The importance of mental health care for clinicians during times of crisis

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The COVID-19 pandemic has affected the physical and mental health of the global population in many ways. Clinicians have been uniquely affected by this crisis; overwork, inadequate personal protective equipment (PPE), and first-hand witness to the effects of a deadly pathogen have exacted a heavy toll. Close contact with patients with COVID-19 exacerbates these stressors further, as does the overall uncertainty of everyday life.

As an occupation, clinical care has always carried burdens affecting the mental health of doctors, nurses, and other care staff. Long shifts, fast pace, and high-stress situations can lead to anxiety, depression, and burnout, influencing one’s personal wellbeing and job performance. Unfortunately, the ongoing stigma associated with mental health issues often curtails help-seeking and may increase the risk of self-harm.

While the stressors of clinical care are high at baseline, they have increased substantially during the pandemic. A systematic review of nearly 100,000 healthcare professionals in 21 countries revealed that one in five clinicians reported symptoms of depression, anxiety, or post-traumatic stress disorder (PTSD) during the COVID-19 pandemic. 

A survey conducted by the US Physicians Foundation in 2020 reported that more than half of physicians disclosed feelings of burnout. Among physicians, 18% reported an increase in the use of medications, alcohol, or illicit substances to cope with pandemic-related stress, 8% reported thoughts of self-harm, and nearly one in four knew a physician colleague who died by suicide.

Although the COVID-19 pandemic has had an unprecedented impact on the psychological wellbeing of clinicians, self-care is not always a priority in an occupation that prides itself on putting the needs of patients first. Yet patients will undoubtedly get better care when their caregivers are healthy, both mentally and physically. Self-care practices shown to reduce burnout in clinicians include exercise, good sleep habits, maintaining meaningful relationships and mindfulness strategies, among others.

When facing major life stressors over a more extended period of time, access to mental health care is associated with symptom relief, restored functioning, and prevention of progression toward more severe psychiatric conditions and dangerous maladaptive behaviours, including suicidal thoughts or behaviours.

Moreover, psychiatric intervention may be important to distinguish pathologic manifestations such as adjustment disorder from everyday feelings of anxiousness associated with stressful events. Destigmatising mental health issues will further help to ensure fairness, respect, and social justice in order to build resilience at an organisational level while contributing to the wellbeing of individual healthcare workers.

The COVID-19 pandemic, though extreme in many ways, is not likely to be the last healthcare crisis affecting the psychological wellbeing of clinicians. Just as we’ve learned about the pathophysiology of COVID-19 and the SARS-CoV-2 virus, we must learn and implement strategies to build resilience in the healthcare workforce to ensure their health and safety during times of crisis and beyond.