Coronavirus, Research

16 November, 2021

New research identifies mental health impacts of the pandemic on nursing home staff

This image shows a member of staff in a nursing home helping an older lady who is using a walking frame, with both wearing masks for infection control.

New mental health research shows nursing home staff experienced symptoms of post-traumatic stress disorder (PTSD), low mood and moral injury during the COVID-19 pandemic.

The findings come from the first phase of a research study which has been developed to better understand the mental health impact of the pandemic on nursing home staff. The COWORKER Nursing Home Study is being undertaken by St Patrick’s Mental Health Services (SPMHS), Trinity College Dublin (TCD), the Royal College of Surgeons Ireland and Nursing Homes Ireland.

Mental health needs

Mental health needs

The pandemic has significantly changed work and social environments, particularly affecting people working in healthcare settings such as nursing homes. As well as investigating the pandemic’s impact on nursing home staff’s wellbeing, the COWORKER study hopes to identify the mental health needs of clinical and non-clinical nursing home staff and to help inform appropriate responses. It also aims to provide a timely opportunity for nursing home staff to recognise if they have been experiencing mental health difficulties and to seek support where needed.

The study is led by Professor Declan McLoughlin, Research Professor of Psychiatry at TCD and Consultant Psychiatrist with us here at SPMHS. Its first phase involved an anonymous, cross-sectional survey of 390 nursing home staff in the Republic of Ireland during the third wave of the COVID-19 pandemic.

Of all those who responded:

  • 45% reported moderate or severe symptoms of PTSD
  • 39% reported low mood
  • One in seven reported thinking of ending their life over the previous week
  • One in 11 reported planning to end their life.

As well as low mood and suicidal thinking, the research uncovered considerable moral injury among nursing home staff. Moral injury is psychological distress experienced when a person feels betrayed by higher authorities or when they witness or engage in acts that go against their moral and ethical beliefs.

Differences between roles

Differences between roles

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

However, when it came to PTSD, the study did not find any significant differences between professions, suggesting that non-clinical staff, nurses and healthcare assistants experienced PTSD to a similar degree.

The high levels of post-traumatic symptoms found in the research are like those reported in nursing home staff internationally, indicating that this is a common experience globally during the pandemic.

Disproportionate impact on nursing homes

Disproportionate impact on nursing homes

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

Speaking about the impact of these findings, Professor Declan McLoughlin 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, 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 continued following the rollout of Ireland’s vaccination programme. They will soon begin to recruit nursing home staff to participate.

Click here for more information on the second phase of this study.

See more about mental health in the pandemic

See more about mental health in the pandemic