Canadians are concerned about the mental health of health workers — they should be

If the health workforce was a patient, it would be in critical condition. The public seems to get it.

New results of a nation-wide survey by the University of Ottawa, conducted among members of the Angus Reid Forum (March 4-8, 2022) paint a troubling picture of how we feel about health workers. Overall, nine out of 10 Canadians (87 per cent) say they are concerned about the mental health of health care workers. This level of concern is even higher than ratings of our own worsening mental and physical health. When asked how things have changed since March 2020, 54 per cent of Canadians say their own mental health has worsened, and 53 per cent say their overall physical health and well-being has worsened.

After two years of pandemic stress, we are much more likely to express concern about the mental health of health workers than to say we’ve experienced a worsening of our own health.

People are not only concerned about how health workers are doing; they also express concern about what this means for their access to, and quality of, health care. Overall, four out of five Canadians (79 per cent) say they are concerned about being able to access health care services because of the shortage of health workers. Slightly more (84 per cent) say they are concerned about the quality of health care services.

Women are significantly more likely than men to express concern about the mental health of health workers, health access and quality of care. Perhaps this is because the health system is primarily a women’s workforce, with 82 per cent identifying as women, and growing, each year.

Regionally, half of those in Atlantic Canada (53 per cent) expressed strong agreement that they are concerned about being able to access health care services because of labor shortages — by far the highest rate in the country. Perhaps the importance of health care to provincial elections is most salient in this region.

If the public gets it, why doesn’t it seem to be the case for our politicians? The recent federal budget was like crickets about these growing concerns.

The pandemic has caused remarkable increases in rates of burnout and other mental health concerns, already prevalent among nurses and doctors before the pandemic, due to health and safety concerns and unsustainable workloads. Health workers have faced 16+ hour days, cancelled vacations and forced redeployment.

And then there is the violence.

We were warned pre-pandemic of the increasing violence nurses experience in health care, caused by understaffing, inadequate security and increased patient numbers, and how even in medicine, women faced incivility, bullying and harassment.
In its 2019 report, Violence Facing Health Care Workers in Canada, the House of Commons Standing Committee on Health noted that health care workers are four times as likely to face workplace violence than any other profession, yet most goes unreported due to a culture of acceptance.

Few of the critical recommendations from the report have ever been implemented. We are still waiting for the recommended public awareness campaign about the violence faced by health care workers or the pan-Canadian prevention framework. We are also still waiting for the much-needed update to the Pan-Canadian Health Human Resources Strategy to address staffing shortages and reflect the well-being of health care providers.

While health care workers care for us, they have not received the support and care they need from our governments through supportive public policy.

As more than 65 health care organizations and 300 health workforce experts and organizational leaders stated in an open Call to Action last year, the time is now for the federal government to take the lead in supporting provinces, territories, regions, hospitals, health authorities and training programs with an investment in better health workforce data and decision-making tools.

Canada needs to make informed staffing decisions, optimize contributions of the available workforce and enable safer workplaces. Right now, we are working in the dark.

There is both a sound economic argument for such an investment — with the health workforce making up eight per cent of Canada’s GDP, or over $175 billion in 2019 – and a sound humanistic argument in support of health workers.

The status quo must be seen for what it is — the most expensive and least tenable option going forward.

Dr. Ivy Lynn Bourgeault is a Professor of Sociological and Anthropological Studies at the University of Ottawa and the Lead of the Canadian Health Workforce Network.