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The Mental Health of Healthcare Workers in COVID-19

If you are a healthcare worker and are concerned about your mental health, go to mhanational.org/frontline to be screened and find resources and support. If you are experiencing a mental health crisis, call 1-800-273-TALK (8255) to reach a 24-hour crisis center, or text MHA to 741741 to reach a trained Crisis Counselor 24/7.

Throughout the COVID-19 pandemic, Mental Health America (MHA) has witnessed increasing numbers of anxiety, depression, loneliness, and other mental health concerns. COVID-19 has had a profound negative effect on the mental health of the nation, especially among those who are faced with combatting the virus.

While many throughout the U.S. are coping with the fear and uncertainty of COVID-19 from their homes, essential workers, including healthcare workers, must expose themselves to the virus every day. Healthcare workers are also experiencing conditions that have been compared to a war zone, continuously witnessing the direct effects of the pandemic as it spreads throughout communities. It is essential that we provide resources to help healthcare workers cope with the mental health impact of their work.

From June-September 2020, MHA hosted a survey on mhascreening.org to listen to the experiences of healthcare workers during COVID-19 and to create better resources to help support their mental health as they continue to provide care.

The responses collected from the 1,119 healthcare workers surveyed indicated that they are:

  • Stressed out and stretched too thin: 93% of health care workers were experiencing stress, 86% reported experiencing anxiety, 77% reported frustration, 76% reported exhaustion and burnout, and 75% said they were overwhelmed.
  • Worried about exposing loved ones: 76% of healthcare workers with children reported that they were worried about exposing their child to COVID-19, nearly half were worried about exposing their spouse or partner, and 47% were worried that they would expose their older adult family member(s).
  • Emotionally and physically exhausted: Emotional exhaustion was the most common answer for changes in how healthcare workers were feeling over the previous three months (82%), followed by trouble with sleep (70%), physical exhaustion (68%) and work-related dread (63%). Over half selected changes in appetite (57%), physical symptoms like headache or stomachache (56%), questioning career path (55%), compassion fatigue (52%) and heightened awareness or attention to being exposed (52%). Nurses reported having a higher exposure to COVID-19 (41%) and they were more likely to feel too tired (67%) compared to other healthcare workers (63%).
  • Not getting enough emotional support: 39% of healthcare workers said that they did not feel like they had adequate emotional support. Nurses were even less likely to have emotional support (45%).
  • Struggling with parenting: Among people with children, half reported they are lacking quality time or are unable to support their children or be a present parent.

Demographics

The following analysis is based on the responses of 1,119 healthcare workers surveyed on MHA Screening (mhascreening.org) from June 1-September 1, 2020.

The majority (76 percent) of respondents were young adults ages 18-44.

Age

Count

Percentage

18-24

241

21.54%

25-34

354

31.64%

35-44

258

23.06%

45-54

136

12.15%

55-64

101

9.03%

65+

29

2.59%

Grand Total

1,119

100.00%

Most (70 percent) of the respondents were White, followed by Black or African American (10 percent), and Hispanic or Latino (8 percent).

Race/Ethnicity

Count

Percentage

White (non-Hispanic)

778

69.53%

Black or African American (non-Hispanic)

113

10.10%

Hispanic or Latino

88

7.86%

Asian or Pacific Islander

65

5.81%

More than one of the above

47

4.20%

Other

18

1.61%

Native American or American Indian

10

0.89%

Grand Total

1,119

100.00%

The largest groups of respondents were other healthcare staff (30 percent) and nurses (22 percent). Nineteen percent of respondents identified their position as “Other,” which included mental health professionals, social workers, and pharmacy staff, among others.

What is your title or position?

Count

Percentage

Other patient care (CAN, lab technician, X-ray, therapist, front desk, etc.)

335

29.94%

Nurse

245

21.89%

Other

207

18.50%

Community-based healthcare workers

89

7.95%

Doctor

81

7.24%

Support staff (janitor, food service staff, administrative, etc.)

