{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T19:40:23Z","timestamp":1768074023429,"version":"3.49.0"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T00:00:00Z","timestamp":1657756800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:sec><jats:title>Introduction\/Background<\/jats:title><jats:p>HealthCare worker (HCW) mental health and wellbeing are uniquely affected by the complexities of COVID-19 due to exposure to the virus, isolation from family and friends, risk and uncertainty. Little if any inquiry has examined the effects on an entire healthcare system, particularly immediately post-surge. We sought to examine the prevalence of psychiatric symptoms and behavioral health difficulties as a healthcare system transitioned out of the first wave. We assessed the effects of work role, setting and individual diversity factors on employee distress and coping strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>This was an Institutional Review Board approved, unfunded, voluntary survey sent via REDCap link, to all employees of Hartford HealthCare, a mid-sized healthcare system (<jats:italic>N<\/jats:italic> \u2248 29,900) between May 15th and June 26th, 2020. Two system-wide emails and two emails targeting managers were sent during this time frame. Eight thousand four hundred and ninety four employees (28.4% of all e-mails distributed) participated in the survey, representing clinical, support, administrative, and medical staff across hospital, outpatient, residential, and business settings. The survey contained items assessing personal background, work environment\/culture, and formal measures, including: patient health questionnaire-9 (PHQ-9), general anxiety disorder-7 (GAD-7), primary care post-traumatic stress disorder screen for DSM-5 (PC-PTSD), alcohol use disorders identification test (AUDIT-C), and the insomnia severity index (ISI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Almost 1\/3 of respondents (31%) reported symptoms of clinically significant anxiety; 83% moderate to severe depression; and 51% moderate to severe insomnia. Thirteen percent screened positive for post-traumatic stress disorder. Frontline staff (<jats:italic>p<\/jats:italic> \u2264 0.001 vs. others) and females (<jats:italic>p<\/jats:italic> &amp;lt; 0.001 vs. males) endorsed the highest levels of distress, while race (<jats:italic>p<\/jats:italic> \u2264 0.005) and ethnicity (<jats:italic>p<\/jats:italic> &amp;lt; 0.03 for anxiety, PTSD and insomnia) had a complex and nuanced interaction with symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pandemic stress effects all healthcare employees, though not equally. The effects of work role and environment are intuitive though critical. These data suggest individual diversity factors also play an important role in mental health and wellbeing. All must be considered to optimize employee functioning.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyg.2022.924913","type":"journal-article","created":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T16:37:28Z","timestamp":1657816648000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Healthcare Worker Mental Health and Wellbeing During COVID-19: Mid-Pandemic Survey Results"],"prefix":"10.3389","volume":"13","author":[{"given":"Kevin P.","family":"Young","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana L.","family":"Kolcz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"Ferrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"O\u2019Sullivan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenneth","family":"Robinson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"780","DOI":"10.4103\/2249-4863.201153","article-title":"Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities.","volume":"5","author":"Bhaskar","year":"2016","journal-title":"J. Fam. Med. Prim. Care."},{"key":"B2","author":"Boniol","year":"2019","journal-title":"Gender Equity in the Health Workforce: Analysis of 104 Countries. Working paper 1."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1789","DOI":"10.1001\/archinte.158.16.1789","article-title":"for the Ambulatory Care Quality Improvement Project (ACQUIP). The AUDIT Alcohol Consumption Questions (AUDIT-C): an Effective Brief Screening Test for Problem Drinking.","volume":"158","author":"Bush","year":"1998","journal-title":"Arch. Intern. Med."},{"key":"B4","year":"","journal-title":"Health Equity Considerations &amp; Racial &amp; Ethnic Minority Groups."},{"key":"B5","year":"","journal-title":"COVID Data Tracker"},{"key":"B6","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1001\/jama.2020.10531","article-title":"Policy Solutions for Reversing the Color-blind Public Health Response to COVID-19 in the US.","volume":"324","author":"Dowling","year":"2020","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.19686","article-title":"Prevalence of Depression Symptoms in US Adults Before and During the COVID-19 Pandemic.","volume":"3","author":"Ettman","year":"2020","journal-title":"JAMA Netw. Open."},{"key":"B8","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1001\/jamapsychiatry.2017.2161","article-title":"Prevalence of 12-Month Alcohol Use, High-Risk Drinking, and DSM-IV Alcohol Use Disorder in the United States, 2001-2002 to 2012-2013: results From the National Epidemiologic Survey on Alcohol and Related Conditions.","volume":"74","author":"Grant","year":"2017","journal-title":"JAMA Psychiatr."