# Frontline Healthcare Workers’ Reluctance to Access Psychological Support and Wellness Resources During COVID-19

## TL;DR

This study explores why emergency department healthcare workers avoided psychological support during the pandemic, finding practical and emotional barriers were common.

## Contribution

The study identifies specific practical and emotional barriers preventing ED healthcare workers from accessing psychological resources during the pandemic.

## Key findings

- 75% of healthcare workers with significant emotional symptoms did not seek psychological support.
- Most non-seekers cited practical barriers like access and confidentiality, while a smaller group reported emotional barriers like stigma.
- Burnout and psychiatric symptoms were prevalent among ED staff, with many not utilizing available resources.

## Abstract

Background/Objectives: We sought to determine the factors associated with Emergency Department (ED) healthcare workers (HCW) reluctance to seek, utilize, or take advantage of psychological support services during the pandemic. Methods: A 53-item survey, delivered via REDCap, was completed by ED staff in seven hospitals between 15 July 2020 and 24 August 2020. Results: 351 participants (28.7% response rate) completed the survey with 20.1% of respondents endorsing clinically significant psychiatric symptoms and 31.7% of participants endorsing burnout. 75% of those who endorsed significant emotional symptoms did not seek formal psychological support. Most of those (33/44) who did not seek support, despite anxiety and/or depression, reported experiencing practical barriers (access, cost, time, confidentiality) while emotional barriers (not wanting to acknowledge needing help; stigma; embarrassment) were endorsed by 22.7% (10/44). Conclusions: These findings offer several opportunities for intervention, including changes to workflow and culture in the ED which may address emotional barriers to self-care and pragmatic system changes that may help address practical barriers.