Pandemic stress as bad for rural health workers

The pandemic impacted the mental health of rural and regional healthcare workers as severely as their metropolitan colleagues, despite fewer Covid cases.

There were widespread mental health impacts on healthcare workers from dealing with Covid-19. Picture: Paul Ellis/AFP

The Covid pandemic impacted the mental health of rural and ­regional healthcare workers as ­severely as their metropolitan colleagues, despite them dealing with fewer Covid cases, a national study has found.

The study, published in the Australian Journal of Rural Health, said the situation was exacerbated by more than 43,000 people moving from cities to regional areas during the pandemic.

It revealed that rural-based healthcare workers were already severely stressed before the pandemic, with a significantly higher prevalence of pre-pandemic mental illness compared with metropolitan health workers.

Led by Natasha Smallwood from Mon­ash University’s Central Clinical School, 1473 healthcare workers in rural Australia, and 6373 healthcare workers in metropolitan areas, were surveyed as part of the Australian Covid-19 Frontline Healthcare Workers Study.

“Despite having low Covid-19 case numbers in rural Australian health services compared with metropolitan counterparts over the course of 2020, there were widespread mental health impacts on the workforce,” the study concluded.  

“Rural health services need specific and flexible training, education, work policies and practices that support psychological wellbeing now in preparedness for future crises.”

The study was the largest examining the psychosocial impacts of the pandemic on rural healthcare workers.

“Concerningly, despite this being a period of low Covid-19 prevalence nationally and extremely low in rural areas, approximately 82 per cent of participants self-reported having experienced mental health concerns during this period of the Covid-19 pandemic, as well as moderate to high levels of self-­reported anxiety, burnout and ­depression,” it found.

It found rural participants were older, more likely to work in allied health, nursing or health administration and worked longer than metropolitan colleagues.

Levels of resilience between metropolitan and rural healthcare workers were similar. However, during the pandemic, there were high levels of mental health issues, depersonalisation and emotional exhaustion.

In rural populations, mental health symptoms were more pronounced in younger healthcare workers who were concerned about transmitting Covid to their families, experiencing worsening relationships and working in ­primary or allied health environments.

Associate Professor Smallwood said the pandemic generated significant disruption and stress that “impacted rural workers and metro workers ­differently”.

In rural Australia there was greater emphasis on the provision of integrated primary healthcare, outreach services and general practice- based hospitals, she said.

“During the pandemic, we also saw a significant influx of people away from metro areas to rural areas, further straining the ­existing healthcare networks,” she said.

“Healthcare services through­out rural Australia need to be aware of the widespread mental health impacts of Covid-19 within their healthcare workforce.”

Mental health services should be put into place in rural areas for the prevention, early detection and effective management of ­adverse psychological effects.