Front-line COVID-19 caregivers face risks to their mental health, University of Utah study says

Doctors, nurses and first responders are at risk of stress, depression, anxiety, insomnia and alcohol abuse.

(Trent Nelson | Salt Lake Tribune file photo) Health care workers conduct COVID-19 testing at the University of Utah Health's Farmington Health Center on Friday, July 31, 2020. A new study, conducted in part by U. of U. Health scientists, find more than half of health care workers dealing with COVID-19 cases are also more at risk for mental health problems.

Front-line health care workers dealing with COVID-19 have another thing to worry about, according to a recent study: Risks to their mental health.

More than half of doctors, nurses and emergency responders who are involved in caring for COVID-19 patients could be at risk for such mental health problems as acute traumatic stress, depression, anxiety, problematic alcohol use and insomnia, a study led by scientists at University of Utah Health found.

“What health care workers are experiencing is akin to domestic combat,” said Andrew J. Smith, director of the U. Health Occupational Trauma Program at Huntsman Mental Health Institute and the study’s corresponding author, in a statement Tuesday.

Health care workers “aren’t necessarily going to develop PTSD,” Smith said, but “they are working under severe duress, day after day, with a lot of unknowns.”

Researchers found the risk of experiencing these mental health conditions were comparable to rates observed during such crisis events as Hurricane Katrina and the 9/11 terror attacks.

Charles C. Benight, co-author of the study and a professor of psychology at the University of Colorado, Colorado Springs, said in a statement, “front-line providers are exhausted, not only from the impact of the pandemic itself, but also in terms of coping day to day. … They’re trying to make sure their families are safe [and] they’re frustrated over not having the pandemic under control.”

For the study, researchers surveyed 98 hospital staff (doctors and nurses) and 473 emergency responders — firefighters, police officers and EMTs — in the Mountain West between April 1 and May 7, 2020. Overall, 56% of the respondents screened positive for at least one mental health disorder.

The study was conducted early in the pandemic, with a small sample size, and in a part of the country that wasn’t hit as hard by the pandemic at that point. The researchers are working on a larger version of the study, with health care workers they interviewed in late 2020.

The study appears in the Journal of Psychiatric Research. Besides U. Health and UC-Colorado Springs, researchers from the University of Arkansas for Medical Sciences, Central Arkansas VA Health Care System, Salt Lake City VA Healthcare System and the National Institute for Human Resilience (based at UC-Colorado Springs) took part in the study.

The study found a significantly increased risk of acute traumatic stress, anxiety and depression among health care workers who were exposed to the coronavirus or who were at greater risk of infection because they were immunocompromised. Finding those workers and offering them alternative roles, the researchers said, could reduce the anxiety, fear and sense of helplessness associated with becoming infected.

About 36% of the health care workers in the study reported risky alcohol use. In more typical circumstances, it’s estimated that 21% of physicians and 23% of emergency responders abuse alcohol.

One surprising finding in the study: The more COVID-19 cases the health care workers treated, the less anxious they felt.

“As these health care professionals heard about cases elsewhere before COVID-19 was detected in their communities, their anxiety levels likely rose in anticipation of having to confront the disease,” Smith said. “But when the disease started trickling in where they were, perhaps it grounded them back to their mission and purpose.”