Suicidal thoughts and behaviour among healthcare workers in England during the COVID-19 pandemic: A longitudinal study.

BACKGROUND

During the COVID-19 pandemic, concern has been raised about suicide risk among healthcare workers (HCWs). We investigated the incidence risk and prevalence of suicidal thoughts and behaviour (STB), and their relationship with occupational risk factors, among National Health Service HCWs in England between April 2020 and August 2021.

METHODS

In this longitudinal study, we analysed online survey data completed by 22,501 HCWs from 17 NHS Trusts at baseline (Time 1) and six months (Time 2). The primary outcome measures were suicidal ideation, suicide attempts, and non-suicidal self-injury. We used logistic regression to investigate the relationship between these outcomes and demographic characteristics and occupational factors. Results were stratified by occupational role (clinical/non-clinical).

RESULTS

Time 1 and Time 2 surveys were completed by 12,514 and 7,160 HCWs, respectively. At baseline, 10.8% (95% CI = 10.1%, 11.6%) of participants reported having experienced suicidal thoughts in the previous two months, whilst 2.1% (95% CI = 1.8%, 2.5%) of participants reported having attempted suicide over the same period. Among HCWs who had not experienced suicidal thoughts at baseline (and who completed the Time 2 survey), 11.3% (95%CI = 10.4%, 12.3%) reported such thoughts six months later. Six months after baseline, 3.9% (95% CI = 3.4%, 4.4%) of HCWs reported attempting suicide for the first time. Exposure to potentially morally injurious events, lack of confidence about raising safety concerns and these concerns being addressed, feeling unsupported by managers, and providing a reduced standard of care were all associated with increased suicidal ideation among HCWs during the COVID-19 pandemic. At six months, among clinicians, a lack of confidence about safety concerns being addressed, independently predicted suicidal ideation.

CONCLUSION

Suicidal thoughts and behaviour among healthcare workers could be reduced by improving managerial support and enhancing the ability of staff to raise safety concerns.

Informations de copyright

Copyright: © 2023 Padmanathan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

MH, RR, and SW are senior NIHR Investigators. SW has received speaker fees from Swiss Re for two webinars on the epidemiological impact of COVID 19 pandemic on mental health. SW is a Non Executive Director of NHS-England. RR reports grants from DHSC/UKRI/ESRC COVID-19 Rapid Response Call, grants from Rosetrees Trust, grants from King’s Together rapid response call, grants from UCL (Wellcome Trust) rapid response call, during the conduct of the study; & grants from NIHR outside the submitted work MH reports grants from DHSC/UKRI/ESRC COVID-19 Rapid Response Call, grants from Rosetrees Trust, grants from King’s Together rapid response call, grants from UCL Partners rapid response call, during the conduct of the study; grants from Innovative Medicines Initiative and EFPIA, RADAR-CNS consortium, grants from MRC, grants from NIHR, outside the submitted work. SS reports grants from UKRI/ESRC/DHSC, grants from UCL, grants from UKRI/MRC/DHSC, grants from Rosetrees Trust, grants from King’s Together Fund, and an NIHR Advanced Fellowship [ref: NIHR 300592] during the conduct of the study. NG reports a potential COI with NHSEI, during the conduct of the study; he is the managing director of March on Stress Ltd which has provided training for a number of NHS organisations. NG is not aware if the company has delivered training to any of the participating trusts, as he is not involved in commissioning specific pieces of work. DL is funded by the National Institute for Health and Care Research ARC North Thames. PM reports grants from NIHR and the Cassell Hospital Charitable Trust outside the submitted work. PM is part-funded by the NIHR ARC West. PP and PM report a grant from Bristol and Weston Hospitals Charity outside the submitted work. PP was funded by the Medical Research Council Addiction Research Clinical Training programme (MR/N00616X/1). Other authors report no competing interests. The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. This does not alter our adherence to PLOS ONE policies on sharing data and materials.