How Can We Support Healthcare Workers' Mental Health During COVID-19?

What you need to know

• Healthcare workers are at high risk of developing mental health issues like PTSD due to traumatic experiences during the COVID-19 pandemic
• Hospitals and clinics can take proactive steps to support staff mental health and build resilience
• Individual healthcare workers can practice self-care and utilize mental health resources to cope with stress
• Special attention is needed to support minority healthcare workers who face additional risks and burdens

Understanding trauma and PTSD in healthcare workers

Healthcare workers on the frontlines of the COVID-19 pandemic are facing extremely challenging and often traumatic experiences. While their focus is on caring for patients, these workers are also at high risk of developing mental health issues themselves, particularly posttraumatic stress disorder (PTSD).

PTSD can develop after a person experiences or witnesses a traumatic event involving actual or threatened death, serious injury, or violence. For healthcare workers during the pandemic, this could include things like:

• Witnessing multiple patient deaths
• Feeling helpless to save critically ill patients
• Fearing for one’s own health and safety
• Being overwhelmed by the volume of sick patients
• Lacking adequate protective equipment or resources

It’s important to understand that experiencing trauma does not automatically lead to PTSD. In fact, most people exposed to trauma do not develop the disorder. However, healthcare workers are at higher risk compared to the general population. Studies have found PTSD rates of 14-20% among physicians and nurses, compared to about 7% in the general public.

Someone with PTSD may experience symptoms like:

• Intrusive memories or flashbacks of the traumatic event
• Nightmares
• Avoiding reminders of the trauma
• Negative changes in thoughts and mood
• Feeling constantly on guard or easily startled
• Difficulty sleeping or concentrating

For healthcare workers, these symptoms can significantly impact their personal lives and ability to function at work. Without proper support, PTSD can lead to long-term mental health struggles.

The toll on healthcare workers

The COVID-19 pandemic has created uniquely stressful circumstances for healthcare workers. Early studies from China found that over 50% of frontline workers were experiencing symptoms of depression, anxiety, or PTSD.

Several factors contribute to the high psychological toll:

• Prolonged periods of intense stress and trauma exposure
• Fear of contracting the virus and infecting loved ones
• Lack of adequate personal protective equipment in some cases
• Difficult ethical decisions about rationing care
• Isolation from family and normal support systems
• Exhaustion from long hours and staff shortages

Healthcare workers often feel they need to “stay strong” and may be reluctant to admit they are struggling. However, unaddressed mental health issues can lead to burnout, medical errors, substance abuse, and leaving the profession altogether.

The pandemic’s impact has not been equal across all healthcare workers. Studies have found that women, nurses, and frontline workers directly treating COVID-19 patients tend to experience higher rates of psychological distress. Additionally, minority healthcare workers face disproportionate risks, often working in under-resourced facilities and communities hit hardest by the virus.

Building resilience and preventing PTSD

While the challenges are daunting, there are many steps that both individual healthcare workers and hospital leadership can take to support mental health and build resilience:

For individual healthcare workers:

• Practice self-care basics like getting enough sleep, eating well, and exercising
• Take breaks during shifts to rest and recharge when possible
• Connect with supportive colleagues, friends and family
• Use relaxation techniques like deep breathing or meditation
• Seek professional mental health support if needed
• Be aware of signs of burnout or PTSD in yourself and coworkers

For hospital and clinic leadership:

• Provide education on stress management and recognizing signs of PTSD
• Offer regular mental health screenings for staff
• Ensure adequate personal protective equipment and safety measures
• Allow for sufficient rest periods and time off
• Create peer support programs and opportunities for staff to process difficult experiences
• Make professional mental health services easily accessible
• Train leaders to model self-care and support staff wellbeing

One key recommendation is to integrate mental health professionals directly into healthcare teams. This makes it easier for workers to access support and normalizes caring for mental health.

Regular “huddles” at the start and end of shifts can help teams process challenges together. Case consultation groups allow staff to discuss difficult cases in a supportive environment.

For healthcare workers experiencing persistent distress, seeking formal mental health treatment is strongly encouraged. Professional help can provide tools to manage PTSD symptoms and build resilience.

Supporting minority healthcare workers

The pandemic has highlighted and exacerbated existing health disparities, with communities of color being disproportionately impacted. This creates additional burdens for minority healthcare workers, who are more likely to:

• Work in facilities with fewer resources
• Serve in lower-income communities with higher COVID-19 rates
• Have less access to personal protective equipment
• Face discrimination and bias in the workplace

To address these inequities, healthcare organizations should:

• Ensure equal access to protective equipment and safety measures
• Provide additional mental health resources and support
• Offer cultural competency training for all staff
• Address systemic racism and bias in hiring, promotion and workplace culture
• Include diverse voices in leadership and decision-making

Minority healthcare workers may benefit from culturally-relevant mental health resources and peer support groups. Leaders should make extra effort to check in on the wellbeing of minority staff members.

Conclusions

• Healthcare workers are experiencing high rates of trauma and mental health issues during the COVID-19 pandemic
• Proactive steps by both individuals and organizations are needed to prevent PTSD and support resilience
• Integrating mental health support into healthcare teams is key
• Special attention and resources are needed to support minority healthcare workers facing additional burdens
• Caring for the mental health of healthcare workers is crucial for maintaining a strong healthcare system during this crisis and beyond