81

7.24%

EMT/Paramedic

50

4.47%

Physician’s Assistant or Nurse Practitioner

31

2.77%

Grand Total

1,119

100.00%

Fifty-two percent of healthcare workers surveyed did not have direct known exposure to COVID-19 patients but had the potential for exposure. Twenty-eight percent were working directly with COVID-19 patients.

Nurses were more likely to report having exposure to COVID-19 patients than the general population of healthcare respondents. Among nurses, 41 percent reported they were working directly with COVID-19 patients, and 49 percent reported they had potential exposure.

Among Nurses: Are you working directly with COVID-19 patients?

Count

Percentage

No, but I have potential exposure to COVID-19. (e.g. in COVID-19 patient rooms, work on same floor as COVID-19 patients, use same cafeteria, etc.)

119

48.57%

Yes

100

40.82%

No, I have no exposure to COVID-19 while at work

26

10.61%

Grand Total

245

100.00%

However, most (73 percent) respondents to the Healthcare Workers survey had not previously contracted COVID-19 at the time of surveying. 10 percent either had confirmed or suspected cases of COVID-19, and 17 percent were unsure.

Experiences of Healthcare Workers During COVID-19

MHA asked healthcare workers, “In the last three months, which of the following feelings have you been regularly experiencing? Check all that apply.”

Stress was the most commonly reported feeling, with 93 percent of healthcare workers indicating that they had regularly experienced stress in the last three months. This was followed by anxiety (86 percent), frustration (77 percent), exhaustion or burnout (76 percent), and feeling overwhelmed (75 percent). Gratitude, hope, and pride were reported by fewer people, although nearly a third (31 percent) reported that they regularly felt gratitude.

In the last three months, which of the following feelings have you been regularly experiencing? Check all that apply.

Count

Percentage

Stress

1038

92.76%

Anxiety

963

86.06%

Frustration

861

76.94%

Exhaustion/Burn-out

850

75.96%

Overwhelmed

844

75.42%

Sadness

751

67.11%

Unappreciated

670

59.87%

Anger

631

56.39%

Fear

618

55.23%

Loneliness

611

54.60%

Powerless

566

50.58%

Disconnected

552

49.33%

Grief

374

33.42%

Gratitude

347

31.01%

Hope

310

27.70%

Pride

220

19.66%

MHA also asked healthcare workers, “In the last three months, have you experienced an increase in any of the following? Check all that apply.”

Healthcare workers were most likely to report that they had increases in emotional exhaustion in the last three months (82 percent). This was followed by trouble with sleep (70 percent), physical exhaustion (68 percent), and work-related dread (63 percent). Over half of healthcare workers also reported experiencing changes in appetite (57 percent), physical symptoms like headache or stomachache (56 percent), questioning their career path (55 percent), compassion fatigue (52 percent), and heightened awareness, worry or attention to being exposed (52 percent).

In the last three months, have you experienced an increase in any of the following? Check all that apply.

Count

Percentage

Emotional exhaustion

919

82.13%

Trouble with sleep (difficulty falling or staying asleep)

785

70.15%

Physical exhaustion

764

68.28%

Work-related dread

703

62.82%

Change in appetite (overeating or undereating)

634

56.66%

Physical symptoms - headache, stomachache, etc.

623

55.67%

Questioning career path

617

55.14%

Compassion fatigue

584

52.19%

Heightened awareness/worry/attention to being exposed

580

51.83%

Lower self-esteem

499

44.59%

Upsetting thoughts, images and/or dreams

475

42.45%

Racing thoughts

452

40.39%

More likely to smoke, drink, and/or use substances

430

38.43%

Emotional Support for Healthcare Workers

When asked about emotional support, the largest group (39 percent) of healthcare workers indicated that they did not feel they had adequate emotional support. Another 26 percent were unsure if they were receiving adequate emotional support.

Nurses were even less likely to report that they had adequate emotional support than other healthcare workers. Among the nurses surveyed, 45 percent reported that they did not have adequate emotional support and 24 percent were not sure.

Over half of healthcare workers were receiving emotional support from family (57 percent) and friends (53 percent). Many healthcare workers also reported receiving emotional support from their same-level coworkers (38 percent).

From whom do you receive emotional support? Check all that apply.

