High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross-sectional survey

Natasha Smallwood; Leila Karimi; Marie Bismark; Mark Putland; Douglas Johnson; Shyamali Chandrika Dharmage; Elizabeth Barson; Nicola Atkin; Claire Long; Irene Ng; Anne Holland; Jane E Munro; Irani Thevarajan; Cara Moore; Anthony McGillion; Debra Sandford; Karen Willis

doi:10.1136/gpsych-2021-100577

High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross-sectional survey

Gen Psychiatr. 2021 Sep 6;34(5):e100577. doi: 10.1136/gpsych-2021-100577. eCollection 2021.

Authors

Natasha Smallwood^{1

2}, Leila Karimi^{3

4}, Marie Bismark^{5

6}, Mark Putland^{7

8}, Douglas Johnson^{9

10}, Shyamali Chandrika Dharmage¹¹, Elizabeth Barson¹², Nicola Atkin^{13

14}, Claire Long¹⁵, Irene Ng^{16

17}, Anne Holland^{2

18}, Jane E Munro^{19

20}, Irani Thevarajan²¹, Cara Moore²², Anthony McGillion²³, Debra Sandford²⁴, Karen Willis^{25

26}

Affiliations

¹ Department of Respiratory Medicine, Alfred Hospital, Prahran, Victoria, Australia.
² Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia.
³ School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.
⁴ School of Medicine and Healthcare Management, Caucasus University, Tbilisi, Georgia.
⁵ Department of Psychiatry, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁶ Department of Public Health Law, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.
⁷ Department of Emergency Services, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
⁸ Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia.
⁹ Departments of General Medicine and Infectious Diseases, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
¹⁰ Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia.
¹¹ Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.
¹² Department of Allied Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
¹³ Parkville Integrated Palliative Care Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
¹⁴ Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia.
¹⁵ Department of Geriatric Medicine, Western Health, Footscray, Victoria, Australia.
¹⁶ Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
¹⁷ Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia.
¹⁸ Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia.
¹⁹ Rheumatology Unit, Royal Children's Hospital, Parkville, Victoria, Australia.
²⁰ Arthritis and Rheumatology, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
²¹ Department of Infectious Diseases, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
²² Department of Intensive Care Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
²³ School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia.
²⁴ Royal Adelaide Hospital, University of South Australia, Adelaide, South Australia, Australia.
²⁵ College of Health and Biomedicine, Victoria University, Footscray, Victoria, Australia.
²⁶ Division of Critical Care and Investigative Services, The Royal Melbourne Hospital, Parkville, Victoria, Australia.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a profound and prolonged impact on healthcare services and healthcare workers.

Aims: The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues, as well as the social, workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 pandemic.

Methods: A nationwide, voluntary, anonymous, single timepoint, online survey was conducted between 27 August and 23 October 2020. Individuals self-identifying as frontline healthcare workers in secondary or primary care were invited to participate. Participants were recruited through health organisations, professional associations or colleges, universities, government contacts and national media. Demographics, home and work situation, health and psychological well-being data were collected.

Results: A total of 9518 survey responses were received; of the 9518 participants, 7846 (82.4%) participants reported complete data. With regard to age, 4110 (52.4%) participants were younger than 40 years; 6344 (80.9%) participants were women. Participants were nurses (n=3088, 39.4%), doctors (n=2436, 31.1%), allied health staff (n=1314, 16.7%) or in other roles (n=523, 6.7%). In addition, 1250 (15.9%) participants worked in primary care. Objectively measured mental health symptoms were common: mild to severe anxiety (n=4694, 59.8%), moderate to severe burnout (n=5458, 70.9%) and mild to severe depression (n=4495, 57.3%). Participants were highly resilient (mean (SD)=3.2 (0.66)). Predictors for worse outcomes on all scales included female gender; younger age; pre-existing psychiatric condition; experiencing relationship problems; nursing, allied health or other roles; frontline area; being worried about being blamed by colleagues and working with patients with COVID-19.

Conclusions: The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare workers. Crisis preparedness together with policies and practices addressing psychological well-being are needed.

Keywords: COVID-19; anxiety; depression; mental health; post-traumatic; stress disorders.