Abstract
AbstractBackgroundThe National Health Service (NHS) is suffering from a workforce crisis of mental and physical sickness and attrition following the COVID-19 pandemic. An in-depth understanding of healthcare workers’ (HCWs) experiences during the pandemic is required to understand the impacts on their mental health in this challenging work environment. This qualitative study explores HCWs’ concerns during the COVID-19 pandemic - expressed in real-time during an active mental health crisis.DesignThis study involved analysis of data from “Shout”, a text message-based, UK-wide mental health support service which, during the pandemic, was advertised to HCWs specifically. Pseudo-random sampling of scripts of anonymised text message conversations between HCWs and Shout Volunteers from April 2020 – March 2021 was undertaken, with data fully anonymised by Shout before researchers accessed them on a secure purpose-built platform. Following application of exclusion and inclusion criteria, 60 conversations were coded to develop a thematic framework and analysed using grounded theory, with sub-themes triangulated to create final themes. Quotes extracted from this process were then synthesised for publication.ResultsThree themes emerged from the data: 1) Poor mental health, sub-themes: (a) overwhelming negative feelings or emotional distress experienced, and; (b) active crisis/resurgent symptoms. 2) Negative work experiences, sub-themes: (a) negative NHS work culture and expectations; (b) inadequate structures and arrangements for support; (c) trauma at work, and; (d) abuse at work. 3) The impact of the COVID-19 pandemic, sub-themes: (a) additional work pressure, and; (b) isolation and risk.ConclusionThis study explores the challenges and mental health concerns in HCWs during an active crisis. Organisational stressors, mental health provision and additional resources for HCWs to recover from the pandemic remain a vital issue in current NHS service provision.Strengths and limitationsThis study uniquely provides an analysis of HCWs’ mental health experience, recorded in real-time across the pandemic, thereby free from recall bias.The study analysed insights from a unique and valuable dataset of particularly vulnerable HCWs (i.e. those in active crisis) in their own words, enabling rich insight into the nature and circumstances of severe distress in HCWs.The individuals using the Shout text service are more likely to be in a severe mental health crisis and not therefore representative of the whole HCW community, but given the study is aligned with the principles of qualitative enquiry, we do not seek to be representative of, or generalizable to, the whole population.This paper is not able to represent the views of all HCW’s, and whilst we consider different groups of HCW’s in the body of the analysis, there are relatively small numbers in each group.
Publisher
Cold Spring Harbor Laboratory
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