Teachers Reported Greater Mental Health Distress Than Health Care Workers in COVID-19 Pandemic

Teachers in the United States reported greater levels of anxiety, depression, and isolation during the COVID-19 pandemic than health care workers. These findings were published in the Educational Researcher.

Investigators from the Johns Hopkins Bloomberg School of Public Health sourced data for this study from the US COVID-19 Trends and Impact Survey, which was a large online survey conducted by Carnegie Mellon University in collaboration with Facebook.

Random Facebook users were invited to respond to a questionnaire about physical and mental health symptoms between September 2020 and March 2021. Differences in anxiety, depression, and isolation were evaluated on the basis of profession and whether the individual worked in-person or remotely.

The study population comprised 135,488 teachers and 2,640,486 individuals employed in other sectors. The teacher and comparator cohorts comprised 84.1% and 63.9% women, 26.3% and 22.6% of participants were aged 35 to 44 years, 26.7% and 23.1% were aged 45 to 54 years, and 45.1% and 44.9% lived in an area with a population of ≥1 million, respectively.

In the entire study cohort, men reported less anxiety (odds ratio [OR], 0.525; P <.001), depression (OR, 0.708; P <.001), and isolation (OR, 0.814; P <.001) than women; older participant groups reported less anxiety (OR range, 0.126-0.697; all P <.001), depression (OR range, 0.132-0.634; all P <.001), and anxiety (OR range, 0.217-0.697; all P <.001) than individuals aged 18 to 24 years; and individuals with a college degree, professional degree, or graduate degree reported more anxiety (OR range, 1.096-1.115; both P <.001) and isolation (OR range, 1.134-1.293; both P <.001) but less depression (OR range, 0.770-0.816; both P <.001) than individuals with less than a high school education.

Stratified by profession, health care workers reported significantly less anxiety (OR, 0.696; P <.001), depression (OR, 0.952; P <.01), and isolation (OR, 0.957; P <.01) and office workers reported less anxiety (OR, 0.807; P <.001) but more depression (OR, 1.041; P <.05) and isolation (OR, 1.198; P <.001) compared with teachers.

Among the teachers, 106,000 worked in-person and 28,693 worked remotely.

In a teacher-specific analysis, remote workers reported significantly greater depression (OR, 1.122; P <.01) and isolation (OR, 1.563; P <.001) but similar levels of anxiety. Consistent with the main analysis, men reported less anxiety (OR, 0.600; P <.001) and depression (OR, 0.880; P <.01) than women and older age groups reported less anxiety (all P <.001), depression (all P <.001), and isolation (all P <.001) than teachers aged 18 to 24 years.

The results of this study may have been biased by the reliance on self-reported data.

These data indicated that during the pandemic, teachers in the US reported more anxiety, depression, and isolation than health care workers. In general, negative mental health effects were more common among women and younger individuals.

We spoke about this study with 1 of the authors, Joseph M Kush, PhD, of James Madison University and formally of Johns Hopkins Bloomberg School of Public Health.

What was the motivation of this study?

“We were interested in looking at teachers and how they were doing in relation to their mental health throughout the pandemic. A lot of educational research looking at the pandemic has focused on student achievement, or more pure public health questions, like mask usage in schools. But we were curious to know how teachers are doing.

There were 2 primary research questions. The first was looking at the health outcomes among teachers and comparing those rates to professionals in other occupations. The second was to look at teachers specifically and see if there are any differences between in-person vs remote working.”

Were you surprised by any of your results?

“Overall, the results were unfortunate, shall we say? We saw high anxiety symptoms, high depression symptoms, and isolation among everyone. We saw some differences between teachers teaching remote and in-person. Basically, those teaching in person had lower rates of these problematic mental health outcomes. That makes some intuitive sense, if you’re working remote, you’re by yourself and you might feel isolated and have some anxiety symptoms as compared to those that are put together as a community.”

Do you know of any similar study that looked at the mental health of teachers compared with other professions prior to COVID-19? Is it possible that teachers have higher levels of mental distress in general?

“The short answer is yes, it is possible. To your point, we don’t have that kind of pre- postpandemic data. There have been some studies from the past that looked at occupational stress among some 30 different occupations, and teachers were some of the highest. But what is occupational distress? That may be different than anxiety symptoms or feelings of isolation. There’s been a lot of research into teacher burnout or stress globally, but less is known about specific mental health outcomes.”

The results of this study suggest there is a great unmet need for mental health care among teachers. What do you think these results mean for society?

“One thing that motivated us when we [conducted this research] is that we really want teachers to have more of a voice. Unfortunately, a lot of decisions that are made are done so excluding teachers. I understand the pandemic occurred and there was a rapid response, I understand the urgency, but in many cases, teachers were excluded, and that seems problematic. There’s research showing that when teachers are included in decision making processes, they feel more of a sense of community at their workplace. This is so important because there are such strong outcomes when teachers are negatively impacted.”

Do you have plans to expand this research?

“Yes. I do plan on continuing to work in this area. These data are really cool and unique, and I want to continue working on it. There are still these follow-up questions that are going to be really illuminating, such as, why do we see such differences? Do we have other variables that can explain these trends? We’ve taken a snapshot and documented anxiety and depression levels during the pandemic, but we are thinking about ways in which we can link these data to pre-COVID-19 data, which would be really exciting. Then we can talk about longitudinal effects. How are things progressing over time?”

What is the big take-home message of this work?

“I think it is important to document and to see where teachers are. [These results can be] a call for action. Excluding teachers from decision making is not the best approach. We really just want to give teachers a voice and use data to do that.”