A new global study on the impact of the COVID-19 pandemic on the mental health of healthcare workers: The HEROES study

August 2020

The COVID-19 pandemic has placed unprecedented stress on healthcare systems in Australia and across the world, resulting in an overwhelmed workforce. Healthcare workers face a high risk of infection, all the while grappling with major workplace changes, increased workloads, and high-stress situations (and, in some instances, without adequate support, training and resources).

This emotional and physical burden may have harmful and potentially lasting impacts on healthcare workers’ mental health and wellbeing, and patterns of substance use (1-3). Indeed, emerging cross-sectional research from China and the US indicates that healthcare workers are experiencing high levels of depression, anxiety and distress during this pandemic (4-6). It is crucial to study the impact of this ongoing crisis on healthcare workers longitudinally, however, as the harms may persist and some (e.g., post-traumatic stress disorder) may only become evident over time. This information is urgently needed to ensure the development of appropriate and targeted supports for healthcare workers. 

The COVID-19 Healthcare workers (HEROES) study

The COVID-19 Health Care Workers (HEROES) Study is an international collaboration of more than 20 countries across five continents, established to provide insights into the short- and medium-term impact of the COVID-19 pandemic on the mental health and wellbeing of healthcare workers in different countries, with different resources and strategies to address surges in illness.

The Australian arm of the study is led by NDARC, in collaboration with investigators from the Black Dog Institute and Columbia University in New York. The broader international study is led by the University of Chile and Columbia University as equal partners.

The Australian component of the COVID-19 HEROES study aims to:

  1. Describe the prevalence and trajectories of mental health, substance use and psychosocial functioning of healthcare workers across different healthcare settings and phases of the pandemic,
  2. Examine the way in which the COVID-19 pandemic has modified the organization of health services and their clinical practices, and the impact of these changes on healthcare workers’ wellbeing over time, and
  3. Contribute to a global understanding of these effects through comparisons of Australian data with that of other participating countries.

Research design

We will aim to recruit ~1500 healthcare workers (including clinical, administrative and support staff) from across Australia for this prospective online cohort study. Over the course of 12 months, participants will complete four confidential online surveys tracking changes in mood, anxiety, stress, substance use, physical and emotional wellbeing, and availability of supports.  Additionally, we will be asking about COVID-19 experiences, including workplace changes and the adequacy of training and personal protective equipment.

Why it is important

This study will provide insights into the mental health needs and concerns of healthcare workers in Australia and across the world, as they grapple with the impacts of the COVID-19 pandemic on workload, personal risk of exposure, and system-level changes in models of service delivery. Importantly, it will help us understand who is most at risk of harm and how best to time supportive services.  We plan to use findings to inform policy and develop supports and interventions for healthcare workers impacted by this crisis and similar challenges in the future


1. Wong TW, Yau JKY, Chan CLW, Kwong RSY, Ho SMY, Lau CC, et al. The psychological impact of severe acute respiratory syndrome outbreak on healthcare workers in emergency departments and how they cope. European Journal of Emergency Medicine. 2005;12(1).

2. Maunder RG, Lancee WJ, Balderson KE, Bennett JP, Borgundvaag B, Evans S, et al. Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12(12):1924-32.

3. Salazar de Pablo G, Vaquerizo-Serrano J, Catalan A, Arango C, Moreno C, Ferre F, et al. Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis. J Affect Disord. 2020;275:48-57.

4. Rossi R, Socci V, Pacitti F, Di Lorenzo G, Di Marco A, Siracusano A, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Network Open. 2020;3(5):e2010185-e.

5. Shechter A, Diaz F, Moise N, Anstey DE, Ye S, Agarwal S, et al. Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020;66:1-8.

6. 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 Network Open. 2020;3(3):e203976-e.