Impact of the COVID-19 pandemic on the mental health and wellbeing of UK healthcare workers

James Gilleen, Aida Santaolalla, Lorena Valdearenas, Clara Salice, Montserrat Fuste

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The COVID-19 pandemic has placed healthcare workers (HCW) under considerable burden. The study objective was to meet the urgent need to understand the psychological impact of the pandemic on UK HCW and identify the factors which raised risk of, or protected against, poor mental health.


The study reports baseline survey data from a prospective cohort design. The survey contained validated scales of anxiety, depression, PTSD, and stress, and gathered information about roles, workplace, and COVID-19-related factors including COVID-19 preparation and workplace risk management.


2773 UK HCWs completed the survey between 22ndApril and 10th May 2020.

Main outcome measures

Using established criteria, respondents were classified as high or low symptomatic on each symptom scale and logistic regressions were conducted to reveal explanatory models of risk and protective factors. Change in wellbeing from pre to during COVID-19 was also quantified and mental health symptom severity of key HCW subgroups was compared.


A large proportion of UK HCW reported high levels of mental health symptoms. Specific clusters of factors conferred risk of high symptoms. ‘Fixed’ factors included being female, being FL, pre-existing mental health diagnosis, and experience of stressful/traumatic events. An additional set of ‘controllable’ factors also significantly increased risk of high symptoms: PPE availability, workload, lack of COVID-19 preparation, training, and communication of clinical procedures. Resilience and sharing stress reduced risk, as did ethics panel support for those making decisions about patient treatment. Allied HCW and especially managers were at risk of high symptoms, particularly PTSD. BAME HCWs were significantly at risk of high PTSD and were more worried than non-BAME about COVID and PPE. Wellbeing across the cohort, but particularly of frontline workers (FL), had significantly worsened compared to pre-COVID-19 levels.


Poor mental wellbeing was prevalent in HCW during the UK COVID-19 response. A number of ‘controllable’ factors including reducing perception of preventable risk should be targeted, and protective factors promoted, to reduce the detrimental effect of COVID-19 and other pandemics on HCW mental health.

© 2021, CUP. This is an author produced version of a paper published in BJPsych Open uploaded in accordance with the publisher’s self- archiving policy. The final published version (version of record) is available online at the link. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
Original languageEnglish
JournalBJPsych Open
Publication statusPublished - 29 Apr 2021


  • COVID-19
  • Coronavirus
  • Wellbeing
  • Healthcare Workers
  • Anxiety
  • Depression
  • PTSD

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