Providing Support for the Mental Health of Health Care Workers

This supplement is the result of an initiative of the U.S. Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health (NIOSH) to present the challenges to health care workers’ mental health, document processes in place and recommend additional measures to address mental health burdens in occupational settings.

Opening this issue, Howard & Houry’s article (pp. 137–141) sets the stage for the ensemble of articles in this supplement. In this editorial, the authors urge health leaders to act with regard to occupationally-related mental health burdens and emphasize NIOSH’s commitment to provide support to them in that task.

Schwatka et al. (pp. 142–147) discuss a recent report on clinician burnout by the National Academy of Medicine, pointing out that without proper support from leadership, the report’s recommendations are unlikely to be implemented.

Chen et al. (pp. 148–151) provide an example of how changes in the workplace can be supported, analyzing the results achieved by recipients of grants from the Health Resources and Services Administration (HRSA) related to the Dr. Lorna Breen Act.

Following these editorials, three Notes From the Field examine different aspects of the problem at hand and possible responses.

Simmons et al. (pp. 152–155) present changes in licensing and credentialing in Virginia that allow health care workers to seek mental health care without fearing the loss of their licenses and credentials. Hansel et al. (pp. 156–161) show the results of a small sample survey, which characterize a relatively high prevalence of mental health issues and demonstrate the need for comprehensive approaches to properly address these issues. The last article in this group, by Schwatka et al. (pp. 162–166), presents data from focus groups showing how systemic problems threaten the workplace safety, health, and well-being of hospitalists and stresses the need for organizational leadership to face those issues.

An article by Doukas et al. (pp. 167–170) provides evidence that time-limited clinician-delivered telehealth cognitive behavioral therapy can be highly effective in reducing symptoms of poor mental health among health care workers.

The analytical essay by Krisher et al. (pp. 171–179) ponders the need to properly evaluate and select digital mental health solutions to support health care workers’ mental health and well-being.

This essay is followed by four research articles that illustrate concrete situations faced by specific groups of health care workers. Titler et al. (pp. 180–188) present the results of a statewide survey on nurses’ well-being, which has shown that negative outcomes are prevalent, but derived from easily correctable problems. Zhou et al. (pp. 189–199) report the results of a survey that compares the mental health outcomes of US-born and immigrant caregivers. Findings indicate that the two groups have different risk factors for psychological stress that necessitate targeted treatments. DePierro et al. (pp. 200–203) analyzed the results of a survey of non-physician health care workers to measure the impact of potential determinants on intent to leave the profession during the pandemic; they found that burnout was the strongest correlate, and individuals with a better workplace culture had lower intent to leave. The fourth research article, by Hurtado et al. (pp. 204–212), examines how health care workers’ perceptions about their workplaces’ response to the COVID-19 pandemic affected their well-being, finding that proper safety responsiveness was positively associated with lower psychological distress.

Closing this issue, Anger et al. (pp. 213–231) present a systematic review of the literature about support and treatment of mental health within the health care workforce. The authors show a fairly consolidated approach with evidence of effectiveness, providing a well-documented basis for health care facilities to implement the necessary measures for the well-being of their workers.

Taken together, this ensemble of articles can be a useful resource for protecting the mental health of health care workers. These professionals deserve that protection and support for themselves and the public well-being. There is an urgent need to prevent serious consequences, including the abandonment of an already understaffed health care sector.