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The mental health of staff working in intensive care during COVID-19
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DOI：10.1101/2020.11.03.20208322.png)
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Abstract
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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>Intensive Care Unit (ICU), anaesthetic and theatres staff have faced significant challenges during the COVID-19 pandemic which have the potential to adversely affect their mental health</jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p>To identify the rates of probable mental health disorder in ICU and anaesthetic staff in six English hospitals during June and July 2020</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>An anonymised brief web-based survey comprising standardised questionnaires examining depression, anxiety symptoms, symptoms of Post Traumatic Stress Disorder (PTSD), wellbeing and alcohol use was administered to staff.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>709 participants completed the surveys comprising 291 (41%) doctors, 344 (48.5%) nurses, and 74 (10.4%) other healthcare staff. Over half (58.8%) reported good wellbeing, however 45.4% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6.3%), PTSD (39.5%), severe anxiety (11.3%) or problem drinking (7.2%). 13.4% of respondents reported frequent thoughts of being better off dead, or of hurting themselves in the past two weeks. We found that doctors consistently reported better mental health than nurses.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>We found substantial rates of probable mental health disorders, and thoughts of self-harm, amongst ICU staff; these difficulties were especially prevalent in nurses. These results indicate the need for a national strategy to protect the mental health, and decrease the risk of functional impairment, of ICU staff whilst they carry out their essential work during COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Occ Med Statements: article should contain 3 statements (each max of 3 bullets of max 50 words each)</jats:title><jats:sec><jats:title>What is already known about this subject</jats:title><jats:list list-type="bullet"><jats:list-item><jats:p>Intensive care unit (ICU) staff are regularly exposed to traumatic situations as part of their job</jats:p></jats:list-item><jats:list-item><jats:p>Previous studies have shown them to be at risk of psychological and moral distress</jats:p></jats:list-item><jats:list-item><jats:p>Little is known about the mental health of ICU staff during the current pandemic</jats:p></jats:list-item></jats:list><jats:sec><jats:title>What this study adds</jats:title><jats:list list-type="bullet"><jats:list-item><jats:p>Almost half of ICU staff report symptoms consistent with a probable diagnosis of post traumatic stress disorder, severe depression or anxiety or problem drinking</jats:p></jats:list-item><jats:list-item><jats:p>Around 1 in 7 ICU staff report recent thoughts of self-harm or of wanting to be better off dead</jats:p></jats:list-item><jats:list-item><jats:p>Nursing staff are more likely to report higher levels of distress than doctors or other clinical staff</jats:p></jats:list-item></jats:list><jats:sec><jats:title>What impact this may have on practice or policy</jats:title><jats:list list-type="bullet"><jats:list-item><jats:p>Healthcare managers need to prioritise staff mental health support and timely access to evidence based treatments for ICU staff</jats:p></jats:list-item><jats:list-item><jats:p>Supervisors and managers should be aware that a substantial proportion of ICU staff may perform less well because of their current poor state of mental health</jats:p></jats:list-item><jats:list-item><jats:p>More work is needed to understand whether the high levels of mental health symptoms identified in this study are truly indicative of high levels of clinical need for mental healthcare</jats:p></jats:list-item></jats:list></jats:sec></jats:sec></jats:sec></jats:sec>
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