- A thorough assessment of the evidence on mental health difficulties encountered by frontline healthcare professionals and others during the COVID-19 epidemic reveals a significant burden of mental health symptoms.
- The paper details the pandemic’s impact on healthcare professionals, children, and adolescents, as well as COVID-19 patients with co-morbid illnesses.
- The new study is based on worldwide research performed during the early stages of the epidemic.
The influence of COVID-19 on mental health – Photo by TIZIANA FABI/AFP via Getty Images
Rarely, if ever, have lives been untouched by the COVID-19 epidemic. The impact is particularly severe on some groups of people, including healthcare workers, children and adolescents, and those with underlying medical issues.
A new systematic study conducted by experts at the University of York’s Centre for Reviews and Dissemination and the Mental Health Foundation in the United Kingdom aims to quantify the pandemic’s mental health impact.
“[L]earning from the early months of the COVID-19 pandemic can assist us in preparing for the future, including pandemics,” the scientists wrote.
According to the analysis, frontline healthcare professionals and employees experienced significant levels of anxiety, depression, post-traumatic stress disorder (PTSD), and burnout throughout the epidemic.
Additionally, to COVID-19, the researchers discovered significant rates of mental health problems in children, adolescents, and those living with chronic illnesses.
According to senior author Dr. Noortje Uphoff, “this study identifies the forms of assistance that should be investigated to safeguard the mental health of healthcare professionals and other vulnerable populations during this pandemic and any subsequent coronavirus epidemics.”
The study is published in PLOS ONE.
A meta-analysis of reviews
The current evaluation incorporates 25 additional reviews that were based on original research conducted during the early months of the COVID-19 epidemic. Six healthcare professionals from the United Kingdom also shared their expertise with the researchers.
Dr. Jo Billings of University College London in the United Kingdom, who was not involved in the research, highlighted the importance of this review to Medical News Today.
“By integrating data from a variety of reviews, this study demonstrates that a significant and negative effect on mental health is reliably repeated across multiple studies. This enables us to confidently assert that the detrimental impact is substantial and long-lasting,” she explained.
The majority of the evaluations analyzed — 19 in total — centered on healthcare professionals. Additionally, five studies included children and adolescents, two studies included COVID-19 patients with prior illnesses, and one study included homeless persons.
As Dr. Billings noted, “the analysis identified only a small number of prior evaluations that included these populations, indicating the need for more consideration and study on these vulnerable groups.”
The systematic review investigated the experiences of individuals from a variety of nations. China was included in all of the reviews conducted throughout the research. Two of the reviews were solely focused on that nation.
Twelve of the evaluations examined the effects of COVID-19 on mental health on their own. Another 12 examined a variety of diseases, including COVID-19, SARS, MERS, Ebola, influenza A/H1N1 (swine flu), and influenza A/H7N9, sometimes referred to as “avian influenza” or “bird flu.” The last review focused exclusively on SARS.
Personnel in the healthcare industry
“Healthcare personnel may already be at a higher risk of bad mental health outcomes as a result of the stressful nature of their work,” Dr. Uphoff observes. However, there were some signs that working on the frontlines during an infectious disease epidemic may have a detrimental effect on mental health.”
For example, a year following the SARS pandemic, healthcare professionals were six times more likely to experience mental health problems than the general population. Two years after the crisis, 30% of individuals directly exposed to SARS patients continued to experience considerable emotional fatigue.
Additionally, quarantines were associated with higher alcohol consumption, acute stress disorder, and post-traumatic stress disorder (PTSD), with sleeplessness being more prevalent among healthcare professionals than in the general population.
Dr. Billings highlighted that it might be challenging to monitor frontline employees’ mental health during a crisis in a way that is “neither intrusive or excessively onerous.”
She was particularly concerned about employees’ willingness to speak out, noting that “stigma associated with mental illness remains widespread in healthcare settings.” We need to foster a culture in which healthcare professionals may openly discuss their personal mental health struggles without fear of jeopardizing their careers.”
Children, adolescents, and individuals with special needs
The researchers discovered that quarantine and fear of a pandemic were associated with an increased risk of “acute stress disorder, adjustment disorder, grieving symptoms, and post-traumatic stress disorder” in children and adolescents.
There was a wide range of estimates for the number of children and adolescents who experienced anxiety, ranging from 19 to 37%, whereas 35–44% reported symptoms of depression. Young individuals reported symptoms of PTSD at a rate of 6%, psychological discomfort at a rate of 40%, and acute stress disorder at a rate of 17%.
According to the authors, “[c]hildren and adolescents may be more likely to have negative mental health outcomes when they are exposed to stigma, societal change, such as school closures, and changes in home relationships.”
Students at college reported experiencing symptoms of anxiety, sadness, drug misuse, food problems, and sleeping difficulties.
Additionally, researchers questioned children with cystic fibrosis, who reported less worry about the pandemic than normal youngsters. Their parents, on the other hand, reported higher levels of worry.
The incidence of anxiety was estimated to be between 40% and 82% among COVID-19 individuals with previous physical health problems. It was 50% for depression. Additionally, there were signs that pre-existing mental health disorders may have deteriorated.
Contributions from the six-member panel
The researchers gathered a panel of six hospital or community-based healthcare practitioners in the United Kingdom for a two-hour review and discussion of the systematic review’s findings.
The panel stressed to the researchers the critical nature of colleague support and open communication in the workplace. Where this was not in place, such as for home-based healthcare professionals, it was noted to be a cause of stress.
According to Dr. Uphoff, one of their most surprising and encouraging results was the prevalence of beneficial workplace assistance. However, the areas in which healthcare providers might improve were also evident.
“What kept coming up in review after review were the things that we all expect to find in a workplace: clear communication and direction from management, a balanced workload, access to mental health assistance, and the availability of training and education,” Dr. Uphoff explained.
What follows
“We have identified different forms of mental health assistance that might help protect healthcare professionals’ mental health in the event of a pandemic,” Dr. Uphoff explained. “While the further study on their effectiveness is necessary, we hope that governments and organizations would consider implementing some of these measures.”
Dr. Uphoff also discussed other studies that may be beneficial.
“The nature of systematic studies is that they are perpetually behind schedule — we discovered evidence mostly from hospital employees in China,” she says.
“With the current information, I would like to do another systematic review of mental health during the COVID-19 pandemic, focusing on additional populations who may be more vulnerable in terms of their mental health. This includes youngsters and [elderly adults], essential non-hospital personnel, historically underrepresented populations, and individuals with physical health conditions.”