ENACT project: understanding the risk and protective factors for the mental wellbeing of health and social care workers in Scotland: adapting to the challenges and lessons learned

IBackground: Frontline health and social care workers (HSCWs) have provided an essential service throughout the COVID-19 pandemic. While rapid research has found that HSCWs are at increased risk of developing stress related conditions associated with this pandemic, little is known about what may help protect their mental wellbeing. This study tested two hypotheses: (i) increased scores in COVID-19-related risk factors will predict lower mental wellbeing and (ii) protective factors will mediate the relationship between COVID-19-related risk factors and mental wellbeing.

Method: The study consisted of a cross-sectional online survey exploring the impact of COVID-19 on the mental wellbeing of HSCWs in Scotland. Participants (n = 1364) responded to the survey which included measures of COVID-19 related risk factors (Coronavirus Risk Perception, COVID-19 Stress Measure, COVID-19 Burnout Scale and PTSD Checklist-6) and protective factors (Brief Resilience Coping, Team Resilience & General Help-Seeking Questionnaire) associated with mental wellbeing (Warwick-Edinburgh Mental Well-Being Scale-Short Form), analysed using multiple regression and parallel mediation analyses. Open ended questions, exploring HSCWs’ views of risks and protective factors for their mental wellbeing, were analysed using content analysis.

Results: COVID-stress was found to be a significant independent predictor of wellbeing (b = -.286, SE = .064, t = -4.44, p < .001), where wellbeing declines as COVID-19 stress increases. Both adaptive coping and team resilience significantly predicted better wellbeing and reduced burnout. Content analysis of open text responses found both risks and protective factors for HSCWs’ mental wellbeing.

Implications: These findings emphasise the importance of adaptive coping, team-based resilience in alleviating the negative impact that COVID-19 stress has on HSCWs’ mental wellbeing and in preventing burnout. Work-based supports and access to psychological input for HSCWs who need it is highlighted. Building a resilient workforce moving forward requires attention to staff mental wellbeing and ensuring support systems are robust and accessible.