COVID-19 Chapter 17: Frontline Mental Health

This pandemic has certainly taken its toll on all of us, but one group that has been particularly hard hit are those who have been on the front lines, continuing to take care of patients even when PPE was running low or nonexistent, even when there were no more ICU beds available. During both non-pandemic and pandemic times, physicians and other healthcare workers experience a tremendous deal of stress and pressure that can lead to depression, isolation, anxiety, moral injury, and other mental health issues. In this episode of our Anatomy of a Pandemic series, we seek to understand the factors contributing to the prevalence of these mental health issues among healthcare workers, the stigma that often prevents the seeking of treatment, the role that the COVID-19 pandemic has played in exacerbating these issues, and the ways in which the medical system has done or can do better. We are very excited to be joined by Michael Myers, MD (interview recorded March 29, 2021), psychiatrist and Professor of Clinical Psychiatry at SUNY-Downstate Health Sciences University in Brooklyn, NY and author of several books, including his latest, Becoming a Doctors’ Doctor: A Memoir.

As always, we wrap up the episode by discussing the top five things we learned from our expert. To help you get a better idea of the topics covered in this episode, we’ve listed the questions below:

1. How did you become interested in the field of physician mental health, and what made you choose to pursue it?
2. Can you talk us through some of the challenges healthcare workers face and what impact they have on their mental health? Does this field experience things such as depression, anxiety, substance abuse, and suicide at higher rates than the general public?
3. What does the stigma surrounding mental illness look like in the medical field and how does it contribute to the high rate of mental health issues in healthcare workers?
4. Can you talk a bit about where these mental health issues among healthcare workers originate and how each step of medical training and beyond contributes to the problem?
5. How much of this is a problem unique to the US and how much of it is universal?
6. What are some of those changes you have seen throughout your thirty-five year career as a psychiatrist primarily treating other physicians? How have we gotten better, and what are the areas in which we have failed to make improvements?
7. How do these public health crises, especially COVID-19, amplify the issues that physicians are already facing in terms of mental health?
8. Can you talk a bit about the “healthcare heroes” narrative and how damaging it can be?
9. What is some of the fallout you think we can expect to see in the long-term from the COVID-19 pandemic?
10. As family members or friends or partners of healthcare workers, what are worrying signs that we can look out for? How do we recognize these signs in ourselves as well?
11. For those who maybe have friends or partners or family members who are frontline health workers, what are some of the ways in which we can help and provide meaningful support during these times as well as in non pandemic times?
12. What do you feel are the biggest failings of the medical system in terms of emotional and mental health support for those in medicine? How can we begin to change things? What role should medical school play? Hospitals? Other physicians?

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