The long pandemic wave: depressive symptoms and suicidal thoughts among doctors and nurses during COVID-19 and five years later

Background Healthcare workers widely reported psychological distress during the COVID-19 emergency. While several pandemic-related workplace hazards have been identified as contributing factors, emerging evidence suggests these challenges were rooted in longstanding workplace conditions that predated the pandemic and continue to affect the workforce today. There is a lack of comparative studies tracking the evolution of these mental health outcomes through to the post-pandemic period. This leaves a critical gap in understanding long-term workforce well-being. Methods We conducted a repeated cross-sectional study harmonising independent cohorts (2020 and 2024) from two large multi-country studies (HEROES and MeND), analysing 39,513 participants from the Czech Republic, Italy, the Netherlands, and Spain. Outcomes were assessed using the 9-item Patient Health Questionnaire. Modified Poisson regression models with propensity score weighting were applied to estimate prevalence ratios (PRs) with 95% confidence intervals (CIs). Results Post-pandemic (2024–2025) participants exhibited a 50% higher prevalence of depressive symptoms (PR 1.57; 95% CI 1.46–1.69) and more than twice of suicidal thoughts (PR 2.53; 95% CI 2.21–2.91) compared to the pandemic cohort (2020–2021). For both 2020 and 2024, extended daily working hours, managing angry patients and relatives, and physical violence increased the severity of depressive symptoms. Colleague support acted as a strong protective factor, showing an improvement in symptomatology by almost 50% when reported. Dose-response analyses confirmed the robustness of these associations. Conclusions The apparent post-pandemic increase in workforce mental health problems, possibly linked to persistent occupational hazards, suggests this crisis is not a transient pandemic effect but an established structural situation, warranting timely organisational intervention.