The Covid Syndemic: The Mental Health Crisis Of Mental Health Workers

A syndemic refers to multiple interrelated epidemics happening at the same time. Covid-19 has unleashed and amplified a number of simultaneous personal, social, medical, political, and economic crises. This is the first in a series of articles exploring the impact of the Covid-19 syndemic.

Psychiatrist sees patient via telemedicine

Psychiatrist sees patient via telemedicine


When we think of frontline health workers battling the pandemic, we often think only of the physicians working on-site in hospital settings. But while most mental health professionals aren’t physically serving on the frontlines of this pandemic, they have been hearing about it in excruciating detail from their patients for almost a year.

As the pandemic continues, so does the demand for mental health services. According to the Kaiser Family Foundation, 4 in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder during the pandemic. This figure has risen dramatically from one in ten adults who reported these symptoms from January to June 2019. Research from prior economic downturns shows that job loss is associated with increased depression, anxiety, distress, and low self-esteem. Even those who have not been impacted financially or have experienced the loss of a loved one have still had their lives disrupted and live with the daily uncertainty that the pandemic brings. In a CDC survey of 5,412 Americans during June 2020, 40.9% of respondents reported at least one adverse mental or behavioral health condition, including symptoms of anxiety disorder or depressive disorder (30.9%), symptoms of trauma, and stress-related disorder arising from the pandemic (26.3%). Healthcare workers are putting their physical health at risk by caring for Covid-19 patients and their mental health as they endure unprecedented death tolls.

Mental health professionals are finding themselves charged with the heavy responsibility of guiding others through this time of loss and uncertainty, without most of their usual coping mechanisms. Many are taking on larger caseloads and working longer hours as the demand far exceeds the number of therapists available, leaving little time for respite. According to an American Psychological Association (APA) poll of nearly 1,800 psychologists published in November, 74 percent said they were seeing more patients with anxiety disorders compared with before the pandemic, and 60 percent said they were seeing more patients with depressive disorders.

Psychiatrists have written about the challenges of regulating their own reactions during sessions as they learn how to provide therapy during a pandemic. In an APA poll, 4 in 10 psychologists (41%) said that they felt burned out and 30% said that they have not been able to meet the demand for treatment from their patients.

When their patients are experiencing the same stress and expressing the same anxieties it becomes increasingly difficult for therapists to compartmentalize. An article from the American Psychological Association warns of the risk of psychologists developing “compassion fatigue” during the pandemic. Charles R. Figley, PhD founder of the Traumatology Institute at Tulane University, defines a phenomenon he calls “compassion fatigue” as psychologists or others taking on the suffering of patients who have experienced extreme stress or trauma. “It’s like a dark cloud that hangs over your head, goes wherever you go and invades your thoughts,” he says.

Compassion fatigue manifests as a lack of empathy for patients, physical and emotional exhaustion, and feelings of numbness, anxiety, and depression. All these conditions inhibit therapists from providing care to patients and wreak havoc on their mental health.

The American Psychological Association suggests several strategies to build resilience against compassion fatigue. The most important step is recognizing the signs of compassion fatigue. The Professional Quality of Life measure developed by psychologist Beth Hudnall Stamm, PhD can be used as an objective tool to determine symptoms such as loss of productivity, depression, intrusive thoughts, and compassion satisfaction. Introducing self-care strategies such as adequate sleep, healthy nutrition, physical activity, relaxation and safe socializing as part of a consistent routine is also important. Practicing self-compassion by acknowledging the difficulty of your situation and taking days off without feeling guilty is also encouraged. Finally, therapists should create community by reaching out to their professional networks for support and understanding.

Encouraging mental health professionals to practice these strategies is one step towards preventing burnout. But in addition to caring for our current mental health professionals, we need to encourage more people to enter the profession in order to meet the overwhelming demand.


Read the full article on Forbes

Originally published on Forbes on March 9, 2021

© William A. Haseltine, PhD. All Rights Reserved.