Health Worker Mental Health

May is Mental Health Awareness Month.  Join the National Institute for Occupational Safety and Health (NIOSH) in bringing attention and encouraging steps to improve health worker mental health.

Building Workplaces Where Health Workers Can Thrive

Challenging work conditions put over 20 million U.S. health workers at risk for mental health issues, but supportive work environments can help protect their well-being.  Health workers include everyone working in patient care, such as nurses, physicians, home health aides, and medical assistants.  It also includes many others who serve in critical support roles as well as public health workers.  The challenges they face in the workplace include long hours, staffing shortages, and exposure to violence and harassment [1].

Mental health concerns among health workers include stress, burnout, depression, anxiety, substance use disorders, and suicidal behavior.  Burnout and poor mental health outcomes are longstanding concerns made worse by the unique challenges of the pandemic.

A recent CDC Vital Signs, authored by NIOSH, compared data in 2018, before the pandemic, with data in 2022, after the onset of the pandemic.  It found that health workers are facing a mental health crisis [2]:

• More than double the number of health workers reported harassment at work in 2022 than in 2018.
• Nearly half of health workers (46%) reported often feeling burned out in 2022, up from 32% in 2018.
• Nearly half of health workers (44%) intended to look for a new job in 2022, up from 33% in 2018.  Other research has shown the top reasons for leaving included insufficient staffing, intensity of workload, and the emotional toll of job [3].

Policies and Practices to Promote Well-being

While these findings are concerning, the Vital Signs study also showed certain workplace policies and practices can promote well-being.  Health workers reported fewer mental health issues when they said they work in a supportive environment.  Aspects of a support environment includes:

• Participation in workplace decisions
• Trust between management and workers
• Proactive and helpful supervisors that promote:
  • Stress prevention,
  • Psychological health,
  • Support for productivity,
  • A harassment-free workplace, and
  • Enough time to complete tasks.

NIOSH Resources to Improve Health Worker Mental Health

NIOSH is actively working to help address this issue through the Impact Wellbeing™ campaign.  It provides hospital leaders with evidence-informed solutions to reduce healthcare worker burnout, sustain wellbeing, and build a system where healthcare workers thrive.  It is designed to help hospital leaders go beyond encouraging self-care and individual resilience to focus on operational improvements.

On March 18, the first inaugural Health Workforce Well-being Day, NIOSH expanded the campaign with a new set of resources.  The Impact Wellbeing™ Guide: Taking Action to Improve Healthcare Worker Wellbeing was developed in partnership with the Dr. Lorna Breen Heroes’ Foundation.  The Guide has six evidence-informed Actions designed to improve the professional wellbeing of healthcare workers and strengthen hospital operations.  It was real-world tested for usability by six hospitals within the CommonSpirit Health system across the United States.

In addition to the Guide, Impact Wellbeing has several web resources:

• For hospital leaders – NIOSH has tips on how to effectively communicate with staff.  This includes how to establish two-way communication, use inclusive and stigma-free language, and general communication best practices.
• For healthcare workers – NIOSH also has communication tips for healthcare workers, specifically on how to talk about burnout, moral injury, and mental health at work.  Another page for workers has recommendations on how to advocate for the use of the Guide in their workplaces.

NIOSH has also helped update the science around health worker mental health through a supplemental issue of the American Journal of Public Health.  Sponsored and edited by NIOSH, the issue focused on the theme Addressing the Current Crisis and Building a Sustainable Future.  The fifteen articles provide updated data, original research, and perspectives from organizations taking action to improve health worker mental health.  The special issue is open access.

Finally, NIOSH published a new training, Understanding and Preventing Burnout among Public Health Workers: Guidance for Public Health Leaders.  It helps managers and supervisors prevent burnout in the public health workers they lead and in themselves.  This free online training has a modular format to help busy supervisors fit it into their schedules.  Participants learn about demands that contribute to burnout and resources that can protect workers from burnout.  The course also uses a multi-level framework for choosing among evidence-based interventions.

How You Can Help

Learn more about Impact Wellbeing, health workers and mental health, and about mental health in general.  Visit the NIOSH Total Worker Health® Program and the Healthy Work Design and Well-Being Program to learn more about how work conditions and work design impact worker well-being.

Share resources with health workers.  NIOSH has training and resources for health workers on stress, fatigue, burnout, substance use, and suicide.  You can also share the following resources:

• Mental Health in the Workplace
• Coping with Stress
• Support for Public Health Workers and Health Professionals
• Emergency Responders: Tips for Taking Care of Yourself
• Suicide Prevention
• National Academy of Medicine Action Collaborative on Clinician Well-Being and Resilience

If you or someone you know needs support now, call or text 988 or chat 988lifeline.org.  988 connects you with a trained crisis counselor who can help.

If you or someone you know needs assistance (in English or Spanish) with mental health concerns and/or substance use disorders, prevention, and recovery, please contact SAMHSA’s National Helpline at 1-800-662-HELP (4357) or visit https://www.samhsa.gov/find-help.

References

[1] National Academies of Sciences, Engineering, and Medicine [2019].  Taking action against clinician burnout: A systems approach to professional well-being.  Washington, DC: The National Academies Press.

[2] Nigam JA, Barker RM, Cunningham TR, Swanson NG, Chosewood LC.  Vital Signs: Health Worker–Perceived Working Conditions and Symptoms of Poor Mental Health — Quality of Worklife Survey, United States, 2018–2022.  MMWR Morb Mortal Wkly Rep 2023;72:1197–1205, http://dx.doi.org/10.15585/mmwr.mm7244e1.

[3] Berlin G, Lapointe M, Murphy M [2022].  Surveyed nurses consider leaving direct patient care at elevated rates.  McKinsey & Company, February 17, https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/surveyed-nurses-consider-leaving-direct-patient-care-at-elevated-rates.