The COVID-19 pandemic has created many problems we have never seen before. There has been a lack of discussion around the negative mental health effects of essential workers through this challenging time. We place essential workers in a unique position of having to balance being grateful for having a job and receiving a paycheck while also considering the potential health risks and negative mental health effects of working right now. Various issues related to COVID-19 have had negative effects on essential workers that could have a long lasting impact. Some of these effects include increased anxiety, fatigue, depression, and higher burnout.
There are countless hard decisions essential workers have to make every day: Do I get to see my family and friends anymore? Can I go anywhere else besides work and home? How do I feel when other co-workers are traveling? Is it safe for me to go to the grocery store? How can I ensure my safety while still working? How can I provide high quality care for my patients while also making time for self care during this hard time?
Some companies have limited COVID-19 safety precautions in place, like taking temperature before work and filling out a questionnaire about potential symptoms. However, these might do little to ease the mind of essential workers, as they have no control over what customers or clients are doing once they leave. There will always be a risk of exposure to COVID-19 when anyone leaves their home. Sometimes essential workers can be in a tough position to either continue to go to work to serve people and risk getting exposed to COVID-19 or stay safe at home but have financial stress because of loss of job.
Limited data is available regarding how the pandemic has affected the mental health of essential workers. One study from The University of Massachusetts Amherst published on June 5, 2020 surveyed 2,558 essential workers from different fields. Their results showed that “most essential workers do not feel safe at work (60%), are unable to practice social distancing (71%), and experience increased stress (86%).” The increase in stress is logical as essential workers need to feel safe while working and should be able to count on their employer to practice the appropriate safety measure if they are being required to work.
As a mental health therapist, I am considered an essential worker and was required to go to work because my clients still needed therapy. I have learned firsthand the challenge of trying to maintain unconditional positive regard while also struggling with an increase in personal anxiety. How my company was handling COVID-19 pandemic caused me to leave my job earlier than I would have otherwise. And as a result, I was curious if other essential workers were dealing with the same struggles and created a survey to collect data from essential workers in Texas, mainly therapists and social workers. I received 280 responses from July 10 to July 17, 2020.
These essential workers responded to the following questions:
It makes sense that there is an overall increase in anxiety and stress for essential workers who go out into the world and interact with many people every day, or for those stuck working from home and socially isolating. One respondent shared that “it is difficult to provide mental health services as my own personal mental health has been compromised.” It is particularly concerning when mental health essential workers do not have the time or finances to seek their own help while still being expected to provide top quality care to clients coming to them for mental health support. Another essential worker shared, “I never really had the room to process being a person in a pandemic because I had to focus so much on powering through for my clients.”
The results illustrate that almost three-fourths (73%) of the survey participants feel uncomfortable working outside of the home as an essential worker during this time. There are also essential workers who are expected to continue working, sometimes with additional tasks, and decreased staff support overall, while balancing their own anxiety and external stressors. The comments in the survey repeated consistent themes regarding work: lack of support, lack of communication, and unrealistic expectations from organization/employer, difficulty managing extreme adjustments and still being held to previous expectations, employers not taking safety precautions seriously, lack of cohesive guidelines for my profession, stress of constantly changing protocols, and overall dreading work.
Some workplaces are making it even more difficult for essential workers, with on site COVID outbreaks, not allowing virtual/telehealth to be an option, making threats if therapists take PTO. One essential worker put it in an eye opening way “sometimes I feel like I am a sitting duck, just waiting to be infected and die”. Understandably, some essential workers are making the tough decision to quit or go on leave.
88.5% of essential workers rated their burnout a 5 or above and 45% rating burnout an 8 or above. We should pay attention to the high burnout rates because it will affect the job market for essential workers and their mental health. Workers might change jobs more often than normal, take more time off in between jobs, leave jobs before they planned even without having another job lined up, and an overall decrease in the quality of work being provided. How can we expect therapists to provide badly needed mental health services when their own personal burnout is high?
A few essential workers commented on how they have noticed a higher burnout specifically related to telehealth. They experienced more burnout from having to talk about the COVID-19 pandemic with clients all day, and the sessions felt repetitive and draining. The physical discomfort of having to work from home is notable, as respondents commented on their eyes burning, fatigue, back pain, and difficulty concentrating.
Essential workers are growing tired and more anxious, with almost 80% reporting a higher level of fatigue and almost 75% reporting an increase in anxiety since COVID-19 pandemic. These results are like the study done in Massachusetts, both reported a strong correlation between an increase in anxiety in essential workers and the COVID-19 pandemic. This illustrates that pandemic is affecting essential workers across America similarly.
There is also a noticeable increase in depression with essential workers, 48% but that number will keep growing as the pandemic continues. 43% report that they have noticed a decrease in workplace satisfaction overall. However, there is a slightly uplifting statistic, 25% of essential workers shared an improvement in their sense of purpose. Companies need to be intentional about how they attempt to address the increase in mental health issues presenting in essential workers or else we might have a bigger mental health crisis along with a pandemic.
Any comments or stories you would like to add, keep it as confidential as possible.
The last question of the survey was an optional free-response section, which is where I pulled the direct quotes from essential workers. Out of the 280 responses, 67 responded, and I was fortunate to receive a variety of answers. Each essential worker is a unique situation, but I have addressed some common themes in the article.
Essential workers take on a burden of having to make space for their clients and customers and not having capacity to process their own feelings. One response mentioned they feel uncomfortable sharing their own personal struggles because they know some people are worse off. This viewpoint adds to the argument that every essential worker should be able to access their own mental health care.
Childcare adds even more stress for essential workers with children who are being required to work without the usual childcare options. This challenging change can lead to stressful days of having to juggle work and children and often includes a decrease in income.
One essential worker brought up an important struggle “I have noticed my ability to separate my patients’ distress from bleeding into my own after hours has diminished”. For those essential workers working from home, it can be more difficult to separate home and work life without the commute time to unwind and not having coworkers in the space to debrief with.
There were a few essential workers who shared their inspiring and scary story of having tested positive for COVID-19, one is still working virtually “trying to help as many scared people as I can.” Another person shared their shocking experience of still having to run large group therapy with no social distancing or required mask for patients, and eventually getting COVID-19 at work. They could stay home but not allowed to tell anyone they had tested positive for COVID-19.
There were a handful of positive responses that are worth sharing. One essential worker commented that “overall I feel more connected to people during this time. I am more compassionate.” One therapist shared how they started out doing virtual therapy but recently moved back to in person sessions and shared a client’s perspective that “they are the only person outside of the family that they get to see and it has helped them tremendously”. Another expressed gratitude for the days that are more positive and cherishes the positive feedback from clients even more. While there were people commenting on the lack of time for self-care, a few noted that an increase in time at home led to more availability to practice self care and take up hobbies they had been neglecting, spending more time outdoors. These positive outcomes were less common, but worth noting that it is possible to find some good amongst all the struggles.
COVID-19 pandemic has hit essential workers particularly hard, we need to continue to discuss the negative impact of our mental health. Essential workers are doing what we ask of them, which is leading to more anxiety, exhaustion, depression, and higher burnout. An essential worker shared the excellent point, “that we need to work on finding a better balance between taking extreme precautions to protect our physical health and not putting us in a downward spiral of mental health symptoms”.
If any essential worker would like to share about their situation or emotions during this time, send me an email at firstname.lastname@example.org or fill out the comment section of the survey if you would like to stay anonymous. https://forms.gle/ap9kJoJpG4MauT1H7 I would love to hear potential solutions or suggestions on how to address the mental health of essential workers.