Brittany Bankhead-Kendall, 34, was a newly minted surgeon when the COVID-19 pandemic began. At first, like thousands of other health care professionals, she worked tirelessly in crisis mode.
But by last fall, she was experiencing random and repeated physiological symptoms, including a racing heart and dimmed vision. She diagnosed herself as suffering from post-traumatic stress disorder.
The worst of the pandemic may be behind the country. But for front-line health workers such as Bankhead-Kendall, the psychological scars from the chaos and uncertainty they’ve lived through, and the suffering and death they’ve witnessed, may take much longer to heal.
Health care workers across the country say they feel underappreciated by their employers and disillusioned with the medical profession, according to ongoing research at the University of Washington in Seattle.
More than half of the 300-plus doctors, nurses and other front-line health workers who participated in the study said the pandemic has decreased the likelihood they will remain in their profession.
Nationwide, psychiatrists who specialize in trauma-related mental conditions say they’re seeing increasing numbers of health professionals with work-related depression, anxiety, post-traumatic stress disorder, substance use disorders and insomnia — and they expect to see even more in the months ahead.
A provision aimed at addressing the mental distress of health care workers is included in the $1.9 trillion COVID-19 relief package President Joe Biden signed last week. Named for Dr. Lorna Breen, an emergency physician who died by suicide after caring for COVID-19 patients in New York City at the height of the first surge, the initiative will provide $40 million in grants providers can use to promote mental and behavioral health among their workers.
The provision also includes $80 million to train health care and public safety professionals in strategies to reduce suicide, burnout and mental and behavioral health conditions, and $20 million for a federal Centers for Disease Control and Prevention awareness campaign to encourage health care workers and first responders to seek treatment for their own behavioral health concerns and identify and respond to risk factors in themselves and others.
Bankhead-Kendall took a brief break from the hospital and her home life, went to a wellness retreat, and said in a recent interview with Stateline that she feels replenished. She’s back at her post as a trauma surgeon at Texas Tech University Medical Center in Lubbock. And as an associate professor at the university, she says she encourages the resident physicians she works with to take time off if they need it.
“When I see that look in their eyes, I tell them, ‘It’s OK to feel that it’s not OK,’” she said.
Before the pandemic, one doctor died by suicide every day in the United States, the highest rate of any profession including the military and twice the rate of the general population, according to a review of research presented at the 2018 annual meeting of the American Psychiatric Association. Part of the reason, researchers found, was untreated depression. According to data from the American Foundation for Suicide Prevention, 28% of medical residents experience a major depressive episode compared with 7%-8% of similarly aged people in the general population.
“Health care workers already were on the edge of burnout and exhaustion before the pandemic,” said Dr. Megan Ranney, an emergency physician and public health professor at Brown University in Rhode Island. “Now, many of us are physically and emotionally exhausted. We’ve never seen as much consistent death and hopelessness as we have in the past year.”
But that’s only part of it, Ranney said. “There’s also a feeling that the system has failed us and our patients. With the lack of personal protective equipment in the early months, it felt like we were being asked to go out and sacrifice ourselves.”
Those feelings of disillusionment and abandonment were compounded, Ranney said, by political divisions over COVID-19 data and the refusal by many Americans to comply with public health restrictions. On top of that, pandemic-related financial problems in the medical industry forced layoffs, pay cuts and the closure of many rural and safety net hospitals.
“All of that together has created a sense of moral injury that goes beyond depression and exhaustion,” Ranney said. “Many of us are asking, why do I put my life on the line, deal with death and dying every day and feel I can never do what I want to for my patients? Why would I do that to myself?” The invisible wounds don’t show up until after you come off the battlefield. Once the war is over with COVID, that’s when health care workers are going to start showing up with their mental health concerns.
