Abstract
Introduction: the COVID-19 pandemic had a devastating impact on society, with healthcare workers (HCWs) on the frontline bearing the brunt. As such, HCWs directly involved in the diagnosis, treatment, and care of patients with COVID-19 were at risk of developing psychological distress and other mental health symptoms. The overall aim of this study was to assess mental health symptoms among HCWs treating patients exposed to COVID-19 in Gauteng, South Africa. This research was critically important to determine the physiological burden on HCWs in response to the pandemic, so that mental health responses to the pandemic by HCWs, and psychosocial support structures in place for HCWs in South Africa can be considered. Methods: a cross-sectional study was conducted among frontline HCWs in the Inner City and Johannesburg South region (region F) of Gauteng, South Africa. Data was collected through both an online and an in-person approach. All participants completed a questionnaire enquiring about their socio-demographic characteristics and mental health symptoms. The presence and severity of symptoms of depression, anxiety, and insomnia of HCWs exposed to COVID-19 were assessed using the patient health questionnaire-9 (PHQ-9), the generalised anxiety disorder-7 (GAD-7), and the insomnia severity index-7 (ISI-7). Data analysis was performed using SPSS version 26.0 statistical software. Results: a total of 234 out of 260 contacted individuals completed the survey. The majority of the participants were female (n=190, 81.2%), aged between 36 and 45 years (n=79, 33.8%), were unmarried (n=105,44.9%), and had a tertiary education (n=217, 92.7%). The majority of the participants worked in the public sector (151, 64.5%), while the minority (n=83, 35.5%) worked in the private sector. A considerable proportion of HCWs reported symptoms of depression (n=102, 43.6%), anxiety (n=105, 44.9%), and insomnia (n=70, 29.9%). It was found that there were no significant differences in symptoms of depression (X2=4.8, p>0.05), anxiety (X2=0.8, p>0.05), and insomnia (X2=2.1, p>0.05) between public and private sector HCWs. The results further showed that 49.1% of the participants indicated that psychological services did exist in their place of work, and 50.9% said they did not exist. Perceptions that psychological services existed were more common among HCWs in private healthcare facilities (66.3%) than among HCWs in public healthcare facilities (39.7%). Psychosocial support systems such as mental health counselling, support groups, psychological services, and employee assistance programmes were identified as some of the key services requested by HCWs. Conclusion: the prevalence of depression, anxiety, and insomnia was shown in HCWs in Gauteng, South Africa, and there were differences in perceptions of the psychosocial support systems that exist in the region between private and public sector HCWs. The results indicate that a considerable proportion of HCWs have depression, anxiety, or insomnia, with only half indicating the presence of workplace psycho-social support structures. Psycho-social support structures for HCWs need to be strengthened and made more visible.