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Health Care Workers Mental Health Struggle During an Outbreak

Dianne Montano

California State University, Channel Islands

HLTH 499 Section 002

Dr. Ashley Winans

February 5, 2021
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Mental health has not always been the main priority for those in the healthcare system.

However, in recent years the pandemic has caused a halt on many people’s lives with

unprecedented lockdowns, separation from friends and family, and financial instability. The

pandemic has been recorded to have an increase in reports of stress, anxiety, fear, sadness, and

loneliness. Any epidemic/pandemic outbreak has affected many populations’ mental health,

especially health care workers as they have first-hand experience addressing the public health

concern. Health extends further than the absence of illness or disease yet mental health is often

neglected despite being another layer of health, especially by health care workers themselves.

There are unintentional short and long-term effects on their mental health that seems to be on a

rise. During the pandemic, I have witnessed the deterioration of the mental health of those

around me. Continuing to not address the issue of assessing mental health among healthcare

workers, would lead to devastating results. The healthcare system neglect is slowly coming to

end, but has the damage already been done?

In general, after an epidemic/pandemic outbreak has occurred, healthcare workers tend to

report higher levels of psychological issues that impact their mental health. This is due to

situations requiring healthcare workers to respond immediately either directly or indirectly.

Healthcare workers are the first ones responding and delivering care to patients, often referred to

as ‘frontliners’. The rigorous demand of treating numerous patients with the potential risk of

getting infected themselves increases the risk for psychological issues that can last over an

extended amount of time. Evidence shows that healthcare workers face psychological and mental

health issues such as post-traumatic stress, depression, insomnia, severe anxiety, and high-stress

levels. Healthcare workers have “reported post-traumatic stress symptoms (11–73.4%),

depressive symptoms (27.5–50.7%), insomnia (34–36.1%), severe anxiety symptoms (45%),

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general psychiatric symptoms (17.3–75.3%), and high levels of work-related stress (18.1–80.1%)

(Preti et al. 2020, p. 43). Healthcare workers’ mental health is constantly at risk during and after

an outbreak. There is a relevant psychological impact on their mental health when responding to

outbreaks. Our healthcare system relies heavily on the frontliners, but if conditions persist then

the whole system is at risk of collapsing in on itself. The study retrieved data from healthcare

workers after the large epidemics, with most of the psychological effects seen after the SARS

outbreak. There were a sparse amount of studies surrounding the mental health of healthcare

workers before the current pandemic which further shows the neglect of mental health as a part

of health. Only recently did mental health become a priority for the healthcare system, and many

of the studies address the negligence of mental health of health care workers in the past.

The current pandemic is caused by the widespread virus SARS-CoV-2 otherwise known

as COVID-19 or COVID. The COVID-19 pandemic has impacted over 11 million people’s lives,

resulting in over 200 thousand deaths in the United States alone. There have been many

strategies and policies put into place to combat the pandemic, many without lasting results. The

constant stream of patients, overcrowding in ICUs, shortage of personal protective equipment,

and high potential of contraction are all factors that healthcare workers have to face. Each having

a stronger impact on their mental health. All of these are considerable psychological pressures

that healthcare workers are having right now while addressing COVID. When looking at the

specific effects of the current pandemic, there are similar, if not higher reports of psychological

problems. Healthcare workers that are currently addressing the COVID-19 virus, have “the

lowest reported prevalence of anxiety, depression, and stress [were ] 24.1%, 12.1%, and 29.8%,

respectively” (Vizheh et al., 2020, p. 1967). Pappa et al. (2020) also found a prevalence of

anxiety (23.2 %), depression (22.8%), and insomnia (38.9%). As seen there are common
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symptoms/displays of symptoms that negatively affect healthcare workers, especially when

dealing with the virus. The healthcare system can report the rates of prevalence, yet there is little

access to actual consultation for healthcare workers’ mental health. Mental health issues should

be the immediate priority and focus on intervention methods.

Few studies focus on intervention and prevention strategies made to protect healthcare

workers and their mental health. However, the current pandemic has led to an uproar of studies

and research in ways to properly protect healthcare workers. It is seen that when provided with

adequate protective measures, their risk perception is lower, and this could result in lower

adverse psychological outcomes (Preti et al. 2020). As the spread of COVID-19 continues to

rise, health care workers are starting to become fatigued by the burden they face psychologically.

