Mental Health Symptoms in a Cohort of Hospital Healthcare Workers Following the Peak of the COVID-19 Pandemic in the United Kingdom

Background: The Covid-19 pandemic is likely to lead to a significant increase in mental health disorders in healthcare workers (HCW). We aimed to estimate the prevalence rates of anxiety, depressive and post-traumatic stress disorder (PTSD) symptoms and identity subgroups most at risk, in a HCW population in the United Kingdom (UK).Methods: An electronic survey was conducted between the 05/06/2020 and 31/07/2020 of all hospital HCW in the West Midlands, UK. Data on several exposure variables were collected. Prevalence rates of clinically significant symptoms of anxiety, depression and PTSD were measured using clinically validated questionnaires: Patient Health Questionnaire-4 (PHQ-4) anxiety and depression subscales, and the Impact of Event Scale-Revised (IES-R). Univariate analyses and adjusted logistic regression analyses were performed to estimate the strengths in associations.Findings: There were 2638 eligible participants who completed the survey (female 79·5%, median age 42 [IQR: 32-51] years). The prevalence rates of clinically significant symptoms of anxiety, depression and PTSD were high (34·3%, 31·2% and 24·5% respectively). In adjusted analysis a history of mental health conditions was associated with clinically significant symptoms of anxiety (odds ratio 2·3 [95% CI 1·9–2·7]; p< 0·001), depression (2·5 (2·1–3·0); p< 0·001) and PTSD (2·1 [1·7–2·5]; p< 0·001). The availability of adequate personal protective equipment (PPE), wellbeing support and lower exposure to moral dilemmas at work demonstrated significant negative associations with former symptoms. Whilst female gender was significantly associated with anxiety and PTSD symptoms, smoking was associated with depressive and PTSD symptoms.Interpretation: We report a high prevalence of clinically significant symptoms of anxiety, depression and PTSD in hospital HCW following the Covid-19 pandemic peak. Those with a history of mental health conditions were most at risk. Perceptions of adequate PPE availability, access to wellbeing support and reduced exposure to moral dilemmas may be protective against mental distress in hospital HCW.Funding: The University Hospitals Birmingham, Queen Elizabeth Hospital Charity covered all operational expenses incurred during this study.Declaration of Interests: None.Ethics Approval Statement: The study was approved by the UK Health Research Authority (HRA, Reference: 20/HRA/2865). Research ethics committee approval was not required by the HRA. Site specific approval was obtained from each of the research and development departments of all participating acute general (n=7) and mental health (n=3) NHS hospital Trusts. Informed consent was obtained from all participants and recorded electronically at the start of the study.