Mental health survey of frontline health care workers highlights need for better support

A national survey of COVID-19 frontline healthcare workers found more than half reported mental health symptoms during last year’s pandemic second wave – yet less than one in 10 accessed formal support programs.

This is the first large-scale study of coping strategies used by healthcare workers (HCWs) during last year’s pandemic crisis and has important implications for the current situation having serious impacts on staffing in hospitals in Victoria, NSW and the ACT.

“There are unmet needs for appropriate mental health care and support services among health care workers…with an immediate need for psychological support services that are both desired and acceptable to healthcare workers in both day to day and more so during crisis events,” the study authors say.

The study, published in the journal, General Hospital Psychiatry, was led by Associate Professor Natasha Smallwood, from Monash University’s Central Clinical School and The Alfred hospital, and Professor Karen Willis, from the Royal Melbourne Hospital and Victoria University.

It revealed that healthcare workers with moderate to severe mental health symptoms were significantly less likely to use positive coping strategies such as regular exercise and significantly more likely to drink more alcohol during the pandemic compared with people with mild or no mental health symptoms.

Associate Professor Smallwood warns the survey results point to “an urgent need to develop targeted interventions to safeguard our frontline health care workers during current and future crises,” she said.

According to the online survey of 7846 frontline health care workers (HCW) between 27 August and 23 October last year:

  • The most commonly reported adaptive coping strategies were maintaining exercise and social connections.
  • More than one quarter of health care workers (HCW) reported an increase in alcohol use, which was associated with poor mental health and worsening personal relationships.
  • Few people sought professional help or accessed wellbeing apps – and those who did were more likely to be experiencing moderate to severe symptoms of mental illness.
  • People living in Victoria, in regional areas and those with children at home reported the least use of coping strategies.

Previous studies by these and other researchers have found that during the pandemic HCWs reported higher levels of anxiety, depression and PTSD compared to the general public.

The data comes from findings from the Australian COVID-19 Frontline Healthcare Workers Study. At the time the study was done, there were almost 27,500 active cases nationally. Currently (as of 11 October) there are almost 130,000 active cases of COVID-19.

Of the survey respondents, 52 per cent were younger than 40 years; over 80 per cent were women; over one quarter also had caring responsibilities at home; more than 27 per cent had children home schooling and one third had pre-existing mental illness, with many reporting anxiety, burnout or depression since the start of the pandemic.

Of the strategies used by HCWs to cope with the stress of last year’s pandemic second wave:

  • Almost 45% maintained exercise
  • 25% increased exercise
  • 25% did meditation, yoga or similar
  • More than 31% maintained or increased social interaction
  • 14.2% used a psychological well-being app
  • 26.3% increased alcohol use
  • 12% did none of the above

Of those who sought help for stress of mental health issues from other sources – 18% saw a psychologist; 6% accessed an employee support program at their place of work; 3% sought professional support programs outside of work and almost 74% sought none of the above. The authors note that those with moderate to severe mental health symptoms were more likely to access help from a doctor or psychologist than those with no or only mild symptoms. “However, the group with mild to severe mental health issues were less likely to engage in coping strategies like exercise and being social,” Professor Smallwood said.


Smallwood N, Karimi L, Pascoe A, Bismark M, Putland M, Johnson D, Dharmage SC, Barson E, Atkin N, Long C, Ng I, Holland A, Munro J, Thevarajan I, Moore C, McGillion A, Willis K. Coping strategies adopted by Australian frontline health workers to address psychological distress during the COVID-19 pandemic. Gen Hosp Psychiatry. 2021 Aug 20;72:124-130. doi: 10.1016/j.genhosppsych.2021.08.008.