A recent UHN study shows mental health and wellness programs offered to health care workers during the COVID-19 pandemic are not enough.
“Health care workers feel the burden of the COVID-19 pandemic in extraordinary ways and rates of burnout and distress are high,” explains study lead Dr. Susan Abbey, who is a Clinician Investigator at the Toronto General Hospital Research Institute. “We want to understand the range of concerns impacting the mental health and wellbeing of health care workers, how these concerns are changing over the course of the pandemic and why resources might not be maximized despite being made readily available.”
To shed light on this issue, the research team gathered and analyzed questions posted by staff as part of a series of open forums or virtual town halls hosted by hospital senior leaders. These forums were conducted between March 16 and December 1, 2020 at UHN, which is one of Canada’s largest health care institutions. All of UHN’s 21,555 staff were able to submit questions and upvote or ‘like’ questions posed by others.
To study this data, an approach known as critical discourse analysis was used. This approach studies the elements of language—such as vocabulary, grammar and persuasive style—to provide deep insights into the meaning of text. The approach can also reveal how attitudes and feelings are affected by external factors (i.e., in this case, factors such as media, social media, peers and institutional leaders).
Not surprisingly, the findings revealed that during the first wave of COVID-19, staff expressed nervousness and anxiety related to safety and the risk of COVID-19 infection. At this earliest stages in the pandemic, staff concerns were closely aligned with leadership concerns, which were centered on personal protective equipment supplies, infection control and prevention policies, as well as increased stress on frontline staff.
“Concerns around worker safety have remained high throughout the pandemic,” explains first author Dr. Berkhout. “As the pandemic continued, concerns around trust and transparency in leadership have begun to emerge—these feelings can affect how one manages fear and uncertainty. They can also contribute to burnout and loss of meaning in one’s work.”
Later in the pandemic, health care workers’ concerns grew to include feelings of being undervalued and underappreciated. Some staff voiced concerns relating to communication and information management. Staff also felt that existing employee assistance and wellness programs did not fully address staff concerns. These programs were seen as short-term fixes rather than addressing larger and underlying problems.
“Our study highlights how organizational culture, leadership practices, relationships and communication are critical to support wellness and mental health in staff. The world around us plays a big role in how we are able to cope,” comments Dr. Abbey.
“We need to work together so that staff feel heard, valued and supported in order to truly reduce stress and improve well-being.”
To access additional resources related to coping strategies, please visit anxietycanada.com and the World Health Organization’s #healthyathome campaign.
This work was supported by the Mount Sinai Hospital-University Health Network Academic Medical Organization. Berkhout SG, Sheehan KA, Abbey SE. Individual- and Institutional-level Concerns of Health Care Workers in Canada During the COVID-19 Pandemic: A Qualitative Analysis. JAMA Netw Open. 2021 Jul 1;4(7):e2118425. doi: 10.1001/jamanetworkopen.2021.18425.
Research team members (L to R): Dr. Suze Berkhout is an Education Investigator 2 at The Institue for Education Research, Dr. Kathleen A Sheehan is a Clinician Investigator at The Institute for Education Research and Dr. Susan Abbey is a Clinician Investigator at the Toronto General Hospital Research Institute.