Mental health impacts of COVID-19 widespread within rural health care workforce – despite fewer COVID cases


A national survey of more than 7800 health care workers during the second wave of the COVID pandemic has found that, compared to their metropolitan based colleagues, rural allied and healthcare workers experienced a high prevalence of mental health symptoms, despite treating very few COVID-19 patients.

This was exacerbated by the “sea and tree change” that saw more than 43,000 Australians moving from cities to regional areas during the pandemic.

Importantly the study has revealed that rurally based healthcare workers were already severely stressed prior to the pandemic, with a significantly higher prevalence of pre COVID-19 pandemic mental illness in the rural workforce.

The study, published in the Australian Journal of Rural Health, comes at a time when a report into NSW regional health has found significant systemic failings in the way that healthcare is delivered in the NSW bush.

The study – led by Associate Professor Natasha Smallwood, from the Monash University’s Central Clinical School – interviewed 1473 health care workers in rural Australia and 6373 in metropolitan areas, part of the Australian COVID-19 Frontline Healthcare Workers Study. Rural participants were older and more likely to work in allied health, nursing or health administration and had worked longer than their metro colleagues.

  • The study found that between metro and rural health care workers:
  • Levels of resilience were similar
  • There was significantly higher prevalence of pre COVID-19 pandemic mental illness in the rural workforce

There were high levels of mental health issues, depersonalisation and emotional exhaustion in both groups during COVID
In rural populations – mental health symptoms were more pronounced in younger healthcare workers, concerned about:

  • Transmitting COVID to their families
  • Experiencing worsening relationships
  • Working in primary or allied health environments

According to Associate Professor Smallwood, the COVID pandemic generated significant disruption and stress, “which was exacerbated by the pandemic – and which impacted rural workers and metro workers differently,” she said.

In rural Australia there is greater emphasis on the provision of integrated primary health care, outreach services and general practice based hospitals, she added. “During the pandemic we also saw a significant influx of people away from metro areas to rural, further straining the existing health care networks.”

The authors concluded that “health care services throughout rural Australia need to be aware of the widespread mental health impacts of COVID-19 within their health care workforce,” arguing for mental health services to be put into place in rural areas for the prevention, early detection and effective management of adverse psychological effects.

Reference

Tham R, Pascoe A, Willis K, Kay M, Smallwood N. Differences in psychosocial distress among rural and metropolitan health care workers during the COVID-19 pandemic. Aust J Rural Health. 2022 May 5. DOI: 10.1111/ajr.12873.