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Psychosocial impact of the COVID-19 pandemic on 4378 UK healthcare workers and ancillary staff: Initial baseline data from a cohort study collected during the first wave of the pandemic

Research output: Contribution to journalArticlepeer-review

Danielle Lamb, Sam Gnanapragasam, Neil Greenberg, Rupa Bhundia, Ewan Carr, Matthew Hotopf, Reza Razavi, Rosalind Raine, Sean Cross, Amy Dewar, Mary Docherty, Sarah Dorrington, Stephani Hatch, Charlotte Wilson-Jones, Daniel Leightley, Ira Madan, Sally Marlow, Isabel McMullen, Anne Marie Rafferty, Martin Parsons & 10 more Catherine Polling, Danai Serfioti, Helen Gaunt, Peter Aitken, Joanna Morris-Bone, Chloe Simela, Veronica French, Rachel Harris, Sharon A.M. Stevelink, Simon Wessely

Original languageEnglish
Pages (from-to)801-808
Number of pages8
JournalOccupational and Environmental Medicine
Issue number11
Early online date28 Jun 2021
Accepted/In press29 Mar 2021
E-pub ahead of print28 Jun 2021
Published1 Nov 2021

Bibliographical note

Funding Information: Funding NHS CHECK has received funding from the following organisations and charities for the period of data collection reported in this manuscript: National Institute for Health Research Maudsley Biomedical Research Centre, King’s College London; Rosetrees Trust; and the National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King’s College London. The funders had no role in the design, analysis, interpretation or decision to submit this paper. The joint first authors had full access to the data in the study and had final responsibility, with endorsement from the joint last authors (SW and SAMS), for the decision to submit the paper for publication. The views expressed are the views of the authors and do not necessarily represent the views of their organisations or funding sources. Funding Information: 3Academic Department of Military Mental Health, King’s College London, London, UK 4Department of Psychological Medicine, King’s College London, London, UK 5Department of Biostatistics and Health Informatics, King’s College London, London, UK 6National Institute of Health Research Biomedical Research Centre, London, UK 7Life Sciences and Medicine, King’s College London, London, UK 8Guy’s and St Thomas’ NHS Foundation Trust, London, UK 9Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK 10Adult Nursing, King’s College London, London, UK 11Mental Health Liaison Team, King’s College London, London, UK 12University Hospitals of Leicester NHS Trust, Leicester, UK 13Devon Partnership NHS Trust, Exeter, UK 14Avon & Wiltshire Mental Health Partnership NHS Trust, Bristol, UK 15Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK 16Cornwall Partnership Foundation NHS Trust, Cornwall, UK Acknowledgements We are especially grateful to all the participants who took part in the study. We would also like to extend our thanks to Haifa Issa, Dr Howard Burdett, Melanie Chesnokov, the medical students who helped to recruit participants at the research sites and all National Health Service (NHS) staff who promoted NHS CHECK. We would also like to thank the TIDES study team for their support and collaboration. RoR and DLa are supported by the National Institute for Health Research (NIHR) Applied Health Research North Thames (NIHR ARC North Thames). Funding Information: Competing interests RoR reports grants from DHSC/UKRI/ESRC COVID-19 Rapid Response Call, grants from Rosetrees Trust, grants from King’s Together rapid response call, grants from UCL (Wellcome Trust) rapid response call, during the conduct of the study; grants from Innovative Medicines Initiative and EFPIA, RADAR-CNS consortium, grants from MRC, grants from NIHR, outside the submitted work. SH reports grants from NIHR, grants from Wellcome Trust, grants from ESRC, grants from Guy’s and St. Thomas’ Charity, grants from MRC, grants from UKRI, outside the submitted work; and a member of the following advisory groups: The Health Foundation – COVID-19 Research Programme Panel, NHS England and NHS Improvement – Patient and Carers Race Equalities Framework (PCREF) Steering Group, NHS England and NHS Improvement – Advancing Mental Health Equalities Taskforce, Health Education England – Mental Health Workforce Equalities Subgroup, Maudsley Learning – Maudsley Learning Advisory Board, South London and Maudsley NHS Foundation Trust (SLaM) – Independent Advisory Groups, the SLaM Partnership Group, Lambeth Public Health – Serious Youth Violence Public Health Task and Finish Group, NHS England – Workforce Race Equality Standard Advisory Group, Thrive London – Thrive London Advisory Board, Black Thrive – Black Thrive Advisory Board. Commissions: Welsh Government’s Race Equality Plan; contribution to the evidence review for Health and Social Care and Employment and Income policy areas. SAMS reports grants from UKRI/ESRC/DHSC, grants from UCL, grants from UKRI/MRC/DHSC, grants from Rosetrees Trust, grants from King’s Together Fund, during the conduct of the study. NG reports a potential COI with NHSEI, during the conduct of the study; and the managing director of March on Stress Ltd, which has provided training for a number of NHS organisations although NG is not clear if the company has delivered training to any of the participating trusts or not as NG does not get directly involved in commissioning specific pieces of work. Publisher Copyright: © 2021 BMJ Publishing Group. All rights reserved.

King's Authors


Objectives: This study reports preliminary findings on the prevalence of, and factors associated with, mental health and well-being outcomes of healthcare workers during the early months (April-June) of the COVID-19 pandemic in the UK. Methods: Preliminary cross-sectional data were analysed from a cohort study (n=4378). Clinical and non-clinical staff of three London-based NHS Trusts, including acute and mental health Trusts, took part in an online baseline survey. The primary outcome measure used is the presence of probable common mental disorders (CMDs), measured by the General Health Questionnaire. Secondary outcomes are probable anxiety (seven-item Generalised Anxiety Disorder), depression (nine-item Patient Health Questionnaire), post-traumatic stress disorder (PTSD) (six-item Post-Traumatic Stress Disorder checklist), suicidal ideation (Clinical Interview Schedule) and alcohol use (Alcohol Use Disorder Identification Test). Moral injury is measured using the Moray Injury Event Scale. Results: Analyses showed substantial levels of probable CMDs (58.9%, 95% CI 58.1 to 60.8) and of PTSD (30.2%, 95% CI 28.1 to 32.5) with lower levels of depression (27.3%, 95% CI 25.3 to 29.4), anxiety (23.2%, 95% CI 21.3 to 25.3) and alcohol misuse (10.5%, 95% CI 9.2 to 11.9). Women, younger staff and nurses tended to have poorer outcomes than other staff, except for alcohol misuse. Higher reported exposure to moral injury (distress resulting from violation of one's moral code) was strongly associated with increased levels of probable CMDs, anxiety, depression, PTSD symptoms and alcohol misuse. Conclusions: Our findings suggest that mental health support for healthcare workers should consider those demographics and occupations at highest risk. Rigorous longitudinal data are needed in order to respond to the potential long-term mental health impacts of the pandemic.

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