Over half (53%) of United States public health workers reported symptoms of depression, anxiety, post-traumatic stress disorder (PTSD) or suicidal thoughts since the start of the COVID-19 pandemic, according to a large survey conducted by the Centers for Disease Control and Prevention (CDC).

More than 26,000 state, tribal, local or territorial public health workers responded to the survey, which the CDC submitted between March 29 and April 16, 2021.

Respondents reported symptoms of depression (32.0%), anxiety (30.3%), PTSD (36.8%), or suicidal ideation (8.4%) in the preceding 2 weeks. Adults age 29 or younger (range = 13.6%–47.4%) and transgender or nonbinary individuals of all ages (range = 30.4%–65.5%) reported the highest prevalence of these symptoms. Public health workers who reported that they were unable to take time off from work were more likely to report symptoms of mental health issues. Among all respondents, symptoms increased as their weekly work hours increased and as they devoted more time to COVID-19 response.


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Traumatic events or stressors reported include feeling overwhelmed by workload or family/work balance (72.0%), receiving job-related threats because of work (11.8%), and feeling bullied, threatened or harassed because of work (23.4%). Respondents who reported traumatic events or stressors were more likely to report PTSD symptoms than those who did not experience trauma.

The researchers noted “increases in adverse mental health symptoms among work­ers have been linked to increased absenteeism, high turnover, lower productivity, and lower morale, which could influence the effectiveness of public health organizations during emer­gencies.”

Among the limitations of the study, the researchers could not determine from the convenience sample the number of respondents who did and did not complete the survey. Because the survey was submitted through public health membership associations, the results may not reflect the entire public health population. Screening instruments used do not reflect a mental health disorder diagnosis, although they are clinically validated. And because participants were asked about symptoms in the preceding 2 weeks, the results may not reflect all pandemic-related symptoms.

“Addressing work practices that contribute to stress and trauma is critical to managing workers’ adverse mental health status during emergency responses,” the researchers concluded. “Furthermore, strengthening work systems to encourage behavior changes that promote mental health, such as building awareness of symp­toms of mental health conditions and developing sustainable coping strategies, might improve mental health conditions, particularly for public health workers who are at increased risk, including those who are younger or transgender or nonbinary persons. In addition, employee assistance programs could be evaluated and adjusted to be more accessible and acceptable to workers and focus more on building workplace cultures that promote wellness and destigmatize requests for mental health assistance.”

Reference

Bryant-Genevier J, Rao CY, Lopes-Cardozo B, et al. Symptoms of depression, anxiety, post-traumatic stress disorder, and suicidal ideation among state, tribal, local, and territorial public health workers during the COVID-19 pandemic – United States, March-April 2021MMWR Morb Mortal Wkly Rep. Published online July 2, 2021. doi:10.15585/mmwr.mm7026e1