Covid-19 adding to 'high level of psychological distress' for healthcare staff, medics warn

Healthcare professionals are already exposed to high levels of burnout in Ireland. The coronavirus pandemic is likely to make this worse, a new article has warned. File Picture.

Medics have warned of a "high level of psychological distress among healthcare staff" due to the Covid-19 virus and pre-existing issues, such as burnout, in the Irish healthcare system.

In an article published in the Irish Medical Journal, medics led by Fiona McNicholas, Professor in Child Psychiatry at University College Dublin and Consultant Child and Adolescent Psychiatrist at Our Lady's Children Hospital Crumlin, compared the difficulties faced by healthcare workers during the Sars epidemic in 2003 and said the current coronavirus outbreak was likely to exacerbate those problems.

The article said: "Work-related stress  disproportionately affects healthcare workers and is linked to excessive workloads, working in emotionally charged environments and where demand outweighs capacity. 

"In Ireland, clinician-perceived lack of management and government support, coupled with unrealistic public expectations and cynicism about the possibility of change, compound the issue. 

Increased patient safety incidents, medical errors, lower-quality service provision, along with issues regarding staff retention and psychological ill-health follow.

During the Sars outbreak, which mainly affected Asian countries, half of healthcare workers experienced psychological distress, exacerbated by the risk of quarantine, job stress and the fear of contagion. 

Similar findings were reported by nurses in Ireland during preparations for a flu epidemic, the report said.

"Two aspects of the healthcare work during the Sars epidemic differentiated its psychological impact from other disasters. Importantly, both aspects resonate with the current pandemic, applying even to a greater extent.

"Firstly, the experience of social isolation: the necessity for interpersonal distancing, infection control procedures, diminished collegial social interaction and assignment to work in unfamiliar environments/with unfamiliar colleagues.

"Secondly, while family support is protective against occupational stress in the ‘ordinary’ course of events, in the context of a pandemic, staff with children experience increased psychological distress. 

"This is inferred to relate to the aforementioned fears of healthcare workers that may become ill and unable to care for or risk infecting their children. Both of these factors, prevalent in Covid-19, are likely to herald a high level of psychological distress among healthcare staff," the authors wrote.

Normal coping strategies such as social connections, exercise, and leisure time are severely restricted, they wrote, adding resources will be "more constrained" once the pandemic ends, "presenting a ripe breeding ground for burnout".

The mental health impact of COVID-19 will be significant, in terms of both new onset mental illness and deterioration of existing pathology, highlighting fundamental inequalities between our citizens. We need to do better and adequateky plan for this. https://t.co/jNEXEueiSg

— Fiona McNicholas (@McnicholasFiona) June 12, 2020

"The situation in Ireland, where healthcare workers have already been identified to report the highest rate of burnout, and pre-existing concerns of heath resource adequacy exist, make this an extremely concerning probability," they wrote.

It said psychological supports and training would help to "stress-proof" the working environment, warning that failing to do so could prompt a rise in absenteeism, further undermining the system.

The article said: "We have an ethical duty post-Covid-19 to reflect on the seismic and rapid work-related enforced changes and stressors, and the impact of these on staff well-being so that we can better equip ourselves for future disasters, unfortunately, likely to happen."