Depression trajectories among UK healthcare workers since the COVID-19 pandemic

COVID-19 took a heavy toll on the mental health of UK healthcare workers (HCWs). How staff have recovered since the pandemic, and whether some groups struggled more than others, remains unclear. Understanding how depression has changed over time is essential for providing better support to HCWs. The UK-REACH survey collected six waves of data between 2020 and 2025. The analysis sample comprised 6,250 individuals with data available for two or more waves. Depression was measured using the two-item Patient Health Questionnaire. Latent class trajectory modelling used generalised linear latent and mixed models, with random intercepts and slopes, and time in months from baseline. One- to seven-class solutions were compared using the BIC and entropy. Multinomial logistic regression examined associations between baseline characteristics and class membership. A four-class solution provided the best fit. Most HCWs (73.3%) followed a recovering trajectory, with elevated baseline scores declining over five years. A consistently low symptom class comprised 14.1%. Two adverse trajectories emerged: a persistently high class (8.6%) with sustained elevated symptoms, and a worsening class (4.0%) with progressive deterioration. With the consistently low class as reference, marked occupational disparities were observed. Compared with doctors, nurses & midwives, allied health professionals, dental staff, and other non-clinical staff were more likely to follow the worsening trajectory and less likely to follow the recovering trajectory. Older age was associated with recovery, and female sex with persistently high symptoms. Ethnicity and migration were not strongly associated with adverse trajectories. Most UK HCWs showed gradual recovery following the peak pandemic period, but approximately one in eight followed sustained or worsening trajectories through 2025. These findings highlight the need for targeted mental health support, with attention to those in highest-risk groups.

Key messages

• Most UK healthcare workers recovered from pandemic-era depression by 2025, but one in eight remained on sustained or worsening trajectories, with non-medical staff most affected.

• Four years since the COVID-19 pandemic, nurses and allied health staff were significantly more likely than doctors to follow worsening or persistently high depression trajectories.