Recommendations for Improving the Mental Health of Healthcare Professionals During the COVID-19 Pandemic


avatar Mohammad Taha Saadati Rad ORCID 1 , avatar Sakineh Poorhosein Fookolaee 2 , *

Psychiatry and Behavioral Science Center, Addiction Institute, Mazandaran University of Medical Siences, Sari, Iran
Nursing Department, Faculty of Nursing and Midwifery, Islamic Azad University, Sari, Iran

how to cite: Saadati Rad M T, Poorhosein Fookolaee S. Recommendations for Improving the Mental Health of Healthcare Professionals During the COVID-19 Pandemic. Iran J Psychiatry Behav Sci. 2020;14(2):e103918.

Dear Editor,

In December 2019, a new coronavirus was discovered and identified as 2019-novel coronavirus in patients with viral pneumonia in Wuhan, Hubei Province, China. The disease caused by this newly-found virus was then officially named COVID-19 by the World Health Organization (WHO). COVID-19 has spread rapidly inside and outside of Hubei province and even in other parts of the world. A sharp increase is seen in the number of cases among the world’s population (1, 2). According to WHO, millions of people around the world have been infected by COVID-19.The current outbreak is one of the most challenging situations for the world and Iran (3). In the face of this global crisis, healthcare workers are directly involved in the process of diagnosing, treating, and caring patients with COVID-19 and are at risk for mental distress and adverse health effects. Psychiatric disorders such as stress, depression, and anxiety are on the rise, with an increasing number of confirmed and suspected cases of the disease, high work pressure, lack of protective equipment, widespread media coverage, lack of promising therapeutic agents and feelings of inadequacy, In 2003, in a study conducted during the severe acute respiratory syndrome (SARS) outbreak, health workers feared that they would become infected or infect their family, friends, or colleagues (4-7). Before the outbreak of COVID-19, nearly 50 percent of healthcare workers suffered from job stress and burnout (8). Mental health problems of healthcare staff were widespread, though hidden issues, before the outbreak of COVID-19. These problems have now become more evident due to the massive outbreak.

In a recent study on healthcare staff in Wuhan, a significant proportion of participants had anxiety [44.6%], symptoms of depression [50.4%], insomnia [34.0%], and distress [71.5% ] (9). Also, in another study on medical and nursing staff working in Wuhan, 36.9% had mental health disorders below the threshold, 34.4% had mild disorders, 22.4% had moderate disorders, and 6.2% had severe mental disorders (10). Patient care in hospital wards with less than adequate beds, as well as environmental stress factors such as increased number of patients, long work shifts, and increased number of infected medical staff and their deaths pose as a major risk for the mental health of the healthcare personnel (11). Therefore, it is essential to decrease the levels of anxiety in the present circumstances. It is also important to protect the mental health of healthcare workers in the inpatient wards of COVID-19 patients.

Adequate rest, adequate fluid intake, and proper nutrition can improve the physical and mental health of the health care workers (10). Some studies have shown that multidisciplinary mental health support by psychiatrists, clinical psychologists, psychiatric nurses, and another mental health professionals, clear communication, providing accessible and reliable psychological services such as e-books and mobile applications, and reduction in work shifts of the health workers to less than 16 hours a day can be effective in improving the mental health of health care workers (11-14). Implementing these measures is recommended for the improvement of the mental health status in healthcare personnel during the COVID-19 outbreak.


  • 1.

    Murdoch DR, French NP. COVID-19: another infectious disease emerging at the animal-human interface. NZ Med J. 2020;133(1510):12-5.

  • 2.

    Stein RA. The 2019 coronavirus: Learning curves, lessons, and the weakest link. International Journal of Clinical Practice. 2020.

  • 3.

    World Health Organization. Coronavirus disease 2019 (COVID-19): situation report, 84. World Health Organization; 2020.

  • 4.

    Maunder R, Hunter J, Vincent L, Bennett J, Peladeau N, Leszcz M, et al. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. Cmaj. 2003;168(10):1245-51.

  • 5.

    Lee AM, Wong JG, McAlonan GM, Cheung V, Cheung C, Sham PC, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. The Canadian Journal of Psychiatry. 2007;52(4):233-40.

  • 6.

    Chua SE, Cheung V, Cheung C, McAlonan GM, Wong JW, Cheung EP, et al. Psychological effects of the SARS outbreak in Hong Kong on high-risk health care workers. The Canadian Journal of Psychiatry. 2004;49(6):391-3.

  • 7.

    Bai Y, Lin C, Lin C, Chen J, Chue C, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatric Services. 2004;55(9):1055-7.

  • 8.

    West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. Journal of internal medicine. 2018;283(6):516-29.

  • 9.

    Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020;3(3). e203976. [PubMed ID: 32202646]. [PubMed Central ID: PMC7090843].

  • 10.

    Kang L, Ma S, Chen M, Yang J, Wang Y, Li R, et al. Impact on Mental Health and Perceptions of Psychological Care among Medical and Nursing Staff in Wuhan during the 2019 Novel Coronavirus Disease Outbreak: a Cross-sectional Study. Brain Behav Immun. 2020. [PubMed ID: 32240764]. [PubMed Central ID: PMC7118532].

  • 11.

    Huang J, Liu F, Teng Z, Chen J, Zhao J, Wang X, et al. Care for the psychological status of frontline medical staff fighting against COVID-19. Clinical infectious diseases: an official publication of the Infectious Diseases Society of America. 2020.

  • 12.

    Xiang YT, Jin Y, Wang Y, Zhang Q, Zhang L, Cheung T. Tribute to health workers in China: A group of respectable population during the outbreak of the COVID-19. Int J Biol Sci. 2020;16(10):1739-40. [PubMed ID: 32226292]. [PubMed Central ID: PMC7098026].

  • 13.

    Weaver MD, Landrigan CP, Sullivan JP, O'Brien CS, Qadri S, Viyaran N, et al. The association between resident physician work hour regulations and physician safety and health. The American Journal of Medicine. 2020.

  • 14.

    Jun J, Tucker S, Melnyk B. Clinician Mental Health and Well‐Being During Global Healthcare Crises: Evidence Learned From Prior Epidemics for COVID‐19 Pandemic. Worldviews on Evidence‐Based Nursing. 2020.