Health workers’ Covid-19 mental health crisis

While Covid-19 no longer constitutes a public health emergency, a newly published study has revealed an increase in mental health among health workers at the peak of the pandemic.

Findings of the study titled ‘The Mental Health Toll Among Healthcare Workers During The Covid-19 Pandemic in Malawi’, published on May 6 2024, show that 31 percent of health workers had a high prevalence of Covid-19-related depression, 30 percent had anxiety and 25 percent post-traumatic stress disorder (PTSD).

The study was conducted by University of Malawi lecturers Limbika Maliwichi, Fiskani Kondowe, Jimmy Kainja, Simunye Nyamali and Yamikani Ndasauka.

Kamuzu University of Health Sciences lecturer Chilungamo Mmanga and University of Cape Town health economist Martina Mchenga were also part of the study.

Part of the findings read: “Regression analysis revealed significantly higher rates of depression, anxiety and PTSD among healthcare workers in city referral hospitals compared to district hospitals.”

The study, which was conducted between May and June 2021 in Blantyre, Mangochi, Lilongwe and Karonga, targeted frontline health workers with first-hand knowledge about the Covid-19 situation in hospitals which, among others, included clinicians, nurses, chief nursing officers and matrons.

Blantyre and Lilongwe were selected on the basis that they are cities with the largest referral hospitals that handled the most and most severe cases.

These referral hospitals include Queen Elizabeth Central Hospital and Kamuzu Central Hospital.

Karonga was chosen because as a border district, it was a potential entry for Covid-19 while Mangochi was chosen on the premise that being a lake district, it was anticipated to be affected by dropped levels of tourism.

According to the study, health workers reported experiencing numerous symptoms related to depression, anxiety and PTSD.

“Regarding depressive symptoms, many workers described persistent sadness, hopelessness, loss of interest in everyday activities, fatigue, worthlessness or guilt, difficulty concentrating and recurrent thoughts of death or suicide.

“They exhibited excessive worry, restlessness, difficulty relaxing, irritability, muscle tension, sleep disturbances and panic attacks,” further reads part of the study.

PTSD symptoms by the include unwanted distressing memories of treating Covid-19 patients, emotional and physical reactions when reminded of traumatic pandemic experiences.

The study states that the health workers’ narratives on the mental health symptoms persisted for several months since Covid-19 began which affected their quality of life.

Further, the findings state that narratives by clinicians provide insight into the trauma and moral injury inflicted on health workers by the reality and frequent fatalities of Covid-19.

Health workers who participated in the study also indicated occurrences of

discrimination and stigma, with  some facing social isolation, harassment and violence.

But despite the stigma, many workers were reluctant to seek mental health and psychosocial support for fear of further stigmatisation from colleagues who would perceive them as weak.

The study, therefore, recommend government to include mental health considerations and interventions as a core component of emergency preparedness and response strategies.

Ministry of Health spokesperson Adrian Chikumbe was on Friday unavailable for comment when contacted.

Health and Rights Education executive director Maziko Matemba in an interview on Friday said what worsened the situation was the fact that it was unclear when Covid-19 would end.

“More critical, at the beginning of the pandemic, it took health workers unaware and also, they were overwhelmed with no clear direction; hence, the mental health challenges,” he said.

Matemba said it is important to ensure investments in the health sector, including innovations to avoid situations where health workers encounter similar situations.

Kamuzu University of Health Sciences professor and head of community and environmental health Adamson Muula said in a separate interview despite health workers being trained to be resilient, they are also prone to mental health issues in the line of duty.

n