As many as 1 in 10 UK healthcare workers (HCWs) had suicidal thoughts during the first year of the pandemic, according to a study yesterday in PLOS One. The findings contribute to a growing body of knowledge concerning the mental health strains experienced by health professionals over the past 3 years.
The data came from longitudinal online surveys completed by healthcare workers, students, and volunteers in 17 National Health Service (NHS) Trusts across England during the COVID-19 pandemic. A total of 12,514 participants completed an online survey at baseline and 7,160 participants at 6- month follow up, between April 2020 and August 2021.
The study periods encompassed the two major peaks in the incidence of COVID-19 deaths (April 2020 and January 2021) and the three national lockdowns undertaken by the United Kingdom in the first 18 months of the pandemic.
Over 11% reported suicidal thoughts
The primary outcomes were suicidal ideation, suicide attempts, and non-suicidal self-injury. At baseline, 10.8% (95% confidence interval [CI], 10.1% to 11.6%) of participants reported having experienced suicidal thoughts in the previous 2 months, and 2.1% (95% CI, 1.8%, to 2.5%) of participants reported having attempted suicide over the same period.
In healthcare workers who had not experienced suicidal thoughts at baseline, 11.3% (95% CI 10.4% to 12.3%) reported have those thoughts 6 months later. A total of 3.9% (95% CI, 3.4% to 4.4%) of HCWs reported attempting suicide for the first time at 6 months following baseline.
Our analyses show that among healthcare workers who had not experienced suicidal thoughts when first completing the survey, one-in-ten reported experiencing them six months later.
"Our analyses show that among healthcare workers who had not experienced suicidal thoughts when first completing the survey, one-in-ten reported experiencing them six months later. Additionally, almost one in 25 staff reported having attempted suicide for the first time," said first author Prianka Padmanathan, MB ChB, PhD, MSc, a researcher at the University of Bristol, in a university press release on the study.
25% of clinicians experienced moral injury
In an analysis of the survey results, the authors found several trends linked to suicidal ideation and attempt. Suffering moral injury, lack of access to personal protective equipment (PPE), and feeling unsupported by supervisors or managers, were all linked to an increased likelihood in having suicidal thoughts.
Among clinical HCWs, 28.6% said they experienced a morally injurious event during the first year of the pandemic. Moral injury typically refers to the psychological, social, and spiritual impact of going against one's deeply held moral beliefs and values.
A lack of access to PPE was reported by 9.2% of clinicians and 14.5% of non-clinicians. In addition, 20.5% of clinicians and 17.2% of non-clinicians reported feeling unsupported by managers.
Among clinicians, 9.5% lacked confidence raising safety concerns, while 16.4% lacked confidence that safety concerns would be addressed. Among non-clinicians, 7.0% lacked confidence raising safety concerns, while 9.1% lacked confidence that safety concerns would be addressed.
"These findings highlight the scale of mental health issues across the NHS at a time of unprecedented concern," said Padmanathan. "Improvements in mental health support and addressing structural issues around workforce and resources might significantly reduce suicidal thoughts and behaviour among health care workers."
