Newsroom Feature: Health Worker Mental Health | NIOSH

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. 

Health Workers are More Likely to Experience Mental Health Problems

Challenging work conditions put over 20 million U.S. health workers at risk for mental health problems. Health workers include everyone working in patient care, such as nurses, physicians, home health aides, and medical assistants, and many others who serve in critical support roles. Mental health concerns among health workers include stress, burnout, depression, anxiety, substance use disorders, and suicidal behavior. These mental health concerns are not new. Even before the pandemic, health workers faced challenging work conditions and suffered high rates of poor mental health outcomes. For example, 79% of physicians reported burnout starting before the pandemic [1].

Some of the challenging work conditions in healthcare include:

• Long work hours
• Rotating and irregular shifts
• Intense physical and emotional labor
• Exposure to human suffering and death
• Increased risk of exposure to disease and violence

Recent research shows many health workers are feeling the weight of these challenges and this has intensified with the onset of the COVID-19 pandemic. Shortages in staffing and personal protective equipment, and fatigue, loss, and grief have added a new level of burden to health workers. According to a survey from June-September 2020 [2]:

• 93% of health workers reported being stressed out and stretched too thin;
• 82% shared being emotionally and physically exhausted; and
• 45% of nurses reported that they were not getting enough emotional support.

Other studies during the pandemic found:

• 22% of healthcare workers experienced moderate depression, anxiety, and post-traumatic stress disorder in a collective analysis of 65 studies [3].
• 69% of physicians reported experiencing depression and 13% had thoughts of suicide [1].
• Of physicians reporting burnout, 64% were women [1].
• Nurses, frontline, and younger workers reported more severe psychological symptoms than other health workers [4].

These challenges risk a serious shortage in available health workers. In one survey, 32% of nurses reported they might leave their positions within a year [5]. The top reasons for leaving included insufficient staffing, intensity of workload, and the emotional toll of job.

NIOSH Activities to Improve Health Worker Mental Health

NIOSH is actively working to help address this issue through the new Health Worker Mental Health Initiative. One goal of the Initiative is to raise awareness of health workers’ mental health issues, particularly focusing on the role work conditions play and what employers can do. This effort kicked off with a Call-to-Action webinar in November 2021. The webinar featured presentations and discussions with the U.S. Surgeon General Dr. Vivek Murthy, NIOSH Director Dr. John Howard, Dr. Lotte Dyrbye, Co-Director of the Mayo Clinic Program on Physician Well-Being, and Liz Royal from the Service Employees International Union National Nurse Alliance. A larger, nationwide, multi-layered, social marketing campaign will follow later this year.

The Initiative also aims to:

• Identify and improve data, screening tools, trainings, resources, and policies to address health worker mental health
• Reduce stigma related to seeking and receiving care for mental health
• Identify workplace and community supports for health workers
• Eliminate barriers to accessing care

How You Can Help

Learn more about 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:

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

References

[1] National Institute for Health Care Management [2021]. Physician burnout & moral injury: The hidden health care crisis. March 21,

[2] Mental Health America [2020]. The mental health of healthcare workers in COVID-19.

[3] Li Y, Scherer N, Felix L, Kuper H [2021]. Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLOS ONE, 16(3): e0246454,

[4] Vizheh M, Qorbani M, Arzaghi SM, Muhidin S, Javanmard Z, Esmaeili M [2020]. The mental health of healthcare workers in the COVID-19 pandemic: A systematic review. J Diabetes and Metab Disord, 19(2):1967-1978,

[5] Berlin G, Lapointe M, Murphy M [2022]. Surveyed nurses consider leaving direct patient care at elevated rates. McKinsey & Company, February 17,