'Stressed, uncomfortable, vulnerable, neglected': A qualitative study of the psychological and social impact of the COVID-19 pandemic on UK frontline keyworkers

Objectives Non-healthcare keyworkers face distinct occupational vulnerabilities that have received little consideration within broader debates about 'essential' work and psychological distress during the COVID-19 pandemic. The aim of this study was therefore to explore the impact of the pandemic on the working lives and mental health and well-being of non-healthcare keyworkers in the UK. Design In-depth, qualitative interviews, analysed using a reflexive thematic analysis. Setting Telephone or video call interviews, conducted in the UK between September 2020 and January 2021. Participants 23 participants aged 26-61 (mean age=47.2) years employed in a range of non-healthcare keyworker occupations, including transport, retail, education, postal services, the police and fire services, waste collection, finance and religious services. Results Keyworkers experienced adverse psychological effects during the COVID-19 pandemic, including fears of COVID-19 exposure, contagion and subsequent transmission to others, especially their families. These concerns were often experienced in the context of multiple exposure risks, including insufficient personal protective equipment and a lack of workplace mitigation practices. Keyworkers also described multiple work-related challenges, including increased workload, a lack of public and organisational recognition and feelings of disempowerment. Conclusions In efforts to reduce psychosocial concerns among non-healthcare keyworkers, there is a need for appropriate support during the COVID-19 pandemic and in preparation for other infections (eg, seasonal influenza) in the future. This includes the provision of psychological and workplace measures attending to the intersections of personal vulnerability and work conditions that cause unique risks and challenges among those in frontline keyworker occupations.