Longitudinal Impact of the COVID-19 Pandemic on Stress and Occupational Well-Being of Mental Health Professionals: An International Study

Cary S Kogan; José A Garcia-Pacheco; Tahilia J Rebello; Madeline I Montoya; Rebeca Robles; Brigitte Khoury; Maya Kulygina; Chihiro Matsumoto; Jingjing Huang; María Elena Medina-Mora; Oye Gureje; Dan J Stein; Pratap Sharan; Wolfgang Gaebel; Shigenobu Kanba; Howard F Andrews; Michael C Roberts; Kathleen M Pike; Min Zhao; José Luis Ayuso-Mateos; Karolina Sadowska; Karen Maré; Keith Denny; Geoffrey M Reed

doi:10.1093/ijnp/pyad046

Longitudinal Impact of the COVID-19 Pandemic on Stress and Occupational Well-Being of Mental Health Professionals: An International Study

Int J Neuropsychopharmacol. 2023 Oct 19;26(10):747-760. doi: 10.1093/ijnp/pyad046.

Authors

Cary S Kogan¹, José A Garcia-Pacheco², Tahilia J Rebello³, Madeline I Montoya¹, Rebeca Robles⁴, Brigitte Khoury⁵, Maya Kulygina⁶, Chihiro Matsumoto⁷, Jingjing Huang⁸, María Elena Medina-Mora⁹, Oye Gureje¹⁰, Dan J Stein^{11

12}, Pratap Sharan¹³, Wolfgang Gaebel¹⁴, Shigenobu Kanba¹⁵, Howard F Andrews¹⁶, Michael C Roberts¹⁷, Kathleen M Pike¹⁸, Min Zhao⁸, José Luis Ayuso-Mateos¹⁹, Karolina Sadowska³, Karen Maré¹¹, Keith Denny²⁰, Geoffrey M Reed²¹

Affiliations

¹ School of Psychology, University of Ottawa, Ottawa, Ontario, Canada.
² Centro de Investigación y Docencia Económica, Mexico City, Mexico.
³ Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.
⁴ Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
⁵ Department of Psychiatry, American University of Beirut Medical Center, Beirut, Lebanon.
⁶ Training and Research Centre, Mental-health clinic No.1 named after N.A. Alekseev, Moscow, Russian Federation.
⁷ Japanese Society of Psychiatry and Neurology, Tokyo, Japan.
⁸ Shanghai Mental Health Center and Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
⁹ Faculty of Psychology, National Autonomous University of Mexico and Center for Global Mental Health Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico.
¹⁰ WHO Collaborating Centre for Research and Training in Mental Health, Neuroscience, Drug and Alcohol Abuse, Department of Psychiatry, University of Ibadan, Ibadan, Nigeria.
¹¹ Department of Psychiatry, Neuroscience Institute, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Observatory, South Africa.
¹² SAMRC Unit on Risk and Resilience on Mental Disorders, Department of Psychiatry, University of Cape Town and Groote Schuur Hospital, Observatory, South Africa.
¹³ Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India.
¹⁴ Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.
¹⁵ Kyushu University, Fukuoka and Japan Depression Center, Tokyo, Japan.
¹⁶ Departments of Biostatistics and Psychiatry, Columbia University and New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, USA.
¹⁷ Clinical Child Psychology Program, University of Kansas, Lawrence, Kansas, USA.
¹⁸ Departments of Psychiatry and Epidemiology, Columbia University Irving Medical Center, New York, New York, USA.
¹⁹ Department of Psychiatry, Universidad Autónoma de Madrid, Instituto de Salud Carlos III, Centro de Investigacíon Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Investigacíon Sanitaria La Princesa, Madrid, Spain.
²⁰ Department of Sociology and Anthropology, Carleton University, Ottawa, Ontario, Canada.
²¹ Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA.

Abstract

Background: Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies have examined the effects of the pandemic on mental health professionals despite the heightened demand for their services.

Method: A multilingual, longitudinal, global survey was conducted at 3 time points during the pandemic among members of the World Health Organization's Global Clinical Practice Network. A total of 786 Global Clinical Practice Network members from 86 countries responded to surveys assessing occupational distress, well-being, and posttraumatic stress symptoms.

Results: On average, respondents' well-being deteriorated across time while their posttraumatic stress symptoms showed a modest improvement. Linear growth models indicated that being female, being younger, providing face-to-face health services to patients with COVID-19, having been a target of COVID-related violence, and living in a low- or middle-income country or a country with a higher COVID-19 death rate conveyed greater risk for poor well-being and higher level of stress symptoms over time. Growth mixed modeling identified trajectories of occupational well-being and stress symptoms. Most mental health professions demonstrated no impact to well-being; maintained moderate, nonclinical levels of stress symptoms; or showed improvements after an initial period of difficulty. However, some participant groups exhibited deteriorating well-being approaching the clinical threshold (25.8%) and persistently high and clinically significant levels of posttraumatic stress symptoms (19.6%) over time.

Conclusions: This study indicates that although most mental health professionals exhibited stable, positive well-being and low stress symptoms during the pandemic, a substantial minority of an already burdened global mental health workforce experienced persistently poor or deteriorating psychological status over the course of the pandemic.

Keywords: COVID-19; longitudinal design; mental health workforce; occupational well-being; posttraumatic stress symptoms.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Depression / psychology
Female
Humans
Male
Mental Health
Pandemics
SARS-CoV-2

Grants and funding

VR4-172750/CIHR/Canada