Mental health and well‐being impacts of COVID‐19 on rural paramedics, police, community nurses and child protection workers

Abstract

Objective: To investigate the impact of COVID-19 on the mental health and well-being of rural paramedics, police, community nursing and child protection staff.Method: An online survey was distributed to investigate the sources of stress and support across individual, task and organisational domains. Setting and Participants:The survey was completed by 1542 paramedics, police, community nurses and child protection workers from all states and territories of Australia. This study describes the data for the 632 rural participants. Main outcome measures:The main measures of well-being were the Public Health Questionnaire (PHQ9), the Generalised Anxiety Disorder (GAD7), the Maslach Burnout Inventory (MBI), workplace engagement, intention to quit and COVID-19-related stress. Results:The mean depression and anxiety scores were 8.2 (PHQ9) and 6.8 (GAD7). This is 2-3 times that found in the general community. Over half (56.1%) of respondents showed high emotional exhaustion (burnout). The emotional exhaustion, depersonalisation and personal accomplishment mean scores were 28.5, 9.3 and 34.2, respectively. The strongest associations with burnout and psychological distress were workload, provision of practical support, training and organisational communication. A significant proportion of respondents were seriously considering quitting (27.4%) or looking for a new job with a different employer (28.5%) in the next 12 months. Conclusions: COVID-19 has increased the workload and stress on rural frontline community staff. The major sources of stress were related to organisations' responses to COVID-19 and not COVID-19 per se. The data suggest the most effective mental health interventions are practical and preventive, such as firstly ensuring fair and reasonable workloads.

Mental Health Symptoms and Workplace Challenges among Australian Paramedics during the COVID-19 Pandemic

“…The majority of paramedics reported mental health issues, most commonly symptoms of burnout and anxiety. Whilst there is limited evidence assessing mental health outcomes in paramedic-only samples during public health crises, our findings are consistent with evidence from reviews [ 11 , 26 ], and overseas and Australian studies [ 12 , 17 , 27 , 28 , 29 , 30 ] showing the negative mental health impacts of working as a HCW during the COVID-19 and SARS pandemics [ 31 , 32 ].…”

“…Nevertheless, the sample size achieved is similar to other similar studies [ 47 , 48 ]. The findings may not be representative of the experiences and views of all Australian paramedics; however, there is congruence between our findings and that of other Australians studies drawn from different geographic areas [ 28 ]. Anonymous online surveys may have a sample selection bias, as they provide an avenue for participants to disclose mental health distress, particularly when distress is stigmatised.…”

“…Based on our findings, other studies [ 28 ] and commentary [ 46 ], strategies to enhance pandemic preparedness and supports for paramedics in future crises should include improvements to working conditions, training, PPE supply, consistent communication, more effective leadership and additional mental health support at work. Better health system preparedness through consistent implementation of guidelines, and additional training and resourcing of equipment and staff are needed to manage increased demand during a crisis.…”

“…Disruption, uncertainty and stress negatively impacted on emotional, social and physical wellbeing for most paramedics. They recounted widespread occupational disruptions including unpredictability in the workplace, inconsistent information, and rapid changes to the workplace, and cited adverse working conditions—occupational challenges also reported in qualitative studies with other HCWs during COVID-19 and past pandemics [ 28 , 43 , 44 , 45 ].…”

Return of the unexpected: Rural workforce recruitment and retention in the era of COVID‐19

“…That is, while we do not fully understand the long‐term health impacts of recent events, we are already noticing an increase in mental and physical health concerns. 7 , 8 , 9 In this issue, Roberts et al 10 investigate the effects of COVID‐19 on the mental health of rural paramedics, police, community nursing staff and child protection staff. They reported high levels of depression and anxiety, attributed to the organisational response to COVID‐19.…”