Caring for those who care for us

mental distress

Claudia Marinetti, Director of Mental Health Europe, calls for action to curb the prevalence of mental distress amongst frontline health workers

There is growing evidence that indicates that the pandemic has had a widespread impact on the wellbeing of the whole population and specifically on healthcare workers. The latter are the ones who have risen up to the unprecedented demand of treating COVID-19 patients at enormous cost to their own health and mental wellbeing.

While frontline health workers have given so much, they themselves have gone through very challenging times (working long hours without breaks, heavy shifts, witnessing patients suffering, supporting their patients’ and colleagues’ emotional needs, etc.) These are all factors that have affected their well-being and mental health. A recent study reveals that healthcare workers experience increased mental health distress:

• 30% report being emotionally exhausted.
• 51% report experiencing depression and PTSD. (1)

Nurses across the globe are having poor mental health outcomes due to the impact of COVID-19 as shown by another recent study:

• 41% feeling stressed.

• 32% experiencing anxiety.
• 38% having insomnia.
• 32% experiencing depression. (2)

The combined factors of increased stress, inadequate staffing and understaffing, have unfortunately led to a crisis in the health workers’ sector. The European Federation of Nurses (EFN) has reported this year that a shocking 30% of nurses are leaving the profession (EFN Tour de Table, 2021).

This trend is worrying especially given the fact that COVID-19 may be with us for a while before stability returns. Although frontline health workers normally have sufficient training to deal with the demands of the job, the high stress associated with the unique pressures of the COVID-19 crisis has placed this group at additional risk of experiencing mental health distress.

An integrated care approach is needed to support the mental health needs of our frontline workers

Interventions must be developed urgently to support the mental well-being of frontline health workers and prevent mental distress where possible. Now more than ever, an integrated care approach is needed. As demands for mental health support grow in society and workplaces, different actions must be urgently taken such as increasing the availability of peer-to-peer

support, strengthening community networks and services, thoroughly adopting the psycho-social model of mental health, updating effective digital solutions, and improving policies on mental wellbeing in the workplace, including in the healthcare field. I strongly feel that we must especially care for those who care for us and support mental health for all.

In October 2021, Mental Health Europe’s New Strategic Plan 2022-2025 ‘Bridging Policy Making and Human Experience’ was launched. It highlights some of the areas where MHE will intensify its work such as focusing on high-risk categories (certain population demographics, disadvantaged groups, etc.) and on improving access to care and support for all. It is time to bring mental health to where people are, and the current crisis is an opportunity to reset how we tackle inequality in mental health.

Frontline health workers must be protected with concrete and specific measures
As part of this work, MHE recently released a joint statement with the European Federation of Nurses (EFN) urging EU institutions, all EU Member States, the health sector and other health stakeholders to:

  • Put in place national and local programmes to support frontline nurses to preserve their mental health and prevent trauma.
  • Combat the stigmatisation of nurses taking care of COVID-19 patients.
  • Involve frontline nurses in the co-creation and co- design of health protocols, training, decision-making processes, etc.
  • Work closely with the nursing profession to develop policies that protect frontline staff from unnecessarily difficult or unsafe working conditions.
  • Allocate funds to support frontline nurses to be better prepared for future pandemics (i.e., the allocation of already agreed on EU budgets to inject funds into nursing and nursing research).
  • Urgently adopt European comprehensive long-term strategies on mental health, which also address the needs and specific situation of frontline nurses. (3)

    Frontline nurses could be further alleviated from unnecessary stress by applying these six measures, besides giving them the opportunity to mentally and physically recover from successive COVID-19 waves. This can of course be applied to all other frontline healthcare workers who are facing similar difficult situations. Protecting these workers should be a key element of public health measures during this ongoing pandemic. It is essential that frontline workers receive resources to help them cope with the extra mental health burden their work entails.

    Even if the impact and burden of COVID-19 eventually diminishes in our hospitals, and routine work returns to pre-pandemic levels, frontline workers will remain vulnerable to mental health distress. Like all of us, they will have to consider their mental health needs and will require support from organisational and institutional levels.

    It is time for policymakers and institutions to recognise the importance of good mental health for all. EU strategies and policies that prevent mental distress and promote and protect everyone’s wellbeing are urgently needed. MHE is proactively offering its commitment and expertise to ensure EU decisions reflect the views and needs of all those who are impacted by mental health problems, which is the only way to achieve effective actions for good mental health.


    (1) Mental health among healthcare workers and other vulnerable

    groups during the COVID-19 pandemic and other coronavirus outbreaks: A rapid systematic review, (PLOS ONE Journal, 4 August 2021), doi: journal.pone.0254821

    (2) Abin Varghese et al, ‘Decline in the mental health of nurses across

    the globe during COVID-19: A systematic review and meta- analysis’, Journal of Global Health, Published online 10 April 2021, doi:

    (3) Mental Health Europe (MHE) and the European Federation of Nurses (EFN) Joint Statement ‘Supporting Frontline Nurses’ Mental Health and Wellbeing Creating a resilient nursing workforce’, 10 October 2021.

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