Mental health and wellbeing of health and aged care workers in Australia, May 2021 - June 2022: a longitudinal cohort study.

OBJECTIVES: To assess the mental health and wellbeing of health and aged care workers in Australia during the second and third years of the coronavirus disease 2019 (COVID-19) pandemic, overall and by occupation group. DESIGN, SETTING, PARTICIPANTS: Longitudinal cohort study of health and aged care workers (ambulance, hospitals, primary care, residential aged care) in Victoria: May-July 2021 (survey 1), October-December 2021 (survey 2), and May-June 2022 (survey 3). MAIN OUTCOME MEASURES: Proportions of respondents (adjusted for age, gender, socio-economic status) reporting moderate to severe symptoms of depression (Patient Health Questionnaire-9, PHQ-9), anxiety (Generalized Anxiety Disorder scale, GAD-7), or post-traumatic stress (Impact of Event Scale-6, IES-6), burnout (abbreviated Maslach Burnout Inventory, aMBI), or high optimism (10-point visual analogue scale); mean scores (adjusted for age, gender, socio-economic status) for wellbeing (Personal Wellbeing Index-Adult, PWI-A) and resilience (Connor Davidson Resilience Scale 2, CD-RISC-2). RESULTS: A total of 1667 people responded to at least one survey (survey 1, 989; survey 2, 1153; survey 3, 993; response rate, 3.3%). Overall, 1211 survey responses were from women (72.6%); most respondents were hospital workers (1289, 77.3%) or ambulance staff (315, 18.9%). The adjusted proportions of respondents who reported moderate to severe symptoms of depression (survey 1, 16.4%; survey 2, 22.6%; survey 3, 19.2%), anxiety (survey 1, 8.8%; survey 2, 16.0%; survey 3, 11.0%), or post-traumatic stress (survey 1, 14.6%; survey 2, 35.1%; survey 3, 14.9%) were each largest for survey 2. The adjusted proportions of participants who reported moderate to severe symptoms of burnout were higher in surveys 2 and 3 than in survey 1, and the proportions who reported high optimism were smaller in surveys 2 and 3 than in survey 1. Adjusted mean scores for wellbeing and resilience were similar at surveys 2 and 3 and lower than at survey 1. The magnitude but not the patterns of change differed by occupation group. CONCLUSION: Burnout was more frequently reported and mean wellbeing and resilience scores were lower in mid-2022 than in mid-2021 for Victorian health and aged care workers who participated in our study. Evidence-based mental health and wellbeing programs for workers in health care organisations are needed. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12621000533897 (observational study; retrospective).

Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey.

OBJECTIVES: To estimate the population prevalence of clinically significant symptoms of depression, generalised anxiety, thoughts of being better off dead, irritability, and high optimism about the future, and of direct experience of COVID-19, loss of employment caused by COVID-19 restrictions, worry about contracting COVID-19, or major disadvantage because of the restrictions; to examine the relationship between these experiences and reporting mental symptoms. DESIGN, SETTING, PARTICIPANTS: Anonymous online survey of adult Australian residents, 3 April - 2 May 2020. MAIN OUTCOME MEASURES: Self-reported psychological status during the preceding fortnight assessed with the Patient Health Questionnaire 9 (PHQ-9; symptoms of depression) and the Generalised Anxiety Disorder Scale (GAD-7). Optimism about the future was assessed with a 10-point study-specific visual analogue scale. RESULTS: 13 829 respondents contributed complete response data. The estimated prevalence of clinically significant symptoms of depression (PHQ-9 ≥ 10) was 27.6% (95% CI, 26.1-29.1%) and of clinically significant symptoms of anxiety (GAD-7 ≥ 10) 21.0% (95% CI, 19.6-22.4%); 14.6% of respondents (95% CI, 13.5-16.0%) reported thoughts of being better off dead or self-harm (PHQ-9, item 9) on at least some days and 59.2% (95% CI, 57.6-60.7%) that they were more irritable (GAD-7, item 6). An estimated 28.3% of respondents (95% CI, 27.1-29.6%) reported great optimism about the future (score ≥ 8). People who had lost jobs, were worried about contracting COVID-19, or for whom the restrictions had a highly adverse impact on daily life were more likely to report symptoms of depression or anxiety, and less likely to report high optimism than people without these experiences. CONCLUSIONS: Mental health problems were widespread among Australians during the first month of the stage two COVID-19 restrictions; in addition, about one-quarter of respondents reported mild to moderate symptoms of depression or anxiety. A public mental health response that includes universal, selective and indicated clinical interventions is needed.