Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England

Natalia Kika; Nora Trompeter; Danielle Lamb; Rupa Bhundia; Ewan Carr; Brendan Dempsey; Neil Greenberg; Ira Madan; Christopher Penfold; Rosalind Raine; Simon Wessely; Sharon A.M. Stevelink

doi:10.1371/journal.pone.0326753

Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England

Natalia Kika, Nora Trompeter, Danielle Lamb, Rupa Bhundia, Ewan Carr, Brendan Dempsey, Neil Greenberg, Ira Madan, Christopher Penfold, Rosalind Raine, Simon Wessely, Sharon A.M. Stevelink

Research output: Contribution to journal › Article › peer-review

2 Citations (SciVal)

Abstract

Background The pressures of the COVID-19 pandemic placed mental healthcare professionals at an increased risk of burnout and decreased mental wellbeing. Resilience strategies have been put in place as a protective measure, but little is known about how mental wellbeing evolved over time in this group and how resilience affects it. This study aimed to: 1) investigate long-term changes in burnout and mental well-being among mental healthcare professionals working in the National Health Service (NHS) during the COVID-19 pandemic in the United Kingdom (UK); and 2) examine whether baseline resilience levels predicted decreased burnout and increased mental well-being over the course of the pandemic. Methods The study used data from NHS CHECK, a longitudinal cohort study investigating NHS staff mental health and well-being since the COVID-19 pandemic. Clinical mental health staff (n=3,289) who completed self-report measures at three time points (baseline, 6 and 12 months later). Baseline surveys were conducted during the initial pandemic peak (April 2020 – June 2020; n=543), the initial easing of restrictions (July 2020 – September 2020; n=1,098), and the second peak (October 2020 – January 2021, n=1,648). Results Mixed model analyses showed that burnout scores increased over time, with higher resilience at baseline predicting lower burnout 6 and 12 months later. However, rises in burnout were most pronounced in the high resilience group. Well-being remained relatively stable over time, with staff with higher resilience at baseline reporting higher well-being over time. Conclusions Resilience was linked with both lower burnout and higher well-being in NHS mental health staff throughout the COVID-19 pandemic. Despite showing steeper increases in burnout, staff with high initial resilience still maintained lower absolute levels of burnout compared to those with lower resilience. Healthcare organizations should consider providing interventions focusing on organizational factors in addition to individual-level resilience-focused support.

Original language	English
Article number	e0326753
Journal	PLoS ONE
Volume	20
Issue number	7 July
DOIs	https://doi.org/10.1371/journal.pone.0326753
Publication status	Published - 8 Jul 2025

Bibliographical note

Publisher Copyright:
© 2025 Kika et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Acknowledgements

We wish to acknowledge the National Institute of Health and Care Research (NIHR) Applied Research Collaboration (ARC) National NHS and Social Care Workforce Group, with the following ARCs: North Thames, East Midlands, East of England, South West Peninsula, South London, West, North West Coast, Yorkshire and Humber, and North East and North Cumbria. They enabled the set-up of the national network of participating hospital sites and aided the research team to recruit effectively during the COVID-19 pandemic. This work is independent research supported by the National Institute for Health Research (NIHR) Applied Research Collaboration (ARC) North Thames and the National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency, King’s College London and the University of East Anglia. The views expressed are those of the author(s) and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care. For the purpose of open access, the author has applied [a Creative Commons Attribution (CC BY) license] [an ‘Open Government License’] to any Author Accepted Manuscript version arising.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

ASJC Scopus subject areas

General

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10.1371/journal.pone.0326753Licence: CC BY

Cite this

Kika, N., Trompeter, N., Lamb, D., Bhundia, R., Carr, E., Dempsey, B., Greenberg, N., Madan, I., Penfold, C., Raine, R., Wessely, S., & Stevelink, S. A. M. (2025). Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England. PLoS ONE, 20(7 July), Article e0326753. https://doi.org/10.1371/journal.pone.0326753

Kika, N, Trompeter, N, Lamb, D, Bhundia, R, Carr, E, Dempsey, B, Greenberg, N, Madan, I, Penfold, C, Raine, R, Wessely, S & Stevelink, SAM 2025, 'Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England', PLoS ONE, vol. 20, no. 7 July, e0326753. https://doi.org/10.1371/journal.pone.0326753

