Article Text

NHS staff mental health status in the active phase of the COVID-19 era: a staff survey in a large London hospital
  1. Ikenna David Ike,
  2. Matthieu Durand-Hill,
  3. Eiman Elmusharaf,
  4. Nicole Asemota,
  5. Elizabeth Silva,
  6. Elliott White and
  7. Wael I Awad
  1. Department of Cardiothoracic Surgery, St Bartholomew's Hospital, London, UK
  1. Correspondence to Dr Wael I Awad; wael.awad{at}


Background Experiencing a pandemic can be very unsettling and may have a negative impact on the mental health of frontline healthcare workers (HCWs). This may have serious consequences for the overall well-being of HCWs, which in turn may adversely affect patient safety and the productivity of the institution.

Aims We designed a study to assess the prevalence of generalised anxiety disorder (GAD), depression and work-related stress experienced by the National Health Service staff in a large tertiary London hospital treating patients with COVID-19 during the current active phase of the COVID-19 era.

Methods An anonymous survey was designed with demographic data and three questionnaires. The Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 were used to assess anxiety and depression, respectively. The Health and Safety Executive Management Standards Indicator Tool was used to assess work-related stress. Staff from multiple specialties embracing cardiothoracic surgery, cardiology, respiratory medicine, endocrinology, oncology, imaging, anaesthesia and intensive care at our hospital were asked to complete the questionnaire between 25 May and 15 June 2020.

Results A total of 302 staff members (106 males and 196 females) completed the survey. The overall prevalence of GAD and depression was 41.4% and 42.7%, respectively. The prevalence of GAD and depression was significantly higher in females than in males and was statistically significant. Nurses were four times more likely to report moderate to severe levels of anxiety and depression as compared with doctors. Work-related stress was also observed to be prevalent in our surveyed population with the following standards: relationships, role, control and change showing a need for improvement.

Conclusions Our study presents early evidence suggestive of a high prevalence of GAD, depression and work-related stress in HCWs. It is imperative that coherent strategies are implemented to improve the healthcare work environment during this pandemic and mitigate further injury to the mental health status of the healthcare population.

  • mental health
  • anxiety
  • depression
  • stress disorders
  • post-traumatic

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  • Contributors WIA introduced the concept. IDI, MD-H, EE and WIA designed the study. IDI, MD-H, EE and WIA did the literature search. IDI, MD-H, EE, NA and WIA supervised the study and data collection. IDI and MD-H analysed and interpreted the data. IDI, MD-H and NA wrote the first draft. ES, EW and WIA suggested improvements. IDI, MD-H, EE and NA wrote the final draft. IDI, MD-H and EE made the tables. IDI and WIA reviewed the manuscript. WIA supervised the publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was registered with the Integrated Research Application System (IRAS project ID: 282914) and reviewed by the Health Research Authority (HRA) and local Research Ethics Committee and did not require ethical approval, as participation was voluntary and the completed surveys were anonymised. The study was also approved by the Barts NHS Trust Quality Improvement Committee (ID 11259).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Please contact corresponding author if data are required.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.