Mental health of public health workers damaged during pandemic

Among public health workers who responded to a recent survey, 53% said they had experienced symptoms of at least one mental health problem in the past two weeks.

The most common symptoms of respondents were those associated with post-traumatic stress disorder (PTSD; 36.8%), followed by depression (32%) and anxiety (30.3%); about 8% said they had thoughts of suicide, reported Jonathan Bryant-Genevier, PhD, of the CDC, and his colleagues.

After analyzing the results of this non-probabilistic online survey – which collected responses from 26,174 public health officials across the United States from March 29 to April 16 – researchers found that the highest prevalences of symptoms related to mental health were among minors. 29 (range 13.6% to 47.4%), transgender or non-binary people of all ages (range 30.4% to 65.5%) and those who identified as multiple races (range 12, 1% to 43.4%), the team reported in the Morbidity and Mortality Weekly Report.

The survey also showed that public health workers who were unable to take time off work were almost twice as likely to show symptoms of a mental health problem (prevalence ratio of between 1.84 and 1.93) compared to those who were able to take time off work. .

“Several strategies could reduce unwanted mental health symptoms among public health workers during public health emergencies,” wrote Bryant-Genevier and colleagues. “For example, increasing the size of staff (eg recruiting back-up staff to fill positions) and implementing flexible hours could reduce the need for long working hours; encouraging workers to take regular breaks and holidays could help prevent overwork and reduce the risk of mental disorders. health outcomes. “

The increase in mental health issues among the general population and healthcare workers during the COVID-19 pandemic has been well documented, the authors pointed out. Yet the extent of these symptoms has not been equally measured among public health workers, who have also been key players during the pandemic. And with a generalization deficit among public health workers in the United States, the pressure on this particular group has continued to mount.

For their investigation, Bryant-Genevier and colleagues used questions from the 9-Item Patient Health Questionnaire (PHQ-9) for Depression and Suicidal Ideation, 2-Item General Anxiety Disorder (GAD-2 ) and the 6-item Impact of Event Scale (IES-6) for PTSD.

Among survey respondents, the majority identified as white (17,218) and female (19,873). Notably, one in five respondents said they needed mental health counseling in the past 4 weeks, but did not receive it. Employee assistance programs were available for 66.1% of public health workers surveyed, but only 11.7% of respondents had actually accessed them. However, of all respondents, 27.3% did not know whether or not their employer offered an employee assistance program.

The prevalence of mental health problems among public health workers was higher than the previously reported rate – 40.9% – among the general population. While the prevalence of symptoms of depression and anxiety among public health workers was similar to previous reports, symptoms of PTSD in these workers were found to be 10-20% higher than previously reported rates among healthcare workers, frontline staff and the general public.

Survey respondents reported having experienced traumatic events and stressors since March 2020, including feeling overwhelmed by their workload (72%) and feeling intimidated, threatened or harassed because of work ( 23.4%). Those who reported experiencing trauma and stress were also more likely to report symptoms of PTSD than those who did not experience the same type of trauma.

Although the screening instruments used for the survey are all clinically validated, Bryant-Genevier and colleagues recognized that one of the significant limitations of their study was its use of self-reported mental health symptoms, which do not constitute a diagnosis. mental health disorder. Other limitations, they noted, included the 2-week timeframe covered by the survey questions, which may not reflect the extent of symptoms experienced during the pandemic.