Nearly half of ICU staff 'meet threshold' for PTSD, severe depression or problem drinking amid pandemic, study suggests
The mental health impact the coronavirus outbreak is having on intensive care unit (ICU) staff has been unveiled in “stark” new research.
Since the start of the pandemic, doctors, nurses and other hospital employees have spoken of the emotional burden of treating critically-ill patients, with many enduring exhaustion and sores from their personal protective equipment (PPE).
To better understand the ordeal ICU staff face, scientists from King’s College London had more than 700 workers from nine English hospitals complete an anonymous survey between June and July, when infection rates were relatively low.
Results reveal nearly half (45%) “met the threshold” for severe depression or anxiety, post-traumatic stress disorder (PTSD) or problem drinking.
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Perhaps most concerning of all, around one in eight (13%) reported frequently having thoughts of self-harm or even that they would be better off dead in the two weeks before the survey.
“Our results show a substantial burden of mental health symptoms being reported by ICU staff towards the end of the first wave in July and July 2020,” said lead author Professor Neil Greenberg.
“The severity of symptoms we identified are highly likely to impair some ICU staffs ability to provide high-quality care, as well as negatively impacting on their quality of life.
“The high rate of mortality amongst COVID-19 [the disease caused by the coronavirus] patients admitted to ICU, coupled with difficulty in communication and providing adequate end-of-life support to patients, and their next of kin because of visiting restrictions, are very likely to have been highly challenging stressors for all staff working in ICUs.”
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In September, a Minnesota doctor spoke of the “bone-deep weariness” he endured while working amid the pandemic, adding he was “running on fumes”.
The following month, nurses described how they “absorb the emotions” when a coronavirus victim dies without a loved one present.
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The King’s study was made up of 291 doctors, 344 nurses and 74 healthcare workers in other roles.
The results, published in the journal Occupational Medicine, reveal more than half (59%) reported having good wellbeing.
Of the 45% who were struggling, 40% showed signs of PTSD that “met the threshold for probable clinical significance”.
Just over one in 10 (11%) had symptoms fitting severe anxiety, while 7% reported problem drinking and 6% severe depression.
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“Whilst these results are in some ways not surprising, they should serve as a stark reminder to NHS managers of the pressing need to protect the mental health of ICU workers now in order to ensure they can deliver vital care to those in need,” said Professor Greenberg.
The study was carried out during the UK’s summer, with the pandemic later taking a dramatic turn for the worse.
More than 46,000 people tested positive for the coronavirus on 11 January alone, while just over 4,100 patients were admitted to hospital – a 34% increase on the previous week.
With the NHS under its usual winter pressures, England’s chief medical officer Professor Chris Whitty has warned the next few weeks will be “the worst” for the health service since the pandemic began.
“Evidence-based mechanisms should be in place so all healthcare workers, including ICU staff, can promptly access treatment for mental health issues,” said Professor Greenberg.
“If we protect the mental health of healthcare workers during the COVID-19 pandemic, staff will be better able to sustainably deliver high quality care to the large numbers of patients seriously unwell with COVID-19.”
The scientists acknowledged further research is required, with self-reported questionnaires potentially overestimating the prevalence of mental health symptoms.
Nevertheless, Professor Greenberg concluded: “Our results highlight the potential profound impact COVID-19 has had on the mental health of frontline UK staff and indicate an urgent need for a national strategy to protect staff mental health, and decrease the risk of functional impairment of ICU staff while they carry out their essential work during COVID-19 and beyond.”
For confidential emotional support at times of distress, contact The Samaritans at any time by calling 116 123 or emailing jo@samaritans.org.
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