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Bioscience-Medicine

Stressed, anxious and depressed: Here's how medical providers are faring amid COVID-19

A health care provider works in the COVID-19 unit at Hearthstone Nursing and Rehabilitation in Round Rock.
A health care provider works in the COVID-19 unit at Hearthstone Nursing and Rehabilitation in Round Rock.

Health care workers have been stretched thin during the coronavirus pandemic, working relentlessly to help patients as COVID-19 hospitalizations overload intensive care units.

Some medical staff have placed work ahead of their own well-being and are experiencing increased levels of stress, anxiety and depression, according to researchers at UT Austin.

Dr. Nelly Salgado de Snyder led a study examining how COVID-19 is impacting health care workers and providers who work with underprivileged groups in the U.S., including people without access to many social benefits, like farmworkers, immigrants, refugees and people experiencing homelessness.

Researchers found more than one in 10 health care workers and providers experienced high levels of job-related and personal stressors during the pandemic, like sleep disturbances, family problems, excessive work hours and fear of bringing the virus home.

Most said they leaned on family members or friends for support. Only about 25% of respondents sought professional help either online or in person.

Salgado de Snyder says mental health during the pandemic has been left on the back burner. Listen to the interview above or read the transcript of the extended interview below to learn how health care workers and providers are coping.

The transcript has been edited lightly for clarity: 

KUT: How has working with vulnerable groups like farmworkers, immigrants and people experiencing homelessness during COVID-19 impacted the mental health of health care workers and providers beyond the stressors already present in their profession?

Salgado de Snyder: Quite often they feel they are unable to fulfill the expectations of their clients or to fare adequately to the needs of the clients. So this puts additional stress to their already very stressful tasks that they do day to day, either in clinic-based or hospital-based settings. And as you know, there is a shortage of health care workers and providers because now they have more tasks.

They also have to inform and educate vulnerable groups in addition to tending to their health needs that are directly related to COVID-19 or somehow associated to COVID-19. So this makes their work extremely stressful because they have to deal with their patient's needs and their own needs. Very often it is difficult to prioritize who should they spend more time with, who should they tend to first. And they tend to leave their own needs last. They tend to respond to their patients first.

What are health care workers and providers most stressed about during COVID-19?

Salgado de Snyder: Among the occupational stressors, what they reported were situations such as excessive workload, long working hours. Also, the fear of bringing the virus home to the family because in some clinics or the places that they work, especially in the middle of the pandemic or at the beginning of the pandemic, they did not have sufficient personal protection equipment.

Some of the other occupational stressors were the lack of institutional resources to follow up with their client's needs. Also, their felt inability to connect, especially their immigrant patients, with needed social services, for instance, food banks or assistance with rent or with legal matters. They also had trouble in communicating bad news to their clients, like telling them they or a family member were infected or they were in bad shape as far as their health is concerned.

But then there was also a personal dimension to this that had to do with their own private life. And among these stressors, what they reported, with very high-stress ratings, was insufficient sleep. Some of them reported insomnia. Some of them also reported job loss by their spouse, so they were living with a single income. And since most of our work respondents were women, they also were very stressful about the fact that they did not have proper child care arrangements, while at the same time, facing very high hours and demands in their job. We also found that having been in contact with a patient or a client who had been suspected to have COVID increased considerably their level of stress.

The study mentioned that long-term exposure to such negative stressors could have a lasting effect. What are these frontline workers doing to cope with these stresses in the short term? 

Salgado de Snyder: That is a very good question because their coping responses were limited to, basically, seek the support, help and companionship from family members and friends. Very few of them, about 25%, sought professional counseling either online or person to person, mostly related to the fact that they didn't have time to find these types of services. Other activities that helped were meditation, exercise and mindfulness-type of approaches. Very few used substances to cope with this problem.

What else might work for these health care workers as the pandemic continues? 

Salgado de Snyder: We strongly believe that somehow the organizations in which they work will provide some sort of support to help them cope with the situation that we are all living, but particularly that they are exposed to by giving them access to free online supportive services, counseling services, for them and their family members as well. Perhaps to hire more staff so that they are not exposed to long periods of time with high demanding schedules.

Why is it important to prioritize the mental health of health care workers and providers? 

Salgado de Snyder: Well, because we really don't know how long this pandemic is going to last. We are all in it, and we may not suffer from COVID itself. We may not be ill from that, but we are all being exposed to the mental health strains associated with this — social distancing, the protective behaviors that we all have to perform so that we stay away from hospitals, medications and all of that.

Mental health is one of the aspects that has been neglected in this pandemic. It will cause a definite diminished quality of life and well-being in people's lives. So we need to tend to mental health because it's as important as physical health needs.

Got a tip? Email Dani Matias at dmatias@kut.org. Follow her on Twitter @Matias7Dani

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