Prior to the COVID-19 pandemic, mental health concerns among medical professionals were already a growing area of focus. The demands of the healthcare profession, characterized by long working hours, high levels of stress, and the emotional toll of patient care, contributed to an increased prevalence of psychological issues such as stress, depression, anxiety, and burnout. Numerous studies conducted prior to the pandemic provided evidence of the substantial impact of these mental health challenges on the well-being of medical practitioners, raising concerns about their own health and the potential implications for patient care. Despite the recognition of these issues, limited data highlighted the need for further exploration and understanding of the unique factors contributing to mental health challenges among medical professionals in different settings. This pre-COVID landscape laid the foundation for the subsequent exploration of how the pandemic may have exacerbated these challenges or introduced new dimensions to the mental health concerns faced by healthcare providers.
In 2018, a study aimed to investigate psychological problems, including depression, stress, and burnout, among medical professionals in a government-funded tertiary care institute in India. Out of 1721 surveyed doctors, 445 (27.69%) responded. Results indicated that 30.1% of participants had depression, 16.7% reported suicidal ideations, and over 90% experienced some level of burnout. Resident doctors exhibited higher levels of stress, depression, and burnout compared to faculty. Factors such as long working hours, negative patient-related outcomes, and interpersonal issues were associated with these psychological challenges. The study emphasizes the significant prevalence of stress, depression, and burnout among Indian doctors, highlighting potential implications for patient care and professional interactions. Doctors can experience a range of mental health issues, like depression and anxiety, especially during their training. A major 2015 review of over 17,500 resident physicians worldwide found that around 28.8% had significant depressive symptoms. Anxiety disorders were less studied, but some suggest rates as high as 24% for general anxiety and 4-16% for post-traumatic stress.
Research on how doctors use alcohol and substances, based on their own reports, shows that 5% to 20% of doctors in wealthier countries might have issues with drinking. This is often determined by tests like the Alcohol Use Disorders Identification Test. In a group of 7209 American doctors, 15.3% showed signs of having problems with alcohol. A similar number was found among American surgeons. In a national sample of Danish doctors, 18.9% were identified as having risky alcohol use. Interestingly, of the 383 doctors who reported risky substance use (alcohol or other drugs), 76.9% didn't think it was a big problem. A smaller study in the UK found that 20% of 109 doctors drank more than recommended, but only 5% were considered to have a serious issue with alcohol. This suggests that doctors might drink at a similar or higher rate than the general population. This trend seems to have continued over the last 30 years. Unfortunately, doctors find it hard to ask for help with alcohol or substance issues, which is concerning because it can affect their work. Studies show that in the three months before the study, most doctors who reported making a mistake at work also reported issues with alcohol. Estimates suggest that alcohol might be connected to up to 5% of instances where patient care isn't as good as it could be.
After the COVID pandemic, several instances tried to analyze the effects of the situation on the healthcare professionals who were directly involved in the treatment and management of patients. In a study published in 2023, the findings indicate that many physicians faced emotional and physical health challenges early in the pandemic, and these difficulties persisted and worsened over time, despite efforts to cope. During the survey in Canada's second wave, 70% of physicians experienced worsened emotional health, and 53% reported worsened physical health. About one-third of physicians endorsed symptoms of anxiety and depression. These mental health concerns mirrored the broader population's increased struggles during the pandemic and were consistent with findings in healthcare workers. Lack of clarity in treating COVID-19 patients contributed to trauma among healthcare workers. Surprisingly, the rate of PTSD related to COVID-19 in the study was low (3.7%), possibly due to lower fatal cases in the region. One year later, physicians' emotional and physical difficulties persisted, with a notable fivefold increase in PTSD rates. Anxiety and depression rates remained higher than global levels. Demographic analyses showed certain characteristics created vulnerability at specific times. Behavioral and relational coping strategies were most endorsed, providing support from family, friends, and colleagues. Spiritual coping had a protective effect against depression initially but decreased over time. There was a significant increase in intervention-based coping after one year, mostly among those screening positive for depression. The study, with its comprehensive look into the evolving impact of COVID-19 on physicians' health, emphasizes the need for tailored support programs and recognition of coping strategies' importance. However, the limited participation and the short survey are acknowledged as study limitations.
We can see that the persistent challenges faced by health professionals, as highlighted in recent studies, underscore the urgent need for increased support, awareness, and research in the realm of mental health. The ongoing impact of the COVID-19 pandemic has accentuated the emotional and physical strains experienced by healthcare workers, emphasizing the importance of tailored assistance programs. The high rates of anxiety, depression, and PTSD among health professionals highlight the critical need for proactive mental health initiatives. This necessitates heightened awareness within the healthcare community and the general public regarding the mental well-being of those dedicated to caring for others. Furthermore, substantial research efforts should be directed toward understanding the nuanced factors contributing to mental health struggles among health professionals. By fostering a culture of support, raising awareness, and advancing research endeavors, we can collectively work towards creating a healthier and more resilient healthcare workforce.
Sources
Grover, S., Sahoo, S., Bhalla, A., & Avasthi, A. (2018). Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study. Indian journal of psychiatry, 60(2), 175–188. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_254_17
Harvey, S. B., Epstein, R. M., Glozier, N., Petrie, K., Strudwick, J., Gayed, A., … Henderson, M. (2021). Mental illness and suicide among physicians. The Lancet, 398(10303), 920–930. doi:10.1016/S0140-6736(21)01596-8 (https://doi.org/10.1016/S0140-6736(21)01596-8)
Adams, G. C., Le, T., Alaverdashvili, M., & Adams, S. (2023). Physicians' mental health and coping during the COVID-19 pandemic: One year exploration. Heliyon, 9(5), e15762. https://doi.org/10.1016/j.heliyon.2023.e15762
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