How Did COVID-19 Affect the Mental Health of Healthcare Workers in China?

What you need to know

• Over half of frontline healthcare workers in China experienced high levels of stress symptoms during the early COVID-19 outbreak
• Physical symptoms, emotional exhaustion, and fear of infection were associated with higher stress levels
• Healthcare workers reported not receiving adequate psychological support and resources to cope with the challenges

The mental health toll on healthcare workers

Healthcare workers on the frontlines of the COVID-19 pandemic faced enormous stress and pressure, especially in the early stages of the outbreak. This study surveyed 1,163 healthcare workers in China between February 18 and March 4, 2020, to assess their mental health and identify factors associated with higher stress levels.

The researchers found that 58.1% of healthcare workers showed clinically significant levels of peritraumatic stress symptoms (PTSS). PTSS refers to stress reactions that occur during or immediately after a traumatic event. Some key findings include:

• 78.7% reported at least one physical symptom like headaches or chest discomfort
• 77.9% experienced psychological symptoms like fear, depression or irritability
• 57.3% felt emotionally exhausted
• Only 37.9% reported their overall health as good

Healthcare workers who reported more physical and psychological symptoms tended to have higher stress levels. Those who felt unable to release tension or vent their emotions also showed increased stress.

Factors associated with higher stress

The study identified several factors that were linked to higher PTSS scores:

• Number of physical and psychological symptoms experienced
• Emotional exhaustion and depersonalization (feeling detached)
• Feeling unable to release tension or vent emotions
• Fear of becoming infected

Interestingly, working longer hours (over 8 hours per day) was associated with lower stress levels. The researchers suggest this may be because staying busy provided some distraction from worries.

Healthcare workers with senior professional titles also tended to have lower stress scores. This could be due to more experience helping them cope better with the challenges.

Gaps in support and resources

An important finding was that many healthcare workers felt they did not receive adequate support and resources to deal with the pressures they faced. Some key gaps included:

• Insufficient psychological services and mental health support
• Lack of places to rest and release tension
• Not enough personal protective equipment and infection control measures
• Inadequate economic compensation

The actual support received was lower than what healthcare workers felt they needed across all categories. The biggest gaps were in psychological services and family security/support.

Unique challenges for healthcare workers

The study highlights some of the unique mental health challenges faced by healthcare workers during a pandemic:

• Frequent exposure to death and trauma
• Fear of becoming infected themselves or infecting family members
• Feeling overwhelmed by the suffering they witnessed
• Physical exhaustion from long work hours in challenging conditions
• Lack of time and resources for self-care and stress relief

Healthcare workers may be reluctant to seek mental health support due to stigma or feeling they need to stay strong for patients. But suppressing emotions can worsen stress over time.

Recommendations for supporting healthcare workers

Based on the findings, the researchers recommend several ways to better support the mental health of frontline healthcare workers during pandemics:

• Regular screening and early intervention for stress symptoms
• Providing adequate personal protective equipment and infection control measures
• Ensuring sufficient rest periods and places to decompress
• Offering accessible psychological services tailored to healthcare workers’ needs
• Financial compensation and family support
• Training in stress management and emotional coping skills
• Creating a supportive work culture that normalizes discussing mental health

They emphasize the importance of a comprehensive approach that addresses both the practical needs (equipment, compensation) and psychological needs of healthcare workers.

Long-term mental health impacts

While this study looked at stress reactions in the early stages of the pandemic, the researchers note that healthcare workers may be at risk of longer-term mental health impacts. Without adequate support and treatment, acute stress can develop into chronic conditions like post-traumatic stress disorder (PTSD).

Ongoing monitoring of healthcare workers’ mental health, even after the immediate crisis has passed, is important. So is researching the most effective ways to prevent and treat pandemic-related trauma in this population.

Conclusions

• A high percentage of frontline healthcare workers in China experienced significant stress symptoms during the early COVID-19 outbreak
• Physical health, emotional exhaustion, and fear of infection were key factors associated with stress levels
• There were major gaps between the support healthcare workers received and what they felt they needed
• A comprehensive approach addressing both practical and psychological needs is necessary to protect healthcare workers’ mental health during pandemics