Researchers at the US Centers for Disease Control and Prevention are sounding the alarm over a “mental health crisis” among the country’s healthcare workers.
Using national survey data between 2018 and 2022, a new report from the agency found that nearly half of health workers reported feeling burned out in 2022, up from less than a third four years earlier. Health workers’ reports of being harassed at work also more than doubled.
The report, released on Tuesday, also shows that health workers face worse mental health outcomes than workers in other industries. The findings come on the heels of the largest healthcare worker strike in US history, in which 75,000 unionised Kaiser Permanente employees cited feelings of burnout and chronic understaffing during a walkout in five states and the District of Columbia.
“While health care workers are usually dedicated to caring for others in their time of need, it is now our nation’s health care workers who are suffering, and we must act,” said Debra Houry, the CDC’s chief medical officer.
Even before the pandemic, Houry added, health care workers’ jobs were demanding: providers face long hours and unpredictable schedules, exposure to infectious diseases, and often difficult interactions with patients and their families.
Previous research has shown that health care workers – particularly nurses, allied health professionals and health technicians – are at increased risk of suicide compared to people who don’t work in the medical field.
“Caring for people who are ill can also be very stressful and emotional,” said Houry. “Although you are doing everything you can to save a life, I still remember some of the difficult patient cases I had, such as breaking the bad news of an advanced cancer diagnosis to a working spouse, or being unable to resuscitate a young toddler after a car accident.
“After a shift like that, I had to put on a brave face and take care of my own family. And I didn’t always pay enough attention to my own wellbeing,” she added.
According to Houry, the Covid-19 pandemic exacerbated workplace challenges, with healthcare providers facing a wave of patients, long hours and supply shortages. These stresses fueled a rise in mental health complications, suicidal ideation and, like much of the US adult population, substance abuse problems.
The study found that between 2018 and 2022, healthcare workers reported an increase in poor mental health days. 44% of health care workers reported wanting to look for a new job, up from 33% in 2018.
In contrast, the number of other essential workers who intended to look for a new job fell over the same period.
Meanwhile, the number of healthcare workers who experienced harassment – including violent threats, bullying and verbal abuse from patients and co-workers – rose from 6% to 13% during the study period.
According to the CDC report, harassment had a significant impact on the mental health of healthcare workers: Healthcare workers who reported being harassed were five times more likely to report anxiety than those who were not harassed. Those who experienced harassment were more than three times as likely to report depression and almost six times as likely to report burnout.
For example, 85% of health workers who experienced harassment reported anxiety, compared with 53% of those who did not. 60% of harassment victims reported depression, almost twice as many as health workers who had not been harassed.
However, these outcomes could be prevented through improved workplace policies and practices, the report says.
The study found that health workers who trusted their managers, had enough time to do their jobs and received support from supervisors were less likely to report burnout.
“We urge employers to take this information to heart and take immediate preventive action,” said Casey Chosewood, director of the National Institute for Occupational Safety and Health’s Office of Total Worker Health. “Supportive work environments have a positive impact on health workers.”
The report also recommended that employers encourage “worker participation at all levels” in decision making: health workers who were involved in decision making were about half as likely to report symptoms of depression. Chosewood recommended that supervisors support their workers by monitoring staffing needs and taking reports of harassment seriously.
The CDC’s National Institute for Occupational Safety and Health also plans to launch a national campaign this autumn to help hospital leaders address challenges to health worker well-being – part of an ongoing initiative by the agency to raise awareness of health worker mental health issues.
“The bottom line is this: we need to take the research we have and act,” said Chosewood. “To call our current and long-standing challenge a ‘crisis’ is an understatement. Patients in our communities – all of us, really – will be better off if our health workforce thrives.”
