JMIR Publications

ABSTRACT

Background:

Background During pandemic disease episodes, effective containment and mitigation measures may also negatively influence psychological stability. As knowledge about coronavirus disease (COVID-19) rapidly evolves, global implementation of containment and mitigation measures has varied greatly, as have the impacts to mental wellness. Assessing relevant impacts of COVID-19 on healthcare and non-healthcare workers’ mental health needs may help more effectively mitigate mental health impacts.

Objective:

Objective This study assessed the self-reported prevalence of stress, anxiety, depression, and obsessive-compulsive symptoms in healthcare and non-healthcare workers seeking support through Text4Hope, an evidence-based, text message service supporting Alberta residents’ mental health, during the COVID-19 pandemic.

Methods:

Methods An online cross-sectional survey was used to gather demographic (age, gender 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 and Chi square analysis were 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 logistic regression to determine the association between worker type and likelihood of self-reported symptoms of moderate or high stress, GAD, and MDD, while controlling for other variables.

Results:

Results Overall, 8 267 surveys were submitted by 44 992 Text4Hope subscribers (19.39%); 5 990 were employed (72.5%), 958 (11.6%) were unemployed, 454 (5.5%) were students, 559 (6.8%) were retired, 234 (2.8%) selected “other” for their employment status and 72 (0.9%) did not indicate their employment status. Most employed survey respondents were female (86.2%, n= 4 621). Six-week prevalence in the general sample for symptoms of moderate or high stress, anxiety, and depression were 85.6%, 47.0%, and 44.0%, respectively. Self-reported symptoms of moderate or high stress, anxiety and depression symptoms were all statistically significantly higher in non-healthcare than healthcare workers (P <0.001). Non-healthcare workers reported higher obsessive-compulsive symptoms (worry about contamination and compulsive handwashing behavior) after pandemic onset (P <0.001), while healthcare worker symptoms were statistically significantly higher before and during the COVID-19 pandemic (P <0.001). This finding should be interpreted with caution, as it is unclear the extent to which adaptive behavior might be misclassified by validated tools in healthcare workers or during a pandemic.

Conclusions:

Conclusions Assessing symptoms of prevalent stress, anxiety, depression, and obsessive-compulsive in healthcare and non-healthcare workers may enhance our understanding of COVID-19 mental health needs. Research is needed to understand more fully the relationship between worker type, outbreak phase, and mental health changes over time and the utility of validated tools in healthcare workers and pandemics. Findings underscore the importance of anticipating and mitigating mental health effects using integrated implementation strategies and demonstrate the ease of safely and rapidly assessing mental health needs using a text messaging platform during a pandemic. Clinical Trial: Ethical approval for the research was obtained through the University of Alberta Health Research Ethics Board (Pro00086163)