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title = "Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England",

abstract = "Background The pressures of the COVID-19 pandemic placed mental healthcare professionals at an increased risk of burnout and decreased mental wellbeing. Resilience strategies have been put in place as a protective measure, but little is known about how mental wellbeing evolved over time in this group and how resilience affects it. This study aimed to: 1) investigate long-term changes in burnout and mental well-being among mental healthcare professionals working in the National Health Service (NHS) during the COVID-19 pandemic in the United Kingdom (UK); and 2) examine whether baseline resilience levels predicted decreased burnout and increased mental well-being over the course of the pandemic. Methods The study used data from NHS CHECK, a longitudinal cohort study investigating NHS staff mental health and well-being since the COVID-19 pandemic. Clinical mental health staff (n=3,289) who completed self-report measures at three time points (baseline, 6 and 12 months later). Baseline surveys were conducted during the initial pandemic peak (April 2020 – June 2020; n=543), the initial easing of restrictions (July 2020 – September 2020; n=1,098), and the second peak (October 2020 – January 2021, n=1,648). Results Mixed model analyses showed that burnout scores increased over time, with higher resilience at baseline predicting lower burnout 6 and 12 months later. However, rises in burnout were most pronounced in the high resilience group. Well-being remained relatively stable over time, with staff with higher resilience at baseline reporting higher well-being over time. Conclusions Resilience was linked with both lower burnout and higher well-being in NHS mental health staff throughout the COVID-19 pandemic. Despite showing steeper increases in burnout, staff with high initial resilience still maintained lower absolute levels of burnout compared to those with lower resilience. Healthcare organizations should consider providing interventions focusing on organizational factors in addition to individual-level resilience-focused support.",

author = "Natalia Kika and Nora Trompeter and Danielle Lamb and Rupa Bhundia and Ewan Carr and Brendan Dempsey and Neil Greenberg and Ira Madan and Christopher Penfold and Rosalind Raine and Simon Wessely and Stevelink, \{Sharon A.M.\}",

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AU - Lamb, Danielle

AU - Bhundia, Rupa

AU - Carr, Ewan

AU - Dempsey, Brendan

AU - Greenberg, Neil

AU - Madan, Ira

AU - Penfold, Christopher

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AU - Wessely, Simon

AU - Stevelink, Sharon A.M.

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N2 - Background The pressures of the COVID-19 pandemic placed mental healthcare professionals at an increased risk of burnout and decreased mental wellbeing. Resilience strategies have been put in place as a protective measure, but little is known about how mental wellbeing evolved over time in this group and how resilience affects it. This study aimed to: 1) investigate long-term changes in burnout and mental well-being among mental healthcare professionals working in the National Health Service (NHS) during the COVID-19 pandemic in the United Kingdom (UK); and 2) examine whether baseline resilience levels predicted decreased burnout and increased mental well-being over the course of the pandemic. Methods The study used data from NHS CHECK, a longitudinal cohort study investigating NHS staff mental health and well-being since the COVID-19 pandemic. Clinical mental health staff (n=3,289) who completed self-report measures at three time points (baseline, 6 and 12 months later). Baseline surveys were conducted during the initial pandemic peak (April 2020 – June 2020; n=543), the initial easing of restrictions (July 2020 – September 2020; n=1,098), and the second peak (October 2020 – January 2021, n=1,648). Results Mixed model analyses showed that burnout scores increased over time, with higher resilience at baseline predicting lower burnout 6 and 12 months later. However, rises in burnout were most pronounced in the high resilience group. Well-being remained relatively stable over time, with staff with higher resilience at baseline reporting higher well-being over time. Conclusions Resilience was linked with both lower burnout and higher well-being in NHS mental health staff throughout the COVID-19 pandemic. Despite showing steeper increases in burnout, staff with high initial resilience still maintained lower absolute levels of burnout compared to those with lower resilience. Healthcare organizations should consider providing interventions focusing on organizational factors in addition to individual-level resilience-focused support.

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Resilience during the COVID-19 pandemic: Associations with changes in burnout and mental well-being among NHS mental health staff in England

Abstract

Bibliographical note

Acknowledgements

UN SDGs

ASJC Scopus subject areas

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