Health Care Workers Are Suffering From Mental Health Issues

Workers’ compensation benefits might be available to health care workers who need mental health treatment

Working in health care has always been a challenge, but perhaps never more so than from 2020 to the present.

It’s not news to anyone that the COVID-19 pandemic taxed an already burdened health care system well beyond its capacity, and the individuals who took the brunt of the strain were the health care workers.

Even before covid, there were health care workers who were stressed, depressed, and suffering from mental health challenges related to their jobs. Nursing shortages, underserved communities, changing regulations, and burdensome bureaucracy played a role in making health care a difficult profession for workers at every level.

But we can never return to pre-covid times; even as the pandemic becomes our “new normal,” the burden on healthcare workers will remain.

The CDC defines “work stress” as “the harmful physical and emotional effects when job requirements do not match workers’ resources of needs.” (source)

Mental health can encompass an individual’s psychological, emotional and social wellness. It can affect how we feel, think, and behave.

Severity of mental health crises among health care workers

A survey of 500 health care workers and first responders that was published in late 2021 found that health care workers reported significant psychiatric symptoms that include:

• Post-traumatic stress disorder (PTSD) (38%)
• Anxiety (75%)
• Depression (74%)
• Recent thoughts of suicide or self-harm (15%)

42% of nurses reported experiencing PTSD following the first year of the pandemic. 83% of emergency medical services employees (EMS workers) reported experiencing symptoms of depression and nearly a quarter said they’d considered suicide or self-harm.

Health care workers in a separate study reported other symptoms that included:

• Emotional exhaustion (82%)
• Sleep disturbances (70%)
• Physical exhaustion (68%)
• Work-related dread (63%)
• Changes in appetite (57%)
• Headache or stomachache (56%)
• Feelings of doubt about their career (55%)
• Compassion fatigue (52%)
• Heightened awareness or worry about covid exposure (52%)
• Lower self-esteem (45%)
• Upsetting thoughts, images or dreams (43%)
• Racing thoughts (40%)
• More likely to smoke, drink, or use substances (38%)

Many of the surveyed health care workers were also feeling stressed about issues related to their own families, such as a lack of quality time with their children, homeschooling or remote school, and childcare concerns or shortages.

What causes mental health issues for health care workers?

These symptoms could be related to burnout, stigma, or difficulty accessing mental health care.

Many of the surveyed workers attributed their stress to factors related to the COVID-19 pandemic. They said that they were so overwhelmed by the sheer number of critically ill patients, worried about their own covid risks and risks to their families from exposure, and the emotional distress and heartache from watching so many patients die of COVID-19 in the earlier days of the pandemic.

In addition, workers said that they felt unsupported by their employers or that they were expected to take unnecessary risks. One person surveyed said they felt that their employer didn’t care and that they were “disposable.”

Outside of work, health care workers felt threatened, too. In many instances, the influence of political and community leaders who would urge people not to follow public health guidelines also took a toll. Nurses, doctors, and other health care providers felt that they were enduring tremendous stress at work caring for very sick patients, but then the community wouldn’t do its part by taking recommended precautions to slow the spread of covid.

Working conditions that can lead to mental health problems in health care workers

• Emotional situations with people who are very sick
• Exposure to human suffering or death
• Lengthy or unpredictble shifts, double shifts and other scheduling stresses
• Financial strain and unstable work hours related to as-needed shifts
• Unpredictable intensity of work during a shift
• Demanding physical work and injuries from patient handling
• Infectious diseases, hazardous drugs and other exposure-related concerns

In addition to these pressures, nearly 40% of surveyed health care workers reported that they don’t feel as though they have adequate emotional support at work. That figure was even higher among nurses, specifically. In that group, 45% did not feel supported at work.

Source: Mental Health America

Suicide risks among health care workers

A report published by California Health Care Foundation says that even before the pandemic, female nurses had twice as high a rate of suicide as women in other professions. Work-related stress and mental health problems were always risk factors, but they are heightened because of the pandemic.

The report points out that nurses face a dual burden: They provide the majority of bedside care to patients—working long and stressful shifts—and many then return to caregiving duties at home, either for children or aging parents.

One advocate for suicide prevention notes that stigma is a real problem and one of the contributing factor for suicides among nurses. Some believe that seeking mental health treatment would harm their professional standing or reputation, so they suffer in silence, which leads to bigger problems and sometimes suicide.

