COVID-19 Pandemic Traumatic Stressors and Mental Health Clinicians’ Symptoms and Burnout

Abstract
The COVID-19 pandemic has had a global impact on the healthcare workforce, including multiple effects on nature and demands of professional services by the mental health workforce. In addition to the acute intra-pandemic impacts which were found to lead to persistently poor or deteriorating mental health for a substantial minority of mental health professionals in one survey (Kogan et al., 2023), pandemic-related stressors may have long-term psychosocial effects that could affect mental health clinicians in their practices and professional lives for many years to come. An international multidisciplinary survey of mental health professionals therefore was conducted three to four years after the onset of the COVID-19 pandemic, assessing pandemic-related stressors experienced at work and in personal life, and symptoms of anxiety, depression, secondary traumatic stress, compassion fatigue and satisfaction, and burnout. Participants were recruited via professional societies and networks on five continents (N= 541-582). Fear of COVID-19 infection due to exposures at work was associated with increased secondary traumatic stress (14.19 vs 9.22, P< 0.001), moral injury (9.36 vs 7.84, P< 0.001), feeling unprepared to handle patients (74% vs 49%, P< 0.001), and inability to stop worrying about a client/coworker (75% vs 23%, P< 0.001). Providing services to patients whose family members were hospitalized for COVID-19 was associated with increased inability to stop worrying about a client/worker (75% vs 53%, P< 0.001), and moral injury (5.83 vs 5.08, P< 0.001), but also with increased compassion satisfaction (13.76 vs 16.25, P< 0.001), work satisfaction (15.98 vs 13.44, P< 0.001) and increased sense of pride in work (95% vs 88%, , P< 0.001). Having to isolate due to COVID-19 exposure was associated with increased STS (13.75 vs 8.92, P< 0.001) and moral injury (5.75 vs 4.63, P< 0.001). Thus, providers of mental health services, although not usually considered front-line healthcare workers, appeared to experience trauma-related distress associated with the impact of the pandemic both professionally and personally, while also experiencing compassion and work satisfaction when caring for family members of COVID-affected patients.

Continued tracking of long-term sequelae of pandemic-related potentially traumatic stressors on mental health professionals is warranted, with the aim of preparing the mental health workforce to respond to the ongoing long-term effects of the COVID-19 pandemic and to future epidemic/pandemics.