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Frontline staff need more mental health support

01 September 2020

A SURVEY into the mental health of frontline staff and healthcare professionals has revealed that over 90% believe there is not enough mental health support available for the general public to deal with the aftermath of the pandemic and 66% felt there is not enough workplace support for healthcare professionals and frontline staff.

An overwhelming 80% felt their mental health has suffered because of the pandemic and have reported feelings of depression, anger, anxiety, lack of appetite, trouble sleeping, lack of sexual interest. Over half felt their health has been at risk because of their job throughout the crisis. However, over 80% of those interviewed have been tested for Covid-19 with only 10% testing positive for the virus. 81% have had relatives/family members affected by the crisis. The survey went on to reveal that just over 80% of those interviewed have witnessed patients diagnosed with Covid-19 and nearly half have lost patients to the virus (48%).

Psychotherapist Noel McDermott comments: “Frontline health and social care staff have faced the brunt of the coronavirus pandemic across the globe and will continue to do so. They will also disproportionately face the burden of the mental health problems long after the pandemic has passed. Throughout the height of the crisis, staff have been in coping mode but as things slow down the real difficulties will arise with many of these workers needing months, possibly years of mental health care after things settle down”.

Risk factors for frontline staff

Health workers are extremely resilient and though used to dealing with difficult and often traumatic situations, the Covid crisis has presented particular risk factors which are impacting upon their mental health. Frontline healthcare workers are at increased risk of developing symptoms of post-traumatic stress disorder (PTSD), depression and anxiety, with many struggling with insomnia. 

While providing the care communities need, many frontline staff made the extremely difficult decision of choosing self-imposed isolation around fear of spreading the virus, making them much more susceptible to developing serious mental health problems associated with the pandemic. 

Moral injury causing trauma for staff 

Frontline staff have been faced with what is termed moral injury, where they have been asked to make decisions that conflict with their moral code around who should live or who should die. The term was developed in trying to describe what has happening to soldiers faced with similar war zone decisions, soldiers who were deciding to kill someone. This element, the moral injury, is particularly pernicious in terms of developing effective help for staff with the trauma they carry as shame profoundly interferes with successful outcome in therapy. 

Previous research and experience with pandemics/infections has shown that higher risk of trauma responses are seen in 

  • Newly qualified and inexperienced 

  • Women

  • Those socially isolated

  • Those dealing with the virus and death directly on the frontline

These higher risk factors indicate there is significant risk for our health and social care workforce, additionally, the major symptoms don’t arise while still in the situation as we still are. It’s crucial to be monitoring this now and proactively working with staff to help them identify symptoms and seek help. Most medical staff and most support staff outside of mental health have little or no knowledge of how anxiety depression and trauma manifest and many still fear stigma in asking for help. 

It’s already known that pandemics put health and social care staff at risk (and what the mitigation factors are), but the reality is our mental health services were struggling to cope prior to the pandemic with the mental health needs of the general population let alone adding into the mix the additional burden of health workers with complex trauma and grief responses.

Noel comments: “Health and social care staff are in urgent need of help now. They need more than helpful websites or yet another mental health app. We need an immediate investment in workforce mental health support to provide treatment for our health and social care staff”.