by Pamela Almeida

By spring 2020, healthcare workers (HCWs) were being called heroes. Then gradually the pandemic abated, life returned to normal, and the headlines moved on. But what happened to HCWs’ mental health? In our new study — one of the largest of its kind — we aimed to find out. 

The NHS CHECK study followed more than 22,000 HCWs across 18 NHS Trusts in England from April 2020 through to 2023. The study includes clinical staff and non-clinical staff, including nurses, doctors, administrators and support workers. Rather than just taking a snapshot, we tracked people’s mental health over time, looking for patterns in how symptoms changed, or didn’t. 

For many, the struggles didn’t ease when the crisis did 

The findings showed a mixed picture. In contrast to what the media might suggest, the majority of HCWs reported consistently low levels of mental health symptoms across the entire three-year period. But this figure sits alongside a finding that’s more concerning: a third of staff reported persistently high symptoms of common mental disorders (e.g., depression and anxiety) throughout. It’s worth noting that these measures are screening tools, not clinical diagnoses, but they’re well-validated indicators that something is wrong, and the scale of these findings is hard to ignore. 

These weren’t short-term stress responses to an extraordinary situation. For a substantial portion of the workforce, the mental health burden was persistent. 

Who was most at risk? 

The study identified clear patterns in who was more likely to be in the higher-symptom groups. Women, younger workers (under 30 years of age), single people, nurses, and those with a pre-existing mental health condition at the start of the COVID-19 pandemic were all at greater risk.  

What stands out on the protective side is how consistently one thing made a difference: workplace support. Staff who felt supported by their colleagues and managers were significantly less likely to experience high symptoms of common mental disorders including anxiety disorders, depression and PTSD. Being well supported wasn’t a nice-to-have. It was one of the strongest protective factors in the data. 

This isn’t just a pandemic story 

It would be convenient to frame this as a COVID problem, something extreme, time-limited, now behind us. However, the data does not support that framing. The NHS workforce was already under significant strain before the pandemic. The pandemic made things worse and, for many, the effects have lingered. 

Mental health support for HCWs needs to be part of everyday practice, not something that gets switched on in a crisis and switched off again when the emergency ends. That means investing in peer support, equipping managers to recognise when, why, and how to support their teams, and building organisational cultures where staff feel they can be honest about how they’re doing. By strengthening leadership, team cohesion, and everyday working environments, organisations can help prevent difficulties from escalating and make support feel embedded rather than exceptional. 

The research also flags that future work should look at how broader pressures, cost of living, caring responsibilities, and systemic understaffing, continue to shape staff wellbeing. And given that women are consistently at higher risk, those conversations need to engage with the gendered dimensions of healthcare work. 

What this means 

The NHS staff who kept the health service running during the pandemic deserved better support at the time. Many still do. This study gives us some of the clearest evidence about who is struggling, for how long, and what actually helps. 

The findings point to something relatively simple, even if it’s not always easy to deliver: people do better when they feel supported by the people around them and above them. Building that into how the NHS operates — consistently, not just in a crisis — is both a moral obligation and, the evidence suggests, a practical one. 

What can I do with this? 

I work in policy and/or public health: These findings highlight the importance of including mental health support into workforce planning, rather than relying on short-term crisis responses. Policies that strengthen workplace support, improve staffing, and prepare managers to support staff wellbeing might help reduce psychological distress among healthcare workers. 

I work in service delivery: Services can use these findings to prioritise supportive team cultures and manager training. Paying attention to groups at greater risk may improve staff wellbeing and retention. 

I am a researcher: This study adds to the evidence that mental health difficulties among healthcare workers can persist long after a major crisis. Future research should explore how organisational pressures, gender inequalities, caring responsibilities, and workforce shortages shape long-term mental health trajectories.  

I am a student: This study provides an example of how longitudinal research can be used to understand mental health over time. It may be useful for assignments related to occupational health, healthcare systems, or on the impact of the COVID-19 pandemic on the healthcare workforce.