Riesgos psicosociales y salud mental de los sanitarios y trabajadores sociales en el contexto de la pandemia COVID-19

Resumen

Certainly, our perception of the world we live in has changed since COVID-19 irrupted in our lives in March 2020. Many of our certainties in the European continent were shaked by the unequivocal evidence of our vulnerability as individuals and our lack of preparedness as a society to manage a health emergency of unknown boundaries, despite having one of the most well-developed health systems across the globe.

Much has been said about COVID-19, but never as I can remember, so much has been said about workers, and occupational safety and health, for once, hit the headlines. Healthcare workers - physicians, nurses, nurse practitioners, physician assistants, paramedical workers and alike were applauded daily, in Spain. The new heroes of our times, fulfilling the Hippocratic Oath, providing care to those more in need, while taking health risks of uncertain nature to themselves and their closest relatives. Health and social care workers were frontline workers not only because of their closeness to the virus, but because of the distress and moral dilemmas they faced while seeing people die in isolation or having to choose between one respirator, and too many patients.

The pandemic was officially declared over by WHO in May 2023, and the world has been eager to return to normality, to overcome, to forget. However, adverse effects on the mental health and wellbeing of health and social care workers, one of the largest and steadily growing occupational sectors in the EU, are likely to persist. Health and social care workers across the EU consistently reported poor work conditions and high rates of work-related stress in mid 2022, in as much as 56% of the workforce in the sector, as well as a higher prevalence of mental health problems, compared to professionals in any other sector of activity. There appears to be a concerning trend of increasing exposure to work-related psychosocial risk factors within this sector, with amplified job-demands and limited job resources peaking during the COVID-19 pandemic.

Many of us may experience another pandemic, arising under the current scenarios of climate alterations leading to disease vectors spreading in new areas, the return of old ones, and aggravated human transmission pathways. While we cannot fully predict what the next epidemic could be or how it will hit us, what can be said with high certainty is that caring for those who care, will undoubtedly increase our preparedness as a society in the face of future health emergencies and crises. 

Safeguarding the mental health of workers in the health and social care sector will help retaining a critical workforce by improving their working conditions and wellbeing. It will ensure a better quality of care and patient safety, and ultimately increase the resilience of our health systems in the face of future outbreaks. 

Public bodies such as the European Agency for Safety and Health at Work (EU-OSHA) are currently focusing their research efforts on further understanding and documenting the evidence on the multiple risks- including chemical, physical and psychosocial hazards -experienced by workers in the human health and social care activities sector, and their complex interplay. One ongoing project is quantifying the burden of adverse mental health outcomes measured with validated clinical scales from the beginning of the COVID-19 pandemic until mid-2023. Results shows very high prevalences for many mental health problems and conditions across the sector, also in their more severe clinical forms, and identifies sub-groups at potentially higher risk of suffering mental health problems in a female-dominated sector. Furthermore, it systematically maps and assesses the range of interventions conducted since 2020 to increase psychosocial wellbeing and prevent and manage mental health problems in the sector, to offer practical guidance and a range of scalable examples to workplaces. 

In summary, widescale and long-term systemic interventions are needed, combining organizational and individual focused approaches to protect workers from the challenges for their mental wellbeing posed by complex and changing work environments. Further investment is necessary to ensure decent work conditions in all professions in the sector. Specific training of young professionals entering the labour market should focus on increasing awareness on occupational safety and health, particularly addressing work-related psychosocial risks, and support the destigmatization of mental health at work in the medical professions, creating a supportive culture towards mental health problems.

Maybe some fundamental changes are underway. Signals such as the recent adoption in June 2022 by the International Labour Organization (ILO) in its International Labour Conference (ILC), at its 110th Session, of the Resolution on the inclusion of a safe and healthy working environment in the ILO’s framework of fundamental principles and rights at work, strongly reaffirms the constitutional principle of the protection of workers’ safety and health. The historic decision, expressed and supported by the ILO tripartite constituents, reveals a renewed collective commitment to the protection of life and health at work, embodying this dimension as a fifth category of fundamental principles and rights at work.