53% of public health workers have experienced recent mental health condition symptoms

Most public health workers reported symptoms of one or more mental health conditions between the end of March and mid-April, according to survey results published in MMWR.

“Increases in mental health conditions have been documented among the general population and health care workers since the start of the COVID-19 pandemic,” Jonathan Bryant-Genevier, PhD, of the CDC’s Epidemic Intelligence Service, and colleagues wrote. “Public health workers might be at similar risk for negative mental health consequences because of the prolonged demand for responding to the pandemic and for implementing an unprecedented vaccination campaign. The extent of mental health conditions among public health workers during the COVID-19 pandemic, however, is uncertain.”

Results of a 2014 survey suggested there were approximately 250,000 state and local public health workers in the U.S. In the current study, Bryant-Genevier and colleagues aimed to assess these workers’ mental health conditions via a nonprobability-based online survey conducted between March 29 and April 16. Specifically, they sought to evaluate symptoms of depression, anxiety, PTSD and suicidal ideation among public health workers in state, tribal, local and territorial public health departments. Survey questions queried participants regarding traumatic events or stressors experienced since March 2020, demographics, workplace factors and self-reported mental health symptoms. The researchers assessed mental health symptoms via the nine-item Patient Health Questionnaire (PHQ-9) for depression, the two-item General Anxiety Disorder (GAD-2) for anxiety, the six-item Impact of Event Scale (IES-6) for PTSD and one item of the PHQ-9 for suicidal ideation. They used demographic characteristics and workplace factors to assess prevalence of symptoms of mental health conditions and suicidal ideation.

A total of 26,174 public health workers responded to the survey. Of these, 53% reported symptoms of one or more mental health conditions in the past 2 weeks, with 32% reporting depression, 30.3% reporting anxiety, 36.8% reporting PTSD and 8.4% reporting suicidal ideation. Those aged 29 years or younger and transgender or nonbinary individuals of all ages had the highest prevalence of symptoms of a mental health condition. The researchers noted a higher likelihood for reporting adverse mental health symptoms among public health workers who were unable to take time off from work. Increasing weekly work hours and percentage or work time dedicated to COVID-19 response activities correlated with increasing severity of symptoms.

“Addressing work practices that contribute to stress and trauma is critical to managing workers’ adverse mental health status during emergency responses,” Bryant-Genevier and colleagues wrote. “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.”