What can an employer do to improve mental health in the health care-related workplace?

There are some actions an employer can take—regardless of industry—that can help reduce the risk of work-related mental health issues for workers:

1. Take measures to keep workers safe from a variety of hazards;
2. Make sure work schedules are appropriate, with adequate staffing so workers can have time off;
3. Monitor the quantity and intensity of work;
4. Promote a positive workplace culture;
5. Respect your workers and create a culture where they respect each other;
6. Support a work-life fit;
7. Prevent discrimination and bullying;
8. Increase access to mental health screening tools for self-assessment;
9. Increase access to behavioral and mental health services like Employee Assistance Programs;
10. Provide access to counseling for mental health, substance abuse disorders, and financial needs;
11. Develop activities and programs that would foster a sense of community;
12. Identify and support at-risk individuals by training managers and supervisors to observe changes in mood and behavior;
13. Educate workers about the role each person plays at any level to keep themselves and their coworkers safe;
14. Teach coping and problem-solving skills, including programs for issues outside of work like regarding relationships or parenting;
15. Offer support if a co-worker dies by suicide, illness, accident, or in some other way.

Dr. Lorna Breen Healthcare Provider Protection Act

In March 2022, President Biden signed a law that will provide funding for mental health education and awareness campaigns. The law is named for Dr. Lorna Breen, an emergency medicine physician at New York-Presbyterian Hospital, Columbia University Medical Center who died by suicide in 2020.

Dr. Breen was recovering from covid at the time, but working 12-hour shifts at the hospital. She would stay past the end of her shifts because she was overworked and the hospital was understaffed. She knew she was suffering from the burden of her workload, but she concealed her troubles from her colleagues.

The funding of about $135 million over three years is intended to provide support for programs that will improve medical workers’ mental health and prevent suicides.

Workers’ compensation benefits for health care workers

Workers’ compensation is a nationwide program administered by the states that provides coverage for medical treatment, lost wages, and other expenses to workers who were injured on the job.

Nearly every employer is required to provide workers’ compensation insurance to employees.

Most states allow workers’ compensation to offer benefits for mental illness, emotional issues arising from work, work-related PTSD, and similar conditions. However, it’s not always easy to receive compensation for non-physical issues.

Workers’ compensation insurance is no-fault, so the affected person does not need to prove negligence in order to receive benefits. But you do need to prove that the injury or illness was directly related to conditions or an incident at work.

When your injury is a slip-and-fall, an accidental needle stick, or some other specific accident, it’s easy to prove that it happened at work. But when it’s the result of long-term problems, ongoing conditions, or is a “slow burn” of emotions that build over time, that becomes much more difficult.

You would need to be diagnosed by a physician or accredited counselor as having a specific mental health condition. They would need to note in your chart or medical records that they believe that the condition can be attributed to your experiences at work.

Each state determines the specific amount and type of damages you can recover through workers’ compensation insurance.

These are the benefits that are generally available:

• Medical treatment, including future surgeries, ongoing therapies, or anticipated treatment
• A percentage of your lost income, present and future, during your recovery or if you’re unable to work
• Transportation to medical appointments
• Job retraining and placement services if you’re unable to return to your previous job
• Disability payments
• Survivor benefits to family members or dependents of an employee who died at work

Resources for health care workers experiencing emotional distress

Substance Abuse and Mental Health Service Administration

National Suicide Prevention Lifeline

Disaster Distress Helpline

Physician Support Line

1-800-273-TALK (8255)

Text HOME to 741741

What should you do if you’re a health care worker who feels overwhelmed, depressed, or suicidal?

First, reach out to one of the organizations linked above to seek treatment and counseling. They can refer you to resources in your area and get the help you need before it’s too late.

Don’t try to handle it on your own. Seek professional help—it’s always okay to ask for help. Do it for yourself, your colleagues, your patients, and your family and friends who love you.

Also, paying for treatment should not be a roadblock to getting help. There are low- or no-cost resources, but if you require additional treatment, you might be able to receive workers’ compensation benefits.

If you have a diagnosis of a mental health condition that is related to your work, you can contact a workers’ compensation lawyer for additional help. Because this is less straightforward than a “typical” work-related accident or incident, you might need a lawyer to manage your claim.

Your lawyer is trained and experienced to handle the workers’ compensation system in your state. They will help you get the financial benefits you need to get back on your feet.

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