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Caring for those who care

Mental Health Commission of Canada report led by Queen’s researcher calls for psychological support for distressed health care workers.

Health care worker sits in the dark
Staff shortages and insufficient opportunities for self-care are at the core of health care workers’ mental health problems. (Unsplash/ Mulyadi)

A new report released today by the Mental Health Commission of Canada has found that “while health care workers spend their working hours caring for others, many are challenged to find the time and energy for self-care.” The document summarizes the findings of a survey conducted with almost a thousand health care workers across the country between December 2021 and January 2022. The numbers are startling: 40 per cent of those surveyed are burned out, 50 per cent intend to leave the profession, and just 60 per cent are satisfied with the quality of care they provide.

Queen’s researcher Colleen Grady (Centre for Studies in Primary Care - CSPC) was the lead author of the study, which was co-authored by Denis Chênevert (HEC Montréal) and Angela Coderre-Ball (CSPC). In addition to the survey, the researchers conducted interviews with 30 health care workers from multiple disciplines and health care sectors.

“Health care workers are some of the most resilient and dedicated professionals there are, yet most are at the breaking point,” says Dr. Grady, who is an expert in physician leadership development, psychological health and safety in the workplace, and functional health care organizations. For the past few years, she has been investigating psychological stress in the workplace for family physicians. “This study provided a good opportunity to expand beyond one profession and to explore factors that are unique to other health care workers, types of organizations and even differences between provincial approaches.”

The study included nurses (31 per cent), social workers (11 per cent), personal support workers (six per cent), physicians and paramedics (five per cent each) and others. The biggest share of participants work in hospitals (37 per cent), followed by home and community care and long-term care (13 per cent each). Other workplaces represented in the survey include emergency services, primary care clinics, dental offices, mental health clinics, and others.

According to the report, staff shortages and insufficient opportunities for self-care are at the core of health care workers’ mental health problems. While these issues precede COVID-19, the pandemic made them worse. About half of respondents reported suffering from mild to acute moral distress and 60 per cent say they experience work overload. Distress, exhaustion, and burnout can lead to poorer job performance and, ultimately, to an exodus from the health care sector.

Dr. Colleen Grady (left) and Dr. Angela Coderre-Ball.
Dr. Colleen Grady (left) and Dr. Angela Coderre-Ball are authors of the report.

“It was surprising to me how much of the burden for wellbeing is placed on the shoulders of health care workers themselves, without the time or resources to do so,” says Dr. Coderre-Bell. “A far too common story was nurses who dropped to casual positions to have the time to take care of themselves, only to lose their extended health benefits including benefits for counselling.”

Although the pandemic deepened concerns with staff shortage and work overload, the report found it has also increased awareness for and lessened stigma around mental health issues amongst health care workers.

In the search for solutions

Besides surveying health care workers about their struggles and challenges, the study also questioned them about potential solutions.

The in-depth interviews with health care workers and administrators across Canada revealed how much they value peer and leadership support through open and honest conversations. They also spoke to the importance of utilizing available resources and being vocal about their wants. Importantly, they identified a need to challenge a prevailing “self-sacrifice” and/or “workaholic” mindset.

The interviews also provided insights into how health care workers believe mental health support can be improved: developing specific protocols, securing time off, advocating for sustained human and financial resources, and cultivating an ethical work climate, for example.

“Psychological health and safety must be a priority pursued by organizations through advocacy, strategy, and action," says Dr. Grady. "Every health care worker in Canada deserves to be employed in an organization that prioritizes psychological health and safety."

To read the full report, access the website.