Count

Percentage

Family

634

56.66%

Friends

593

52.99%

Significant other

437

39.05%

Same level co-workers

430

38.43%

Supervisor

171

15.28%

Therapist

169

15.10%

No one

136

12.15%

Support group (live virtual group or social media group)

57

5.09%

Roommate(s)

41

3.66%

Other

33

2.95%

Work-Related Stressors

When asked to select their top three work-related stressors, 61 percent reported uncertainty about when things will settle down or return to normal, and 54 percent reported experiencing burnout. Nearly half (49 percent) also reported that their heavy or increased workload was a major stressor in the previous three months.

What are your top three work-related stressors over the last three months? Check all that apply.

Count

Percentage

Uncertainty about when things will settle down/return to normal

678

60.59%

Burnout

599

53.53%

Heavy/increased workload

544

48.61%

Concern of getting sick myself

484

43.25%

Concern of spreading COVID-19

396

35.39%

Insufficient communication from leadership

337

30.12%

Insufficient PPE

289

25.83%

Working too many hours

271

24.22%

Job security/employment status

253

22.61%

Insufficient training

142

12.69%

Distress about how to effectively treat COVID-19 patients

136

12.15%

Inappropriate role designation

127

11.35%

Working at a new location

121

10.81%

Witnessing high number of deaths

101

9.03%

Other

55

4.92%

Treating coworkers with COVID-19

29

2.59%

Fear of Exposure and Increased Stress at Home

Most healthcare workers reported that they were worried about exposing the people they lived with to COVID-19. Forty-seven percent reported being worried about exposing their older adult family, and 45 percent were worried about exposing their spouse or partner. Seventy-six percent of healthcare workers with children reported they were worried about exposing their children. Nearly half (45 percent) selected more than one option.

Are you worried about exposing the people you live with to COVID-19? If yes, who? Check all that apply.

Count

Percentage

Exposing my child

358

75.80%*

Exposing my older adult family

521

46.56%

Exposing my spouse or partner

509

45.49%

I'm not worried about exposing my household members

170

15.19%

I live alone

158

14.12%

Exposing my roommate

111

9.92%

*Percent determined from the number of respondents who reported having children, as opposed to the whole population of respondents.

When asked about their top three home-related stressors, the majority of respondents (63 percent) reported that they were too tired when they got home from work to do home-related tasks such as cooking and chores. Nurses were even more likely to report feeling too tired after work than other healthcare workers (67 percent). Forty-one percent of healthcare workers reported loneliness as a significant stressor, and over 40 percent reported financial stress.

Among healthcare workers who indicated that they had children, 34 percent indicated that not being able to support children or be a present parent was a major stressor, and 32 percent reported a lack of quality time with their children as a result of COVID-19.

What are your top three personal/home-related stressors over the last three months?

Count

Percentage

I am too tired when I get home to cook, do chores, etc.

700

62.56%

Loneliness

464

41.47%

Financial stress

453

40.48%

Worry and/or guilt about infecting household members

410

36.64%

Taking stress out on my family

384

34.32%

Lack of quality time with partner(s)

341

30.47%

My partner doesn't understand the stress I'm under

279

24.93%

Inconsistent work hours/coordinating schedules

262

23.41%

Other family member(s) needing to take over my responsibilities

112

10.01%

 

 

 

Among people who reported having children:

 

 

Being able to support children/being a present parent

150

34.25%

Lack of quality time with children

142

32.42%

Homeschooling

125

28.54%

Childcare

96

21.92%

Half (50 percent) of healthcare workers indicated they were the primary caretaker within their homes. Another 5 percent normally would be the primary caretaker but had shifted responsibility as a result of COVID-19.

Among the healthcare workers who responded to this survey, 61 percent did not have children at home. However, among those who did report having children at home, 46 percent reported that their children either did not understand or were not concerned about them being a healthcare worker. Forty percent reported that their children were concerned but no more than expected, and 14 percent indicated that their children were extremely concerned.

For resources and supports for healthcare workers, please visit mhanational.org/frontline


The Healthcare Worker Survey was made possible by the generous support of the Johnson & Johnson Foundation.