Article Text

Original research
Mental health crisis in healthcare providers in the COVID-19 pandemic: a cross-sectional facility-based survey
  1. Chih-Wei Sung1,
  2. Chi-Hsin Chen1,
  3. Cheng-Yi Fan1,
  4. Jia-How Chang1,
  5. Chia Chun Hung2,
  6. Chia-Ming Fu3,
  7. Li Ping Wong4,
  8. Edward Pei-Chuan Huang1,3,
  9. Tony Szu-Hsien Lee5
  1. 1Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan
  2. 2Bali Psychiatric Center, Ministry of Health and Welfare, New Taipei City, Taiwan
  3. 3Department of Emergency Medicine, National Taiwan University Hospital, Taipei City, Taiwan
  4. 4Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  5. 5Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei City, Taiwan
  1. Correspondence to Dr Edward Pei-Chuan Huang; edward56026{at}; Professor Tony Szu-Hsien Lee; tonylee{at}


Objectives During a pandemic, healthcare providers experience increased mental and physical burden. Burnout can lead to treatment errors, patient mortality, increased suicidal ideation and substance abuse as well as medical malpractice suits among medical staff. This study aimed to investigate the occurrence of burnout, acute stress disorder, anxiety disorder and depressive disorder among healthcare providers at the third month of the COVID-19 pandemic.

Design A cross-sectional facility-based survey.

Setting Hospitals around the country with different levels of care.

Participants A total of 1795 respondents, including 360 men and 1435 women who participated in the survey.

Primary outcome measures Burnout was assessed using the Physician Work Life Study. A score of ≥3 implied burnout.

Results Of the 1795 respondents, 723 (40.3%) reported burnout, and 669 (37.3%) cared for patients with COVID-19. Anxiety levels were mild in 185 (10.3%) respondents, moderate in 209 (11.6%) and severe in 1401 (78.1%). The mean Center for Epidemiologic Studies Depression Scale-10 score was 9.5±6.3, and 817 (45.5%) respondents were classified as having depression. Factors associated with burnout were working in acute and critical care (ACC) divisions (adjusted OR (aOR)=1.84, 95% CI 1.20 to 3.39, p=0.019), caring for patients with COVID-19 (aOR=3.90, 95% CI 1.14 to 13.37, p=0.031) and having depressive disorder (aOR=9.44, 95% CI 7.44 to 11.97, p<0.001).

Conclusions Physicians and nurses are vulnerable to burnout during a pandemic, especially those working in ACC divisions. Anxiety disorder, depressive disorder and care of patients with COVID-19 may be factors that influence the occurrence of burnout among healthcare providers.

  • COVID-19
  • mental health
  • occupational & industrial medicine

Data availability statement

No additional data are available.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

No additional data are available.

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  • Contributors EPCH and TSHL conceived the main study. CWS and CHC conceived the primary analysis. CWS, EPCH and TSHL designed the study. CYF performed the data extraction. CWS and CYF performed the statistical analyses. JHC, CCH and CMF contributed to the interpretation of results. CWS drafted the manuscript, which LPW, EPCH and TSHL contributed to, revised critically and approved.

  • Funding The study was subsidised by the National Taiwan Normal University (202003HS002) and by the National Taiwan University Hospital Hsin-Chu Branch (110-HCH019).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.