Putting it all on the line: Caring for COVID-19 patients leads to depression, distress for healthcare workers

Healthcare workers diagnosing, treating and caring for COVID-19 patients are experiencing a significant psychological burden and may develop poor mental health outcomes, according to new research out of China.   

The study, published in JAMA Network Open, included survey responses from more than 1,200 nurses and physicians from 34 different facilities who treated COVID-19 patients in China. Answers were collected in late January and early February 2020.

The authors noted that the 2003 SARS outbreak led to adverse psychological reactions among providers—many considered quitting or experienced signs of depression—and thought a similar situation may be occurring with this rapidly spreading virus that has already caused so many problems throughout the world.  

“Facing this critical situation, health care workers on the front line who are directly involved in the diagnosis, treatment, and care of patients with COVID-19 are at risk of developing psychological distress and other mental health symptoms,” wrote lead author Jianbo Lai, MSc, Zhejiang University School of Medicine in China, and colleagues. “The ever-increasing number of confirmed and suspected cases, overwhelming workload, depletion of personal protection equipment, widespread media coverage, lack of specific drugs, and feelings of being inadequately supported may all contribute to the mental burden of these health care workers.”

Of the patients surveyed for this analysis, 64.7% were between the ages of 26 and 40 and 76.7% were women. While 60.8% of respondents were nurses, the remaining 39.2% were physicians. Also, 60.5% of respondents worked in Wuhan, China—where the virus famously originated—while a majority of the remaining workers treated patients in Hubei province outside of Wuhan.   

Lai et al. also noted that 41.5% of respondents identified as frontline healthcare workers who “directly engaged in diagnosing, treating or caring for patients with or suspected to have COVID-19.”

Overall, the team found that “a considerable proportion of patients” reported symptoms of depression, anxiety, insomnia and distress. In all instances, frontline workers experienced “more severe degrees” of the mental health symptoms than other providers. Those workers were also associated with a higher risk of symptoms related to depression, anxiety, insomnia and distress.

The study also found that healthcare workers in Wuhan were at an increased risk of unfavorable mental health outcomes.

“These findings indicated more stress among health care workers in Wuhan, the origin and epicenter of the epidemic in China,” the authors explained.

What can be done to help these healthcare providers? The researchers called for significant steps to be taken to help them get the care they need.

“Protecting health care workers is an important component of public health measures for addressing the COVID-19 epidemic,” Lai et al. concluded. “Special interventions to promote mental well-being in health care workers exposed to COVID-19 need to be immediately implemented, with women, nurses, and frontline workers requiring particular attention.”