healthcare staff is suffering during the pandemic. 

It's naturally a privilege when I can help healthcare workers through hypnotherapy to handle, deal and cope better with the challenges and demands they are facing. Yet mental health support needs to be more readily accessible and available. Without this, more and more staff will suffer with poor mental health which will take its toll as we continue to move this pandemic.

If you are struggling with mental health issues, such as stress, anxiety or depression, then there are many things that we can do through hypnotherapy sessions to help you feel stronger and to feel better in yourself. Whether it's dealing with negative thoughts and feelings, being able to feel calmer, find some mental space or some other aspects of your thoughts, feelings and actions, it is possible to feel confident, strong and capable even as you deal with the challenges and demands from the pandemic.

 

Stay safe and well,

Dan Regan

Online Skype and Zoom Hypnotherapy  

Face-to-face hypnotherapy in Ely & Newmarket

 

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References:

Greenberg, N., Weston, D., Hall, C., Caulfield, T., Williamson, V. and Fong, K., 2020. The mental health of staff working in intensive care during COVID-19. medRxiv.

Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V.G., Papoutsi, E. and Katsaounou, P., 2020. Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and Immunity.

Sasangohar, F., Jones, S.L., Masud, F.N., Vahidy, F.S. and Kash, B.A., 2020. Provider burnout and fatigue during the COVID-19 pandemic: lessons learned from a high-volume intensive care unit. Anesthesia and analgesia.

Wright, H.M., Griffin, B.J., Shoji, K., Love, T.M., Langenecker, S.A., Benight, C.C. and Smith, A.J., 2020. Pandemic-related mental health risk among front line personnel. Journal of Psychiatric Research.