The COVID-19 pandemic has impacted the mental health of the general public, healthcare workers, and other frontline workers in the United States. However, little research has been conducted to assess the pandemic’s mental health effects on public health workers.
A wide variety of professionals are considered to be public health workers, including health educators, nurses, epidemiologists, sanitarians, technicians, engineers, nutritionists, laboratory workers, and others. According to a 2014 survey, there are an estimated 250,000 state and local public health workers in the U.S.
Since the pandemic’s start, many of these workers have been involved in implementing public health measures, including a nationwide COVID-19 vaccination campaign. The prolonged demand for their services might put them at similar risk for negative mental health consequences as other healthcare and frontline workers.
Assessing the Situation
To help learn more, researchers from the CDC and colleagues conducted an anonymous online survey from March 29 to April 16, 2021, among people employed by state, tribal, local, and territorial public health departments. The results of the survey were published in the July 2 edition of the CDC’s Morbidity and Mortality Weekly Report (MMWR). Survey questions asked participants about traumatic events or stressors they experienced over the past year, demographic information, workplace factors, and self-reported mental health symptoms.
According to the responses from more than 26,000 people, 53% reported having at least one mental health symptom of depression, anxiety, or post-traumatic stress disorder (PTSD) on screening tests for the respective conditions, or suicidal ideation in the two weeks prior to completing the survey. Of those surveyed, most reported working directly on COVID-19 response activities (92.6%), and 12.6% reported having been diagnosed with COVID-19.
Workplace Factors and Demographic Variations
Respondents reported experiencing traumatic events or stressors since March 2020, including:
- Feeling overwhelmed by workload or family/work balance (72.0%)
- Feeling bullied, threatened, or harassed because of work (23.4%)
- Receiving job-related threats because of work (11.8%)
For all respondents, the severity of symptoms increased as the proportion of time spent on COVID-19-related activities and the time spent at work increased. Public health workers who were unable to take time off of work when needed were nearly twice as likely to report mental health symptoms as those who were able to take time off.
The highest prevalence of mental health symptoms was reported among younger respondents aged 29 years or less (range = 13.6%-47.4%), transgender or nonbinary respondents of all ages (range = 30.4%-65.5%), and those who identified as multiple races (range = 12.1%-43.4%). Prevalence of PTSD symptoms was higher among respondents who had a post-baccalaureate graduate education (40.7%). Among all respondents, the prevalence of reported PTSD symptoms was 10-20% higher than previously reported among healthcare workers, frontline workers, and the general public. Visit our previous blog post about PTSD among healthcare workers for additional information
Impacts and Solutions
The authors of the report note that increases in mental health symptoms among workers are associated with increased absenteeism, high turnover, lower productivity, and lower morale. These types of impacts could influence public health organizations’ ability to respond to emergencies such as the COVID-19 pandemic. The authors suggest several strategies that could reduce adverse symptoms among public health workers:
- Expanding staffing size, by hiring more employees or recruiting volunteers who could backfill when needed;
- Implementing flexible schedules to reduce the number of long work hours;
- Encouraging regular breaks and time off to avoid burnout;
- Implementing and promoting employee assistance programs; and
- Strengthening workplace systems and cultures to encourage behavior that enhances mental health, develops long-lasting coping strategies, and destigmatizes appeals for mental health assistance.
Some experts warn that the true mental health impacts of the pandemic might not be known for years. Anyone who has experienced trauma or is feeling mental health symptoms related to the COVID-19 pandemic, or for any other reason, is encouraged to reach out to your employer, a colleague, friend, or family member. If you or someone you know needs immediate help with mental health symptoms, call 1-800-273-8255, or visit the National Suicide Prevention Lifeline website for other helpful information.
Share your Experiences
All public health workers, their family members, and close community contacts are invited to join the HERO Registry, a community of people who share what it is like to work and live during the COVID-19 pandemic. As a Registry member you can help identify priorities for research and possible solutions for public health care workers impacted by the pandemic. In addition, the HERO Registry is starting point to participate in COVID-19 related studies such as HERO-TOGETHER, a paid post-vaccination research opportunity.