Mental health of intensive care staff should be immediate priority

A new study led by UCL and King’s College London on staff working in intensive care units (ICUs) has highlighted almost half of staff are likely to meet the threshold for PTSD, severe anxiety or problem drinking.

The researchers surveyed staff working in ICUs in nine English hospitals during June and July 2020, to explore depression, anxiety symptoms, symptoms of post-traumatic stress disorder (PTSD), well-being and alcohol use.

The seven hundred and nine participants, included 291 (41%) doctors, 344 (49%) nurses and 74 (10%) other healthcare staff. Over half (59%) reported good well-being; however, 45% met the threshold for probable clinical significance on at least one of the following measures: severe depression (6%), PTSD (40%), severe anxiety (11%) or problem drinking (7%).

The study, published in Occupational Medicine, shows the impact of working in critical care during the COVID-19 pandemic. The researchers found poor mental health was common in many ICU clinicians although they were more pronounced in nurses than in doctors or other healthcare professionals.

Professor Kevin Fong (UCL STEaPP), a UCLH consultant and National Clinical Advisor with NHS England’s Emergency Preparedness Resilience and Response team for COVID-19, who was a senior author on the paper, said: “This collaboration between KCL Institute of Psychiatry and UCL’s STEaPP has proved to be a genuinely important piece work. Coping with COVID has come at enormous cost to our frontline NHS staff. I have visited intensive care units up and down the country, and spent time working with my own teams at UCLH. Covid is like nothing we’ve ever seen before and has seen us stretch ourselves to the very limits of what can be done.

 “The effort had been nothing short of remarkable but we need to think carefully about how we protect our staff now and rest and recover them in the aftermath.” 

Lead author, Professor Neil Greenberg, from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King’s College London said: “Our results show a substantial burden of mental health symptoms being reported by ICU staff towards the end of the first wave in July and July 2020. The severity of symptoms we identified are highly likely to impair some ICU staff’s ability to provide high quality care as well as negatively impacting on their quality of life.

“The high rate of mortality amongst COVID-19 patients admitted to ICU, coupled with difficulty in communication and providing adequate end-of-life support to patients, and their next of kin because of visiting restrictions, are very likely to have been highly challenging stressors for all staff working in ICUs.”

The work was funded by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response at King’s College London in partnership with Public Health England (PHE), in collaboration with the University of East Anglia and Newcastle University. 

Read the full paper in Occupational Medicine here