Mental health symptoms in a cohort of hospital healthcare workers following the first 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 amongst healthcare workers (HCW). Aims We evaluated the prevalence of anxiety, depressive and post-traumatic stress disorder (PTSD) symptoms in a HCW population in the United Kingdom (UK), to identify subgroups most at risk. Methods An electronic survey was conducted between the 05/06/2020 and 31/07/2020 of all hospital HCW in the West Midlands, UK using clinically validated questionnaires: Patient Health Questionnaire-4 (PHQ-4) and the Impact of Event Scale-Revised (IES-R). Univariate analyses and adjusted logistic regression analyses were performed to estimate the strengths in associations. Results 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 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 ( p ≤0.001). Conclusions We report a high prevalence of clinically significant symptoms of anxiety, depression and PTSD in hospital HCW following the initial Covid-19 pandemic peak in the UK. Those with a history of mental health conditions were most at risk. Adequate PPE availability, access to wellbeing support and reduced exposure to moral dilemmas may protect hospital HCW from mental health symptoms. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The University Hospitals Birmingham Charity covered the operational expenses incurred during this study (Remittance Reference No: C05976). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the UK Health Research Authority (HRA, Reference: 20/HRA/2865). Research Ethics Committee approval was not required for this study and this was confirmed by the HRA. Site specific approval was obtained for participant recruitment from each of the research and development departments of all participating hospital Trusts (University Hospitals Birmingham NHS Foundation Trust, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham Women's and Children's Hospital NHS Trust, Royal Wolverhampton Hospital NHS Trust, Walsall Healthcare NHS Trust, Dudley Group of Hospitals NHS Trust, University Hospital Coventry and Warwickshire NHS Trust, Coventry and Warwickshire Partnership NHS Trust, Black Country Mental Health Partnership Trust, Birmingham and Solihull Mental Health NHS Trust). Informed consent was obtained from all participants and recorded electronically at the start of the study. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All relevant data and results included in this article have been published along with the article and its supplementary information files. Anonymised data can be obtained on reasonable request from the corresponding author at the end of the STAT-STRESS Covid-19 study.