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The mental health impact of the covid-19 pandemic on healthcare workers, and interventions to help them: A rapid systematic review
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Abstract
Background: The covid-19 pandemic has heavily burdened, and in some cases overwhelmed, healthcare systems throughout the world. Healthcare workers are not only at heightened risk of infection, but also of adverse mental health outcomes. Identification of organizational, collegial and individual risk and resilience factors impacting the mental health of healthcare workers are needed to inform preparedness planning and sustainable response. Methods: We performed a rapid systematic review to identify, assess and summarize available research on the mental health impact of the covid-19 pandemic on healthcare workers. On 11 May 2020, we utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence, the visualization of a database of 20,738 screened studies, to identify studies for inclusion. We included studies reporting on any type of mental health outcome in any type of healthcare workers during the pandemic. We described interventions reported by the studies, and narratively summarized mental health-related outcomes, as study heterogeneity precluded meta-analysis. We assessed study quality using design-specific instruments. Results: We included 59 studies, reporting on a total of 54,707 healthcare workers. The prevalence of general psychological distress across the studies ranged from 7-97% (median 37%), anxiety 9-90% (median 24%), depression 5-51% (median 21%), and sleeping problems 34-65% (median 37%). Seven studies reported on implementing mental health interventions, and most focused on individual symptom reduction, but none reported on effects of the interventions. In most studies, healthcare workers reported low interest in and use of professional help, and greater reliance on social support and contact with family and friends. Exposure to covid-19 was the most commonly reported correlate of mental health problems, followed by female gender, and worry about infection or about infecting others. Social support correlated with less mental health problems. Discussion: Healthcare workers in a variety of fields, positions, and exposure risks are reporting anxiety, depression, sleep problems, and distress during the covid-19 pandemic, but most studies do not report comparative data on mental health symptoms. before the pandemic. There seems to be a mismatch between risk factors for adverse mental health outcomes among healthcare workers in the current pandemic and their needs and preferences, and the individual psychopathology focus of current interventions. Efforts to help healthcare workers sustain healthy relationships to colleagues, family and friends over time may be paramount to safeguard what is already an important source of support during the prolonged crisis. Expanding interventions' focus to incorporate organizational, collegial and family factors to support healthcare workers responding to the pandemic could improve acceptability and efficacy of interventions. Other: The protocol for this review is available online. No funding was received.
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“Several factors have been reported to increase the risk for psychological symptoms in healthcare workers, including being a nurse, female gender, and frontline work (Muller et al., 2020; Pappa et al., 2020).”
From Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic. (2025) · cites this paper as Muller et al., 2020
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“Several factors have been reported to increase the risk for psychological symptoms in healthcare workers, including being a nurse, female gender, and frontline work (Muller et al., 2020; Pappa et al., 2020).”
From Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic. (2025) · cites this paper as Muller et al., 2020
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“Several factors have been reported to increase the risk for psychological symptoms in healthcare workers, including being a nurse, female gender, and frontline work (Muller et al., 2020; Pappa et al., 2020).”
From Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID‐19 pandemic. (2025) · cites this paper as Muller et al., 2020
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“Pappa et al. 11 identified thirteen studies in a search on 17 April 2020 and pooled prevalence rates; they reported that more than one of every five healthcare workers suffered from anxiety and/or depression; nearly two in five reported insomnia.”
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Søvold, L. E., Naslund, J. A., Kousoulis, A. A., Saxena, S., Qoronfleh, M. W., Grobler, C., & Münter, L. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.679397 · Cited by 973
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“A recent systematic review of 59 studies with 54,707 participants showed that one or two of every five healthcare professionals reported anxiety, depression, distress and/or sleep problems during the current COVID-19 pandemic, which were primarily associated with increased workload [31].”
BackgroundCOVID-19 pandemic effects on health worker's mental health: systematic review and meta-analysis
Aymerich, C., Pedruzo, B., Pérez, J. L., Laborda, M., Herrero, J., Blanco, J., Mancebo, G., Andrés, L., Estévez, O., Fernandez, M., et al. (2022) · European Psychiatry · doi:10.1192/j.eurpsy.2022.1 · Cited by 234
Metadata
- Authors
- Muller, A. E., Hafstad, E. V., Himmels, J. P. W., Smedslund, G., Flottorp, S., Stensland, S. Ø., Stroobants, S., Van de Velde, S., & Vist, G. E.
- Affiliations
- Norwegian Institute of Public Health (NO)
- Oslo University Hospital (NO)
- Corresponding author
- Muller, Ashley Elizabeth
- ORCID
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 293
- Pages
- 113441
- ISSN
- 0165-1781 (ISSN-L)
- PMC
- PMC7462563
- OpenAlex
- W3081708086
- Cited by
- 895
- References
- 114
- Citations by year
- 2026: 24 · 2025: 71 · 2024: 116 · 2023: 177 · 2022: 258 · 2021: 237 · 2020: 12
- FWCI
- 13.37
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychiatry Research (publishedVersion, cc-by)
- medRxiv (acceptedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion, cc-by)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Keywords
- COVID-19 pandemic, healthcare workers, mental health, anxiety, depression, sleep disorders, psychological distress, social support, occupational exposure to COVID-19, gender differences, mental health interventions, help-seeking
- MeSH terms
- Occupational Stress, Betacoronavirus, COVID-19, SARS-CoV-2, Female, Health Personnel, Humans, Male, Mental Health, Pneumonia, Viral, Risk Factors, Social Support, Coronavirus Infections, Internationality, Pandemics
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