Certain interventions are being proposed and implemented to aid healthcare workers. Albott et

al. (2020) found that early prevention can be focusing on basic physiological and self-care,

starting with adequate sleeping. Followed by engaging in cognitive and emotional stress

inoculation which allows healthcare workers to pinpoint anticipating, planning, and deterring

which helps prepare workers for the specific stressors they will be facing. It addresses the

traumatic experiences that healthcare workers are not always going to be fixed by following this

method but it is a start.

Certain studies propose incorporating resilience intervention as a way to battle the

onslaught of mental issues that arise when addressing an outbreak (Albot et al. 2020; Pollock et

al. 2020). The main purpose of resilience intervention is to maintain their sense of

“physiological well-being, self-efficacy, and hope, so they can continue to do their work in the

midst of a crisis and to emerge without posttraumatic stress reactions or burnout” (Albott et al.,

2020, p. 6). The premise that if healthcare workers can identify the stressors early on, they may
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become resistant to the negative psychological impact that it may have and continue to work

without negative symptoms. The issue with resilience intervention is that “is limited empirical

evidence about interventions that protect the mental health” for healthcare workers. Mental

health is different because it is not a ‘visible’ illness/ disease, therefore it's more difficult to prove

the effectiveness of the intervention. Pollock et al. (2020) further support this by addressing the

“lack of both quantitative and qualitative evidence from studies ...that can inform the selection of

interventions that are beneficial to the resilience and mental health of frontline workers.”

Healthcare workers need to have the ability to cope with the negative mental issues that emerge

during/after an outbreak, but it will be a while to know how effective the resilience interventions

are.

Mental health has often been neglected, especially among healthcare workers. The

current pandemic caused a chain reaction for the healthcare system to increase the amount of

research and ways to help protect healthcare workers and lessen the burden they may face

psychologically. Healthcare workers are crucial in responding to outbreaks, and when faced with

potentially psychological negative consequences that are detrimental to healthcare workers, but

also the public health as their ability to effectively deliver care to patients is halted. An outbreak

demands healthcare works to constantly place themselves in situations with a high risk of

infection, inadequate protection, overworking, frustration, discrimination, along other factors.

The current pandemic forcing them into further isolation as they can not have contact with

families and friends. The main priority for the healthcare system is to address the mental health

and psychological impacts that health care workers face as they have neglected to do so in

previous years. The implementation of prevention strategies is slowly showing progress, but the

full impact is still unknown due to how recently it has been introduced.
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References

Albott, C. S., Wozniak, J. R., McGlinch, B. P., Wall, M. H., Gold, B. S., & Vinogradov, S.

(2020). Battle buddies: Rapid deployment of a psychological resilience intervention for

health care workers during the COVID-19 pandemic. Anesthesia & Analgesia, 131(1),

43–54. https://doi.org/10.1213/ane.0000000000004912

Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020).

Prevalence of depression, anxiety, and insomnia among healthcare workers during the

COVID-19 pandemic: A systematic review and meta-analysis. Brain, Behavior, and

Immunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020.05.026

Pollock, A., Campbell, P., Cheyne, J., Cowie, J., Davis, B., McCallum, J., McGill, K., Elders, A.,

Hagen, S., McClurg, D., Torrens, C., & Maxwell, M. (2020). Interventions to support the

resilience and mental health of frontline health and social care professionals during and

after a disease outbreak, epidemic or pandemic: a mixed methods systematic review.

Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd013779

Preti, E., Di Mattei, V., Perego, G., Ferrari, F., Mazzetti, M., Taranto, P., Di Pierro, R., Madeddu,

F., & Calati, R. (2020). The psychological impact of epidemic and pandemic outbreaks

on healthcare workers: Rapid review of the evidence. Current Psychiatry Reports, 22(8).

https://doi.org/10.1007/s11920-020-01166-z

Vizheh, M., Qorbani, M., Arzaghi, S. M., Muhidin, S., Javanmard, Z., & Esmaeili, M. (2020).

The mental health of healthcare workers in the COVID-19 pandemic: A systematic

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https://doi.org/10.1007/s40200-020-00643-9