Mental Health of Healthcare Workers during Crises: Insights from Systems Engineering

Abstract

Background: Healthcare workers (HCWs) experience substantial occupational stress and psychological strain during crises, which can compromise both their well-being and the quality of patient care. This study examined the mental health of healthcare workers during crises, guided by a Systems Engineering Initiative for Patient Safety (SEIPS) framework. The study addressed five research questions and one null hypothesis tested at 0.05 level of significance. Methods: A mixed-methods research design informed by human factors engineering principles was employed. The study was conducted in selected public and private healthcare facilities in Anambra State, Nigeria, including tertiary hospitals, general hospitals, private/mission hospitals, and Primary Health Centres. A multistage sampling procedure yielded a sample of 100 healthcare workers, including physicians, nurses, allied health professionals, and administrators. Data were collected using a structured questionnaire, semi-structured interviews, and focus group discussions. The questionnaire measured work-related stressors, psychological well-being, mental health support utilisation, and organisational support, with reliability coefficients ranging from 0.76 to 0.86. Quantitative data were analysed using descriptive statistics and multiple regression analysis, while qualitative data were analysed using thematic analysis guided by the SEIPS framework. Results: The findings revealed that healthcare workers experienced significant work-related stressors during crises, including increased workload, staff shortages, fear of infection, and rapidly changing procedures. Moderate levels of emotional exhaustion and anxiety were observed among participants. Mental health support services were poorly utilised. Multiple regression analysis indicated that work-related stressors, mental health support utilisation, and organisational/system-level support significantly predicted psychological well-being, with organisational support emerging as the strongest predictor. Conclusion: The study highlights that healthcare workers’ psychological well-being during crises is shaped by complex interactions among task demands, organisational structures, environmental risks, and individual coping factors within healthcare work systems. The findings emphasise the need for systems-based interventions, including supportive leadership, workload management, and accessible mental health services, to strengthen healthcare workforce resilience during future crises.