Health care workers in England experience PTSD at twice the rate of general public
New research led by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London in collaboration with the NIHR ARC North Thames at University College London and NHS Trusts across England, has found that health care workers (HCWs) experience post-traumatic stress disorder (PTSD) at twice the rate of the general public.
The research, published in The Lancet Psychiatry, was conducted as part of a study to establish a more accurate prevalence of mental disorders within the NHS workforce. The study also found that 1-in-5 HCWs met the threshold for diagnosable illnesses like depression and anxiety.
Researchers recruited participants from the NHS CHECK study, the U.K.'s largest survey of the mental health and well-being of all NHS staff during COVID-19. More than 23,000 participants completed commonly used self-report measures that look for symptoms of common mental disorders (CMDs) like depression and anxiety as well as PTSD.
This particular study reported on diagnostic interviews with two smaller groups of HCWs, which were broadly representative of NHS staff overall in terms of ethnicity, age, sex and clinical role. 243 participants were surveyed to establish the prevalence of CMDs, while a further 94 helped to establish PTSD prevalence.
While there have been many studies of the mental health of HCWs, especially since the pandemic, the vast majority of these have relied on self-reported screening tools that often over-estimate prevalence of mental disorder. Most of these studies have reported highly elevated, and highly varied, rates of CMD and PTSD. In this study, trained professionals carried out interviews and assessed participants against diagnostic criteria that are considered the gold standard for accurately diagnosing mental disorders.
Researchers found that self-reporting screening measures showed very high prevalence of CMDs and PTSD (52.8% and 25.4% respectively), the diagnostic interview showed the prevalence to be considerably lower—21.5% for CMDs and 7.9% for PTSD. While it is a significant drop, researchers say that these lower and more accurate figures still show that more than 1-in-5 HCWs have a diagnosable mental disorder with rates of PTSD being around double those found amongst the general public.
"Our study has established a more accurate prevalence of PTSD and common mental disorders among all health care workers, not only frontline staff, by using gold standard diagnostic interviews. While it is good news that fewer HCWs have a diagnosable mental disorder than the screening measures have previously suggested, our findings more definitively indicate that many HCWs could benefit from a clinical intervention," says Dr. Sharon Stevelink, the study's joint first author and a Senior Lecturer in Epidemiology at King's IoPPN.
The research suggests that this more accurate picture of prevalence means that resources and therapies can be directed to those most in need.
Professor Simon Wessely joint senior author, and Regius Professor of Psychiatry from King's IoPPN said, "We are not suggesting that those participants who did not meet the criteria for a diagnosable disorder were not in need of any care. However, peer- and team-based interventions can be preferable for effectively helping to manage distress. This then frees up capacity to provided more targeted support for those in greater need."
Professor Neil Greenberg, joint senior author, and a Professor of Defense Mental Health at King's IoPPN said, "These results thankfully show that the often scary rates of common mental disorders and PTSD, reported in less well constructed studies, are inaccurate. It is important to distinguish between the large numbers of NHS staff who may be experiencing distress, and the smaller, but still very important numbers, who are likely to benefit from professional care.
"The NHS should not ignore these results, which show that a sizeable proportion of NHS staff have diagnosable mental health conditions, and are likely be functionally impaired, increasing the likelihood of poor care delivery, accidents, and other undesirable outcomes for patients, themselves, and colleagues."
The NHS CHECK team is currently preparing to follow-up the HCWs who took part in NHS CHECK, to determine changes in our cohort's mental health, and assess the impact of the ongoing pressures of the COVID-19 pandemic alongside a push to deal with the backlog of patients.
"Prevalence of post-traumatic stress disorder and common mental disorders in healthcare workers in England during the COVID-19 pandemic: a two-phase cross-sectional study" was published in The Lancet Psychiatry.
More information: Hannah R Scott et al, Prevalence of post-traumatic stress disorder and common mental disorders in health-care workers in England during the COVID-19 pandemic: a two-phase cross-sectional study, The Lancet Psychiatry (2022). DOI: 10.1016/S2215-0366(22)00375-3