Availability, use, and impact of workplace mental health supports during the COVID-19 pandemic in a Canadian cohort of healthcare workers

Figures & data

Table 1. Characteristics of health care workers working with patients at the time of completing their last questionnaire (N = 4400).

		N	%
Gender	Not female	773	17.6
	Female	3627	82.4
Workplace	Hospital	2823	64.2
	Community	1384	31.5
	Residential	574	13.0
	Home care	452	10.3
Work role	MD	1355	30.8
	RN	2721	61.8
	LPN	66	1.5
	PSW	184	4.2
	HCA	74	1.7
Completed	Phase 2	4064	100.0
	Phase 3	3708	91.2
	Phase 4	3490	85.9
Mental ill-health before pandemic	No	3032	68.9
	Yes	940	21.4
	Unknown	428	9.7
HADS anxiety*“case”	Phase 1	1119	29.1
	Phase 2	1100	27.1
	Phase 3	950	25.6
	Phase 4	840	24.1
HADS depression*“case”	Phase 1	386	10.1
	Phase 2	400	9.8
	Phase 3	377	10.2
	Phase 4	348	10.0

N = 3814 (phase 1) 4064 (phase 2) 3708 (phase 3) 3490 (phase 4).

*% of those working with patients who completed the Hospital Anxiety and Depression Scale (HADS) with a score >10.

Table 2. Reported and cumulative availability and use of workplace mental health supports.

	Phase	Availability				Use				N questionnaires
		Reported		Cumulative		Reported		Cumulative
		n	%	n	%	n	%	n	%
Specialist counselor	2	1799	44.3	1799	44.3	252	6.2	252	6.2	4064
	3	1961	52.9	2387	64.4	325	8.8	432	11.7	3708
	4	2091	59.9	2703	77.4	428	12.3	635	18.2	3490
	Overall	5851	52.0	6889	61.2	1005	8.9	1319	11.7	11,262
Nominated peer support	2	610	15.0	610	15.0	203	5.0	203	5.0	4054
	3	606	16.3	919	24.8	204	5.5	334	9.0	3708
	4	532	15.2	1087	31.1	203	5.8	425	12.2	3490
	Overall	1748	15.5	2616	23.2	610	5.4	962	8.5	11,262
Online support group	2	1036	25.5	1036	25.5	295	7.3	295	7.3	4064
	3	1077	29.0	1534	41.3	239	6.4	438	11.8	3708
	4	750	21.5	1645	47.1	198	5.7	511	14.6	3490
	Overall	2863	25.4	4215	37.4	732	6.5	1244	11.0	11,262
Online stress tool	2	1644	40.5	1644	40.5	428	10.5	428	10.5	4064
	3	1736	46.8	2240	60.4	501	13.5	713	19.2	3708
	4	1384	39.7	2353	67.4	462	13.2	860	24.6	3490
	Overall	4764	42.3	6237	55.4	1391	12.4	2001	17.8	11,262
Helpline if distressed	2	2064	50.8	2064	50.8	81	2.0	81	2.0	4064
	3	2125	57.3	2615	70.5	103	2.8	137	3.7	3708
	4	1916	54.9	2784	80.1	117	3.4	204	5.8	3490
	Overall	6105	54.2	7473	66.4	301	2.7	422	3.7	11,262
Employee Assistance Program	2	2183	53.7	2183	53.7	185	4.6	185	4.6	4064
	3	2094	56.5	2420	65.3	243	6.6	317	8.5	3708
	4	1956	56.0	2510	71.9	346	9.9	477	13.7	3490
	Overall	6233	55.3	7113	63.2	774	6.9	979	8.7	11,262

Since the start of the pandemic has your employer offered supports (availability)? Did you take advantage of this (use)? those working with patients at the time of completing the questionnaire.

Table 3. Cumulative availability and use of work support and support outside work by phase, workplace and work role (N = 11,262 observations from 4400 healthcare workers working with patients).

