Chronicling moral distress among healthcare providers during the COVID-19 pandemic: A longitudinal analysis of mental health strain, burnout, and maladaptive coping behaviours.

The COVID-19 pandemic has presented many novel situations that have amplified the presence of moral distress in healthcare. With limited resources to protect themselves against the virus and strict safety regulations that alter the way they work, healthcare providers have felt forced to engage in work behaviours that conflicted with their professional and personal sense of right and wrong. Although many providers have experienced moral distress while being physically in the workplace, others suffered while at home. Some healthcare providers worked in facilities that were unable to open during the pandemic due to restrictions, which could contribute to a sense of powerlessness and guilt. The current study assessed whether the ability to see patients each week impacted the relationship between an employee's moral distress and their mental health strain, burnout, and maladaptive coping. A total of 378 healthcare providers responded to weekly surveys over the course of 7 months (April 2020-December 2020). Hierarchical linear modeling techniques were used to examine the study variables over time. Results showed that moral distress predicted an individual's mental health strain and burnout, even after controlling for the prior week. However, moral distress was not a significant predictor of maladaptive coping. Interestingly, there was not a significant difference between the average ratings of moral distress between those who were able, and those who were not able to see patients, meaning that both groups experienced symptoms of moral distress. However, cross-level moderation results indicated that the ability to see patients magnified the relationships between moral distress and mental health strain and burnout over time. Implications of the results and recommendations for how moral distress should be addressed among healthcare providers are discussed.

Perceived unit climate of support for mental health as a predictor of stigma, beliefs about treatment, and help-seeking behaviors among military personnel.

Employees in high-risk occupations can experience stigma associated with developing mental health problems and getting treatment for problems that can oftentimes be attributed to traumatic events encountered at work. The present study examined the perceived unit climate of support for mental health as a predictor of changes (over the course of 3 months) in the perceived stigma associated with seeking treatment, positive and negative attitudes toward treatment seeking, and a preference for handling mental health problem oneself, as well as talking with fellow unit members and a mental health professional about a mental health problem. Active-duty military personnel (N = 349 at Time 1, N = 112 matched at Time 2) completed measures assessing unit climate and individual beliefs about treatment at two points in time separated by 3 months. The results of structural equation modeling revealed strong evidence for perceived unit climate of support for mental health at Time 1 predicting a change in perceived stigma and attitudes toward treatment seeking at Time 2. A more positive perceived unit climate of support was associated with decreases in stigma, more positive attitudes toward treatment seeking, and less negative attitudes toward treatment seeking. Among those soldiers with a mental health problem (N = 164), a more positive perceived unit climate for mental health was associated with a greater likelihood of talking with a fellow unit member about the problem and receiving mental health treatment. Implications of the results for unit-level interventions in high-risk occupations are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).