Mental Health Concerns of Frontline Workers During the COVID-19 Pandemic: A Scoping Review

OBJECTIVES: The current COVID-19 pandemic continues to have a significant impact on the mental health of frontline workers worldwide. Currently there are limited published studies addressing mental health issues in frontline workers. The objective of this scoping review is to examine the range of existing global literature on mental health issues reported in frontline workers during the COVID-19 pandemic and to understand what mitigating factors exist.

METHODS: The scoping review was guided by the Levac Colquhoun and O’Brien’s adapted version of Arkey and O’Malley’s framework. We performed a comprehensive search of three databases, Pubmed, APA PsychINFO, and CINAHL, identifying 684 studies. In total, 16 original studies and 4 letters to editors were included in this review.

RESULTS: Of the original studies, 13 were published in China, and the remaining 3 in Italy, Turkey, and Iraq; all letters to editors were published in China. Sources of stress reported in frontline workers across studies included direct contact with COVID-19 patients, isolation, putting loved ones at risk, facing life and death decision making with COVID-19 patients, uncertainty with COVID-19 disease control, limited personal protective equipment, time spent thinking about COVID-19, limited staff/resources/pay, burnout, and stigma. Mental health symptoms and outcomes reported in frontline workers were fear, stress, anxiety, depression, insomnia, burnout, and psychological distress.

CONCLUSION: Findings demonstrate the immediate need to increase mental health awareness and resources at an individual and system wide level. Mental health programs need to be catered towards each unique workplace to provide the necessary resources for frontline workers.