Trinity College Dublin: New research identifies significant mental health impacts of the pandemic on nursing home staff

Findings from phase one of a research study exploring nursing home staff’s mental health during the COVID-19 pandemic have unearthed significant impacts including post-traumatic stress disorder (PTSD), low mood and suicidal thinking.

The COWORKER Nursing Home Study involved researchers from St Patrick’s Mental Health Services; Trinity College Dublin; the Royal College of Surgeons, Ireland; and Nursing Homes Ireland. It was led by Declan McLoughlin, Research Professor of Psychiatry at Trinity College Dublin and Consultant Psychiatrist at St Patrick’s Mental Health Services.

The study was developed to investigate the mental health impact of the pandemic on nursing home staff; to identify the mental health needs of both clinical and non-clinical nursing home staff; and to help inform appropriate responses. It also aimed to provide a timely opportunity for nursing home staff to recognise if they have been experiencing mental health difficulties during the pandemic, and to seek support if required.

Phase one of the COWORKER study comprised a cross-sectional anonymous survey of 390 nursing home staff working in the Republic of Ireland during the third wave of the COVID-19 pandemic. The findings revealed that:

45% of respondents reported moderate or severe symptoms of post-traumatic stress disorder (PTSD)
39% of respondents reported low mood
One in seven respondents reported thinking of ending their life over the previous week, and one in 11 reported planning to end their life
Nursing home staff also reported high levels of post-traumatic stress; moral injury;1 low mood; and suicidal thinking. The high levels of post-traumatic symptoms found from this study are similar to those reported in nursing home staff internationally,2 indicating that this is a common experience globally during the pandemic.

Researchers also examined whether there were any differences in the levels of mental health difficulties between nursing home staff based on their roles, with findings showing significantly more nurses were found to report low mood, while healthcare assistants reported a significantly higher degree of moral injury than non-clinical staff.

The study did not find any significant differences between professions in experiencing PTSD symptoms, indicating that non-clinical staff experienced levels of PTSD symptoms similar to nurses and healthcare assistants.

Speaking about the impact of the findings, Declan McLoughlin, Research Professor of Psychiatry at Trinity College Dublin and Consultant Psychiatrist at St Patrick’s Mental Health Services, said:

“Nursing homes have been disproportionately affected during the COVID-19 pandemic, in particular during the first wave; staff have had to contend with high numbers of COVID-related deaths of residents; exposure to the virus; increased visiting restrictions; and disruption to routine activities in their workplaces.

“The pandemic has presented immense challenges for nursing homes, their staff, residents and families, and yet, few studies to date have explored its specific impact on nursing home staff’s mental health. It is hoped that phase one of the study’s findings will highlight potential areas of concern for nursing home staff so that they can address this and seek support as required.”

Lead author of the study, Dr Conan Brady, Trinity, said:

“The results of the COWORKER study have shown the significant mental health impacts of the pandemic for those working in nursing homes. While we do not know the mental health experiences of staff in these settings before COVID-19, there are many pandemic-related factors that may have impacted on this cohort’s mental health.

“In addition to the restrictions we’ve all faced, other reasons could be job stress or concerns about stigma from working in environments with high levels of COVID-19. There are little data on suicidal ideation in nursing home staff internationally, and this warrants more investigation.”

The researchers now plan to repeat the survey to see if these experiences remain following the rollout of Ireland’s vaccination programme. They will soon begin to recruit nursing home staff to participate. For more information on the second phase of this study see here.

The results of phase one of the peer-reviewed study have been published in the International Journal of Geriatric Psychiatry

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