Outpatient providers face stress and anxiety during COVID-19

As we approach the year mark for initial COVID-19 shelter-in-place orders across the country, new research is emerging about the impact of the epidemic on healthcare providers’ mental health. While there has been a lot of necessary attention on the strain on frontline providers, the mental health consequences of the epidemic on outpatient providers are less clear. It is important to look at these impacts on the wider health care community as they have faced significant obstacles in offering care during the pandemic.

Alison Comfort and her team published results from the first national study exploring how the COVID-19 epidemic has impacted feelings of stress, anxiety, and depression among outpatient health providers in the US. Researchers conducted a survey of physicians, nurses and health staff working in clinics, health departments and college health centers. They found that two-thirds of providers surveyed reported increased stress, and one-third reported increased anxiety or depression. Providers reported that the major sources of stress, anxiety, and depression were patient care, burnout, concern over becoming infected with COVID-19, and fear of the unknown. They also said that their stress, anxiety, or depression was impacted by feeling overwhelmed, being unable to focus, lack of sleep, and worrying about the unknown.

The study captured the intense stress in providers’ own voices:

The most commonly reported reason for increased stress, anxiety, and depression were feelings of inadequacy around patient care: “I hate for a client to not know [if] they can still come see or call us.”
Providers also discussed a sudden increase in responsibilities due to COVID-19 related care. For instance, one clinic manager attributed their stress to: “Increased workload, little sleep, urgent changes, and ever-changing needs.”
Others discussed how changing guidelines and protocols and navigating telehealth visits impacted their stress and anxiety levels: “More worry and concern; the unknown. Changes daily. This is going to be the new ‘normal…’”
Anxiety about COVID-19 among patients and staff, as well as worrying about the possibility of getting the virus themselves and/or infecting family, contributed to providers’ stress levels: “Always wondering if this is the day that I get the virus.”

This important new study highlights how US providers across the medical field, not just front-line workers, are experiencing increased stress, anxiety, and depression during the COVID-19 epidemic. Providers need responses that destigmatize mental illness and accessible counseling and support.