MeCare: Caring for the carers

Healthcare worker wearing a face mask

The MeCare study is investigating the impact of the COVID-19 pandemic on the mental health and wellbeing of frontline healthcare workers and questions if the support available is fit for purpose.

The impact of the pandemic on the mental health of healthcare workers has been significant. As NHS staff work through another demanding winter, the backlog of unmet need among waiting patients continues to grow. While the vaccination programme remains the primary “route out of the pandemic,” attention needs to pivot to the needs of those expected to deliver care to others: healthcare workers.

Measuring the impact

Within this challenging environment, the ARC Northwest London Mental Health and Multimorbidity theme, based at Imperial College London conducted a study among NHS staff to provide data to achieve that understanding. Baseline findings from the second wave of the pandemic demonstrate the deleterious impact of the pandemic on staff. Of the 1,065 respondents to the online survey of clinical and non-clinical staff working in community and acute NHS settings, over half exceeded the score for a probable mental disorder, with approximately 30% likely to have anxiety or depression. Over 50% of participants scored 5 - 8 out of 10 for physical and emotional exhaustion, and nearly one in five scored 9 or 10.

Senior managers should devote attention to if and how their colleagues at the frontline of combating the impact of the virus have been physically, and importantly mentally, affected, asking themselves key questions: To what extent have our staff been impacted? Are the support services we offer fit for purpose, being accessed by those who need them, and having the desired effect in helping staff overcome the problems they encountered? What should future interventions look like to ensure they can return to, and fully function in, the workplace? Ensuring mental health and wellbeing challenges are identified and addressed effectively is premised on understanding the lived experience of staff members.

The worrying mental health burden

Additionally, around 30% reported post-traumatic stress disorder (PTSD) symptoms. Worryingly, a comparable percentage had experienced suicidal thoughts, with one in ten reporting suicidal ideation in the last two months. Over 30% were likely to have occupational burnout, and a level of fatigue that was not only greater than usual (67%) but which, for over half of respondents, interfered with their ability to work. Whilst survey respondents were not necessarily representative of all front-line workers, these figures nonetheless suggest a significant mental health burden in the NW London region needs to be addressed as part of a recovery plan.

The study also looked at some factors that might influence the likelihood of developing mental health problems and help seeking. It found that those staff with poor social connectedness – those who felt less supported by family or friends, or who perceived that people treated them negatively due to working in a care setting - and who perceived that the care they were delivering was poor quality had the worst mental health. These are both factors that could potentially be changed at an organisational level. Thirty percent of respondents were using or had used some form of staff support service – wellbeing activities, such as mindfulness, therapy or counselling, or other employee assistant programmes. Among these, just under two-thirds used wellbeing services, and only approximately one-fifth used employee assistance programmes.

Making 'difficult chocies'

As Dr Dasha Nicholls [pictured right], lead for the Mental Health and Multimorbidity theme at the NIHR ARC Northwest London, and Principal Investigator of the study, commented:

“These results show that NHS workers might be particularly affected by fears of infection transmission, disruption of normal supportive structures, and work stress. Many will have to make difficult choices to deliver care they know is not necessarily the best, explain difficult decisions to relatives, or make decisions that jar with their personal values.”

The study, which is ongoing, focuses on the short- and medium-term psychological impact of the pandemic on North-West London NHS staff, identifying psychosocial indicators of resilience and vulnerability, and evaluating the effectiveness of staff support programmes offered through employer organisations. Data collection is being repeated at 3, 12 and 18 months, to see how staff feel over time and what is helping or not.

“The study promises to provide very rich data on vulnerable staffing groups by role, socio-economic status and ethnicity,” added Dr Nicholls. “Further research is needed to explore how the psychological burden of providing care during the pandemic changes over time.”


For further information on the study, visit the MeCare Study page.

Dr Dasha Nicholls