JMIR Publications

ABSTRACT

Background:

During pandemic disease episodes, effective containment and mitigation measures that limit the disease spread, may also negatively influence psychological stability. As knowledge about the novel SARS-CoV2 and COVID-19 disease rapidly evolves, global implementation of containment and mitigation measures has varied greatly, as have the impacts on mental wellness. Assessing relevant impacts of COVID-19 on healthcare and non-healthcare workers’ mental health needs may enable us to more effectively limit or mitigate mental health impact.

Objective:

This study assessed the prevalence of stress, anxiety, depression and obsessive-compulsive symptoms in healthcare and non-healthcare workers subscribing to Text4Help, an evidence-based, text message service supporting Alberta residents’ mental health, during the COVID-19 pandemic.

Methods:

An online cross-sectional survey was used to gather demographic (age, sex, ethnicity, education, relationship, housing and employment status, employment type, and isolation status) and clinical characteristics using validated tools (self-reported stress, anxiety, depression and contamination/hand hygiene associated obsessive-compulsive symptoms). Descriptive statistics summarized respondent demographics. Chi square analysis was used to compare healthcare to non-healthcare workers’ clinical characteristics. Post hoc analysis was conducted on variables with >3 response categories using adjusted residuals. We performed correlation analysis prior to logistic regression to determine the association between worker type and likelihood of respondent moderate to high stress, likely GAD and MDD, while controlling for other variables.

Results:

Overall, 8 267 surveys were submitted by 44 992 Text4Hope subscribers (19.39%). Of 5 990 employed respondents (72.5%), 958 (11.6 reported being unemployed, 454 (5.5%) were students, 559 (6.8%) were retired and 72 (0.9%) did not indicate their employment status. Most survey respondents in the employed category were female (86.2%, n=4 621). Six-week prevalence in the general sample for moderate/severe stress, anxiety, and depression symptoms was 85.6%, 47.0%, 44.0%, respectively. Self-reported moderate/high stress, anxiety and depression symptoms were all statistically significantly higher in non-healthcare than healthcare workers (p<0.001). The prevalence of obsessive-compulsive characteristics (worry about contamination and compulsive handwashing behavior) after pandemic onset was statistically significantly higher in non-healthcare than healthcare workers (p<0.001); however, the prevalence of healthcare worker worry about contamination and handwashing was statistically significantly higher than non-healthcare workers before the COVID-19 pandemic began (p<0.001).

Conclusions:

Measurement of prevalent stress, anxiety, depression and obsessive-compulsive symptoms in healthcare and non-healthcare workers may enhance our understanding of mental health needs in the COVID-19 pandemic. Further investigation will be necessary to understand more fully the relationship between worker type, outbreak phase, work context, and mental health changes over time. Findings underscore the importance of anticipating and mitigating mental health effects using integrated confinement/mitigation implementation strategies, and demonstrate the ease of safely and rapidly assessing mental health needs using a voluntary participation text messaging platform, during a pandemic.