Prioritizing Caregiver Mental Health During a Pandemic

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By Yuriy Onyskiv, Associate, Innovation Consulting, and Julie Campbell, Director, Innovation Consulting

The word “burnout” has been linked to healthcare caregivers for many years. Healthcare is an industry with excruciatingly long hours, high volumes of patients, and tedious clerical work that often leads to physical, mental and emotional exhaustion.

Burnout has had a negative impact on patient care, caregiver health and the healthcare system as a whole. On top of the typical burdens caregivers face on a day-to-day basis, the COVID-19 pandemic is further exacerbating stress levels—and burnout has become even more ingrained in the status quo.

Caregiver burnout prevalence rates are approaching or exceeding 50%. These levels lead to twice the risk for medical error, increased physician turnover and 25% increased odds of alcohol abuse or dependency. Electronic health records (EHRs) are linked to long hours and a 29% increased rate of caregiver burnout. Prior to the pandemic, burnout was attributed to several drivers at the individual and organizational level, including:

  • Excessive workloads due to financial barriers, incentives, productivity goals and lack of hourly limits
  • Frequent documentation errors in EHRs and other clerical tasks
  • Minimal work-life balance due to demanding schedules and lack of flexibility
  • Poor organizational governance without appropriate leadership and shared decision-making
  • Reduced employee interest and enthusiasm due to lack of development opportunities and pressure from revenue targets compared to patient care

The COVID-19 pandemic has increased pressure on caregivers to work longer hours and to risk the health and safety of themselves and their families. In the U.S., as of May 31, over 60,000 caregivers had contracted COVID-19—and 600 and counting have died. Studies examining the pandemic’s impact on mental health in Italy and China show front- and second-line workers experienced elevated symptoms of insomnia, depression, anxiety and intense stress. In Italy, a study showed that 49% of caregivers had symptoms of post-traumatic stress disorder, in addition to symptoms of depression (25%), high-perceived stress (22%) and anxiety (20%). In China, a study reported an alarming 72% increase in caregivers’ distress rates. These metrics demonstrate the urgency for healthcare organizations to prioritize the mental health of their caregiver population.

Mental health solutions and support mechanisms are not new, but they are relatively newly accessible. Venture capital has jumped on the opportunity to expand mental health coverage globally, with a record $576 million invested in the first quarter this year—up more than 400% compared to the last quarter of 2019. Digital solutions can now provide once difficult-to-access services at scale and at a lower cost to a broad population. Services such as Talkspace, BetterHelp and ReGroup provide virtual and immediate access to psychologists, psychiatrists and social workers—in many cases, at a fraction of the cost of in-person care.

Health systems have been deploying digital mental health and wellness solutions to patients as benefits and support mechanisms, and they have the ability and responsibility to provide these resources to their caregivers as well.

University Hospitals in Ohio has repurposed their outward integrated health platform to offer guided meditation, yoga, acupuncture and other solutions to their caregivers. Harvard is advancing their GlobalMentalHealth@Harvard initiative, which works to build resilient mental healthcare across the organization with digital training tools, executive leadership training and core metrics to evaluate performance. The University of North Carolina at Chapel Hill recently announced a partnership with Google to create their Heroes Health app, allowing caregivers to check in on their mental health, express their distress and remove the stigma of discussing difficulties of providing care.

These mental health efforts are not limited to digital solution deployment. Healthcare organizations can leverage lessons from other disease outbreaks, such as SARS and Ebola.

Eileen Barrett, MD, University of New Mexico associate professor of medicine, says that allowing caregivers to take care of themselves through better sleep, appropriate dietary habits and staying hydrated limits their health risks—and that these tactics were highly effective throughout West Africa during the Ebola crisis. Meanwhile, the U.S. Department of Defense continues to support active-duty caregivers by providing techniques in bright siding, which can help reduce anxiety related to the uncertainty of COVID-19. Cleveland Clinic recently named its first chief caregiver officer, with the primary goal of supporting nearly 70,000 caregivers across the organization—a resource that could be a key champion for caregiver mental health.

Before COVID-19, healthcare systems were already suffering through a mental health crisis—and the pandemic is exacerbating these effects on a vulnerable population. Dedicating time and resources to caregivers’ mental health must be a priority. Organizations can leverage structure, training and awareness, employee engagement platforms, and digital consumer products to monitor the problem and provide access to the right support.

The COVID-19 pandemic is not the root cause of caregiver burnout, but it has reignited the urgency of addressing this issue—and it’s time to focus on finally fixing it.

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