Mental health assessment of healthcare workers in the emergency department of a low middle-income country during COVID-19 pandemic

INTRODUCTION: Emergency department (ED) healthcare workers in Pakistan during the COVID-19 pandemic are facing an acute rise in mental illnesses. In this study, the authors aim to assess the frequency of anxiety and depression among healthcare workers in the ED. METHODS: A cross-sectional online google form-based survey was conducted in the ED of Aga Khan University Hospital, Karachi, Pakistan between July and August 2020. The Hospital Anxiety and Depression (HAD) scale was used for mental illness assessment among ED healthcare workers. Descriptive analysis of grading as per the Likert scale is done through frequencies, means, and standard deviations. Categorical variables were expressed as frequency (%). Mann–Whitney U test was used to compare scores of various groups and sub-groups and the Chi-square test was used to assess the association of depression and anxiety categories among the groups. RESULTS: In the ED, 127 healthcare workers (physicians and nurses) were included in this survey. The median depression score was 8 (IQR 6–10) with 21% (27) falling under depression and 39% (50) under borderline depression. The median anxiety score was 9 (IQR 7–12) with 33% (42) having abnormal, and 38% (48) having borderline anxiety. Healthcare workers working for > 45 h per week have odds of 3.62 [1.374–9.549] of developing depression compared to anxiety with a p-value of 0.009. Similarly, nurses and medical officers develop depression with odds of 2.18 [1.016–4.686] p-value 0.045 and 5.18 [0.197–1.02] p-value 0.002, respectively. CONCLUSION: ED healthcare workers during the COVID-19 pandemic suffered high levels of anxiety and depression, which is a matter of concern. Comprehensive support and training of ED healthcare workers are needed to promote physical and mental well-being and to develop guidelines that should be used during situations that can affect the mental health of healthcare workers.