		Number of workplace supports available						Use of any workplace supports		Any use of supports not accessed through work		N
		None		1–2		3–6
		n	%	n	%	n	%	n	%	n	%
Phase	2	690	17.0	1568	38.6	1806	44.4	955	23.5	946	23.3	4064
	3	274	7.4	943	25.4	2491	67.2	1362	36.7	1263	34.1	3708
	4	149	4.3	573	16.4	2768	79.3	1627	46.6	1528	43.8	3490
Workplace*	Hospital	705	9.7	2001	27.6	4535	62.6	2360	32.6	2351	32.5	7241
	Community	411	9.9	1143	27.4	2616	62.7	1508	36.2	1351	32.4	4170
	Residential	136	9.1	427	28.6	930	62.3	644	43.1	561	37.6	1493
	Homecare	46	6.7	159	23.6	470	69.7	330	49.0	275	40.8	674
Work role	MD	379	10.3	992	27.0	2306	62.7	1172	23.8	916	24.9	3677
	RN	651	9.5	1857	27.2	4323	63.3	2437	28.0	2566	37.6	6831
	LPN	12	7.2	52	31.1	103	61.7	73	43.7	70	41.9	167
	PSW	53	12.9	119	29.0	239	58.2	184	44.8	123	29.9	411
	HCA	18	10.2	64	36.4	94	53.4	78	44.3	62	35.2	176
Overall	N	1113	9.9	3084	27.4	7065	62.7	3944	35.0	3737	33.2	11,262

MD: medical doctor; RN: registered nurse; LPN: licensed practical nurse; PSW: personal support worker; HCA: health care aide.

*Respondents could work in multiple workplaces.

Table 4. Rated usefulness of supports by those who reported use at phase 4.

	Specialist counselor	Nominated peer support	Online support group
Median	30.5	18.0	37.0
Interquartile range	9.0–60.8	7.0–41.0	16.8–57.5
N	428	203	198
	Online stress tool	Helpline if distressed	Employee assistance program
Median	48.0	40.0	47.5
Interquartile range	26.0–65.0	18.0–75.0	16.8–77.0
N	462	117	346

Table 5. Summary of access, use, and case status from HADS for phases 1–4.

Summary of access and use					Summary of case reporting (phases 1–4)
Access at work	Used through work	Used outside help			Never a case		Case of anxiety only		Case of depression only		Case of anxiety and depression
			n	%	n	%	n	%	n	%	n	%
No	–	No	207	4.7	129	6.0	33	2.6	11	7.2	34	4.1
No	–	Yes	64	1.5	17	0.8	22	1.7	1	0.7	24	2.9
Yes	No	No	1546	35.1	1011	46.8	338	26.8	46	30.3	151	18.3
Yes	No	Yes	653	14.8	211	9.8	225	17.8	23	15.1	194	23.5
Yes	Yes	No	820	18.6	462	21.4	233	18.4	29	19.1	96	11.7
Yes	Yes	Yes	1110	26.2	331	15.3	412	32.6	42	27.6	325	39.4
		Overall	4400	100.0	2161	100.0	1263	100.0	152	100.0	824	100.0

N = 4400 healthcare workers.

Table 6. Likelihood (odds ratio) of NOT using supports if ever a case of anxiety or depression.

		All (N = 2239)			Female (N = 1940)			Not female (N = 299)
		OR	95% CI	p=	OR	95% CI	p=	OR	95% CI	p=
Gender	Female	1.00	−	−	−	−	−	−	−	−
	Not female	2.11	1.59–2.81	<0.001	−	−	−	−	−	−
Age (continuous) × 10 years		1.07	0.98–1.17	0.110	1.14	1.04–1.25	0.007	0.77	0.61–0.96	0.021
Work role	MD	1.00	−	−	1.00	−	−	1.00	−	−
	RN	0.82	0.64–1.04	0.096	0.82	0.63–1.07	0.139	0.60	0.33–1.09	0.092
	LPN, PSW, HCA	0.97	0.66–1.43	0.865	0.93	0.61–1.41	0.734	1.27	0.34–4.79	0.723
Access to work supports		0.20	0.14–0.30	<0.001	0.19	0.12–0.29	<0.001	0.23	0.09–0.54	0.001
Anxiety case		1.00	−	−	1.00	−	−	1.00	−	−
Depression case		1.26	0.87–1.82	0.216	1.10	0.73–1.67	0.638	2.49	1.06–5.86	0.037
Anxiety and depression case		0.63	0.51–0.78	<0.001	0.60	0.47–0.76	<0.001	0.82	0.49–1.37	0.456

MD: medical doctor; RN: registered nurse; LPN: licensed practical nurse; PSW: personal support worker; HCA: health care aide.

Data availability statement

The data underlying this article will be shared on reasonable request to the corresponding author.