Psychological Distress, Depression, Anxiety, and Burnout among International Humanitarian Aid Workers: A Longitudinal Study

Abstract

BackgroundInternational humanitarian aid workers providing care in emergencies are subjected to numerous chronic and traumatic stressors.ObjectivesTo examine consequences of such experiences on aid workers' mental health and how the impact is influenced by moderating variables.MethodologyWe conducted a longitudinal study in a sample of international non-governmental organizations. Study outcomes included anxiety, depression, burnout, and life and job satisfaction. We performed bivariate regression analyses at three time points. We fitted generalized estimating equation multivariable regression models for the longitudinal analyses.ResultsStudy participants from 19 NGOs were assessed at three time points: 212 participated at pre-deployment; 169 (80%) post-deployment; and 154 (73%) within 3–6 months after deployment. Prior to deployment, 12 (3.8%) participants reported anxiety symptoms, compared to 20 (11.8%) at post-deployment (p = 0·0027); 22 (10.4%) reported depression symptoms, compared to 33 (19.5%) at post-deployment (p = 0·0117) and 31 (20.1%) at follow-up (p = .00083). History of mental illness (adjusted odds ratio [AOR] 4.2; 95% confidence interval [CI] 1·45–12·50) contributed to an increased risk for anxiety. The experience of extraordinary stress was a contributor to increased risk for burnout depersonalization (AOR 1.5; 95% CI 1.17–1.83). Higher levels of chronic stress exposure during deployment were contributors to an increased risk for depression (AOR 1·1; 95% CI 1·02–1.20) comparing post- versus pre-deployment, and increased risk for burnout emotional exhaustion (AOR 1.1; 95% CI 1.04–1.19). Social support was associated with lower levels of depression (AOR 0·9; 95% CI 0·84–0·95), psychological distress (AOR = 0.9; [CI] 0.85–0.97), burnout lack of personal accomplishment (AOR 0·95; 95% CI 0·91–0·98), and greater life satisfaction (p = 0.0213).ConclusionsWhen recruiting and preparing aid workers for deployment, organizations should consider history of mental illness and take steps to decrease chronic stressors, and strengthen social support networks.

Future role aspirations, achievement motivations and perceptions of personal help-seeking among humanitarian aid trainees

“…Social support represents an important protective factor against adverse mental health effects for the general population, as it appears to provide an effective buffer against stressful experiences Brooks et al 2015;Cardozo et al 2012;Eriksson et al 2012;Musa and Hamid 2008). Social support is defined as emotional and instrumental social interactions that provide an individual with actual assistance or a belief that such assistance is available (Thoits 2011;Hobfoll 1988).…”

“…Past studies in the HA field have found that strong social support may significantly decrease the risk of adverse mental health consequences for workers . Specifically, social support appears to positively predict worker wellbeing, satisfaction (Brooks et al 2015) and resilience (Eriksson et al 2009), as well as mitigate against adverse mental health consequences including psychological distress, burnout (Brooks et al 2015;Cardozo et al 2012;Musa and Hamid 2008), PTSD and depression .…”

Factors Associated with Secondary Traumatic Stress among Emergency Nurses: An Integrative Review

“…Engaging in caring relationship with traumatized victims represented a source of stress that has an impact on the physical and mental integrity of the trauma workers [23]. Secondary exposure to trauma affects the ED nurses physically and mentally [24].…”

Human Security Workers Deployed in Austere Environments: A Brief Guide to Self-Care, Sustainment, and Productivity

“…Research on psychological distress among such workers indicates that chronic exposure to such environmental stressors, including the suffering of others, is associated with negative mental health outcomes, including depression, anxiety, and "burnout" characterized by long-term exhaustion and diminished interest. These outcomes are, in turn, associated with decreased work satisfaction and productivity [1]. To effectively meet the challenges of these environments, workers require strong support from their sponsoring organizations; the best preparation emerges from a transparent and interactive agency-worker partnership that embraces a shared responsibility for mission outcome.…”