},{"key":"B9","year":"2007","journal-title":"National Comorbidity Survey (NCS)."},{"key":"B10","doi-asserted-by":"crossref","first-page":"155","DOI":"10.47102\/annals-acadmedsg.202043","article-title":"Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic.","volume":"49","author":"Ho","year":"2020","journal-title":"Ann. Acad. Med. Singapore"},{"key":"B11","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3760\/cma.j.cn121094-20200219-00063","article-title":"Mental health survey of medical staff in a tertiary infectious disease hospital for COVID-19.","volume":"38","author":"Huang","year":"2020","journal-title":"Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi"},{"key":"B12","doi-asserted-by":"publisher","first-page":"617","DOI":"10.1001\/archpsyc.62.6.617","article-title":"Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.","volume":"62","author":"Kessler","year":"2005","journal-title":"Arch. General Psychiatr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9 validity of a brief depression severity measure.","volume":"16","author":"Kronkey","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.3976","article-title":"Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019.","volume":"3","author":"Lai","year":"2020","journal-title":"JAMA Netw Open."},{"key":"B15","doi-asserted-by":"publisher","first-page":"916","DOI":"10.1016\/j.bbi.2020.03.007","article-title":"Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control.","volume":"88","author":"Li","year":"2020","journal-title":"Brain Beha.v Immun."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.705657","article-title":"The prevalence of posttraumatic stress disorder symptoms, sleep problems, and psychological distress among COVID-19 frontline healthcare workers in Taiwan.","volume":"12","author":"Lin","year":"2021","journal-title":"Front. Psychiatr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1093\/sleep\/34.5.601","article-title":"The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response.","volume":"34","author":"Morin","year":"2011","journal-title":"Sleep"},{"key":"B18","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4103\/shb.shb_32_21","article-title":"The psychological impact of COVID-19 on health-care workers in African Countries: a systematic review.","volume":"4","author":"Olashore","year":"2021","journal-title":"Asian J. Soc. Health Behav."},{"key":"B19","first-page":"1","article-title":"The primary care PTSD screen for DSM-5 (PC-PTSD-5).","volume":"5","author":"Prins","year":"2015","journal-title":"Natl. Cent."},{"key":"B20","doi-asserted-by":"crossref","first-page":"51","DOI":"10.4103\/shb.shb_24_21","article-title":"Impact of COVID-19-related fear and anxiety on job attributes: a systematic review.","volume":"4","author":"Rajabimajd","year":"2021","journal-title":"Asian J. Soc. Health Behav."},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1186\/s12992-020-00589-w","article-title":"Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis.","volume":"16","author":"Salari","year":"2020","journal-title":"Glob. Health"},{"key":"B22","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.mayocp.2016.10.004","article-title":"Executive Leadership and Physician Well-being:Nine Organizational Strategies to Promote Engagement and Reduce Burnout.","volume":"92","author":"Shanafelt","year":"2017","journal-title":"Mayo Clin. Proc."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: the GAD-7.","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"B24","doi-asserted-by":"publisher","first-page":"317","DOI":"10.7326\/M20-1083","article-title":"Psychological Impact of the COVID-19 Pandemic on Health Care Workers in Singapore.","volume":"173","author":"Tan","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"B25","year":"2020","journal-title":"."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2192","DOI":"10.1001\/jama.2020.7197","article-title":"Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs.","volume":"323","author":"Wadhera","year":"2020","journal-title":"JAMA"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17051729","article-title":"Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China.","volume":"17","author":"Wang","year":"2020","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"B28","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1177\/070674370905400504","article-title":"The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk.","volume":"54","author":"Wu","year":"2009","journal-title":"Can. J. Psychiatr."},{"key":"B29","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1176\/appi.ps.202000424","article-title":"Healthcare Workers\u2019 Mental Health and Quality of Life during COVID-19: results from a Mid-Pandemic, National Survey.","volume":"72","author":"Young","year":"2021","journal-title":"Psychiatr. Serv."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.924913\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,14]],"date-time":"2022-07-14T16:37:43Z","timestamp":1657816663000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.924913\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,14]]},"references-count":29,"alternative-id":["10.3389\/fpsyg.2022.924913"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2022.924913","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,14]]},"article-number":"924913"}}