Intended for healthcare professionals

Letters Covid-19: psychological effects on healthcare workers

Covid-19: healthcare students face unique mental health challenges

BMJ 2020; 369 doi: (Published 29 June 2020) Cite this as: BMJ 2020;369:m2491
  1. Christopher A Smith, final year medical student
  1. University of Southampton, Southampton SO17 1BJ, UK
  1. cs5u16{at}

Investigating the exacerbating and mitigating factors that affect healthcare professionals’ mental health in pandemics is important, but Gold’s editorial overlooks a distinct subgroup in the clinical environment: healthcare students.1

Healthcare students share many risk factors with staff; they are also affected by shortages of personal protective equipment, and many have children. But students face unique problems that their professional colleagues do not.

Student income is often dependent on maintenance loans, and many report resulting financial hardship2—an identified risk to mental health in pandemics.3 Strategies proved to boost staff morale, such as hazard pay, are not available for students, and students’ limited extracurricular earning potential has been decimated by a covid driven loss of part time jobs.

When universities closed, so did student societies, removing peer support networks that the editorial identified as protective. When campuses reopen, building friendships and finding support will be even harder for new students constrained by social distancing or even a lack of physical lectures,45 increasing the likelihood of isolation and loneliness. For international students arriving in the UK, perhaps to a new language and culture, this will be an even bigger problem, especially if they face a period of quarantine.6

Finally, lockdown hindered saying goodbye to friends, celebrating important milestones, and dealing with the loss of loved ones. Expecting young people to move on, emotionally and geographically, without closure could lead to mental health crises at a time when student services are already overwhelmed and notoriously unsuitable for the demands of healthcare degrees—being placed miles from universities and working long shifts preclude making appointments during business hours, for example.

As both medical schools7 and students8 prepare to restart clinical placements, it is key that students remain supported on placement and that mental health services are cognisant of the unique challenges facing these communities in the wake of covid-19.


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