Association between perceived discrimination and mental health outcomes among health workers during the initial COVID-19 outbreak.

Abstract

During the initial COVID-19 outbreak, health systems faced unprecedented organizational stress. Meanwhile, reports of episodes of discrimination and violence towards healthcare workers increased globally. This study explores the association between perceived discrimination and mental health outcomes in a large sample of healthcare workers in Spain. Healthcare workers from inpatient and outpatient facilities (N=2,053) filled an on-line questionnaire in May or June 2020. Mental health outcomes included depression symptoms (Patient Health Questionnaire [PHQ-9]), psychological distress (General Health Questionnaire [GHQ-12]) and death thoughts (Columbia Suicide Severity Rating Scale [C-SSRS]). We also measured perceived discrimination and/or stigmatization due to being a healthcare worker since pandemic onset. Regression models adjusted for potential confounding sources (age, sex, history of a mental health diagnosis and type of job) were fitted. Thirty percent of the respondents reported discrimination and/or stigmatization. Perceived discrimination was associated with higher depression (B=2.4, 95 percent CI: 1.8, 2.9) and psychological distress (B=1.1, 95 percent CI: 0.7, 1.4) scores, and with a 2-fold increase in risk of reporting death thoughts (OR=2.0, 95 percent CI: 1.4, 3.1). Perceived discrimination is a modifiable driver of mental health problems among healthcare workers. Mass media, legislators, and healthcare institutions must put in place prevention and restoration strategies to limit discrimination towards healthcare workers and reduce its mental health impact.Los sistemas de salud fueron sometidos a un nivel de estr s sin precedentes durante la primera ola de la pandemia de COVID-19 Al mismo tiempo se registr un aumento de episodios de discriminaci n y violencia contra los trabajadores sanitarios Este estudio explora la asociaci n entre la discriminaci n percibida y la salud mental en una gran muestra de trabajadores sanitarios en Espana Trabajadores sanitarios hospitalarios y no hospitalarios N 2 053 completaron una encuesta en l nea entre mayo y junio de 2020 Se incluyeron los siguientes indicadores de salud mental s ntomas depresivos PHQ-9 malestar psicol gico GHQ-12 e ideas de muerte C-SSRS Tambi n se midi la discriminaci n y o estigmatizaci n percibida desde el inicio de la pandemia por el hecho de ser trabajador sanitario Se calcularon modelos de regresi n ajustados por potenciales fuentes de confusi n edad sexo antecedentes psiqui tricos y tipo de trabajo Un 30 de los encuestados refirieron haberse sentido discriminados y o estigmatizados La discriminaci n percibida se asoci con mayores puntuaciones en depresi n B 2 4 intervalo de confianza IC al 95 de 1 8 a 2 9 y malestar psicol gico B 1 1 IC 95 de 0 7 a 1 4 y con el doble de riesgo de referir ideas de muerte OR 2 0 IC al 95 de 1 4 a 3 1 La discriminaci n percibida es un estresor modificable que puede disparar problemas de salud mental en profesionales sanitarios Medios de comunicaci n legisladores e instituciones sanitarias deben poner en marcha estrategias preventivas y restaurativas reducir la discriminaci n contra los sanitarios y reducir el impacto sobre la salud mental