key: cord-027759-5mz0qlwq
authors: Zhou, Anli Yue; Panagioti, Maria
title: Mental health and the medical profession during the COVID-19 pandemic
date: 2020-06-01
journal: Occup Med (Lond)
DOI: 10.1093/occmed/kqaa076
sha: 
doc_id: 27759
cord_uid: 5mz0qlwq

nan

The coronavirus disease (COVID-19) pandemic threatens to overwhelm well-established healthcare systems, and medical professionals have to work under extreme pressures and uncertainty [1, 2] . In general, medical professionals have been found to experience higher levels of distress and burnout [3] . The COVID-19 pandemic is having an overwhelming psychological impact on medical professionals involved in the care of COVID-19 patients [4] . Front-line staff such as doctors involved in diagnosis, treatment and care are particularly vulnerable to negative mental health outcomes [4] .

Perpetuating factors include the feelings of vulnerability and loss of control, stigmatization, the uncertainty around infection risk and their own health as well as perception of personal danger due to the high mortality rate that is associated with COVID-19 [2, [5] [6] [7] . Furthermore, the perception of fear and vulnerability is also likely to be perpetuated by concerns around personal protective equipment [8] .

Healthcare organizations are recognizing how mental health problems can impact on the quality of healthcare [1, 9] and there have been suggestions to provide ongoing remote psychological support for front-line staff [9, 10] . Clear communication and regular updates on the COVID-19 situation may help alleviate any uncertainty amongst medical staff [2] . Evidence generated during the Severe Acute Respiratory Syndrome (SARS) outbreak suggests that doctors use planning and problem-solving as coping mechanisms [5] . Health organizations with in-house occupational health services can also contribute by producing clear COVID-19 policies and procedures in the healthcare settings so that staff are appropriately prepositioned and prepared [11] . The multidisciplinary nature of in-house occupational health departments can be a source of psychological support for distressed medical staff alongside other services that may be available to front-line staff such as the recently implemented mental health hotline [12] .

There is focus on COVID-19 research at present; however, there is still much to learn about this disease and its mental health impact on medical staff. The major causes of negative health outcomes in healthcare workers during the COVID-19 pandemic are likely to be similar to those observed during the past SARS epidemic [5, 7] . Thus, some preventative actions recommended during the SARS epidemic could benefit medical staff in the current COVID-19 pandemic [2] . Feeling isolated is a common theme identified in doctors in general [13] and this theme has also been prominent during the COVID-19 pandemic [10] . Minimizing isolation through remote communication methods could provide an extra aspect of support [2] . Although there has been emphasis on testing medical personnel for COVID-19, it may also be of benefit to screen medical staff for psychological symptoms so that early intervention and support can be provided [2] .

Due to the overwhelming impact of the COVID-19 pandemic, single and simple solutions are very unlikely to mitigate the negative mental health outcomes of COVID-19 on medical professionals. Multidimensional and multilevel interventions might be needed and healthcare organizations have a duty to consider a range of different strategies to support medical staff during these times of uncertainty.

Managing mental health challenges faced by healthcare workers during covid-19 pandemic

Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed

Association between physician burnout and patient safety, professionalism, and patient satisfaction: a systematic review and meta-analysis

Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019

The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope

Real estimates of mortality following COVID-19 infection

The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital

Covid-19: doctors' leaders warn that staff could quit and may die over lack of protective equipment

Mental health care for medical staff in China during the COVID-19 outbreak

The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus

COVID-19) Outbreak: Rights, Roles and Responsibilities of Health Workers, Including Key Considerations for Occupational Safety and Health

NHS Launches Mental Health Hotline for Staff Tackling COVID-19

Optimising strategies to address mental ill-health in doctors and medical students: 'care under pressure' realist review and implementation guidance

e-mail: yue.zhou@postgrad.manchester.ac.uk