Background

“I still remember the exact moment everything changed for me.” said Dr. Emily Duck. It was March 2020, and I was working a double shift in the ICU when my colleague Sarah collapsed in the hallway. Not from exhaustion, but as a complete mental breakdown. Sarah could not breathe even though her oxygen levels were fine. That is when I realized, said Dr Duck, we were facing something much bigger than a medical emergency. We were staring down a mental health crisis that nobody wanted to talk about.

Sarah’s story is not unique. Across hospitals everywhere, healthcare workers are grappling with mental health in times of crisis in ways that would shock most people. We have become experts at patching up everyone else while quietly falling apart ourselves.

The Truth About What Happens Behind Hospital Doors

You know what nobody tells you about working in healthcare during a crisis? It is not just the long hours or the physical exhaustion that breaks you. It is the constant weight of carrying other people’s pain while pretending you are strong enough to handle your own. Mental health in times of crisis becomes this invisible burden that we all carry but rarely acknowledge.

People see the care providers as these unbreakable heroes, but inside, they are screaming half the time. Imagine the routine of an ER surgeon, who lost two patients in one shift, comforted three different families, and then went home and cried in the shower for an hour.” That is the reality of mental health in times of crisis for healthcare workers—they are expected to be superhuman while feeling completely human.

According to multiple studies, healthcare workers face an elevated level of depression and anxiety compared to the general population (Sialakis et al., 2023). The COVID-19 pandemic has intensified long-standing issues in physician mental health, highlighting the need for urgent, integrated individual and organizational interventions—especially at the systemic level—to protect and support care providers’ wellbeing (Harvey et al., 2021) (Huang et al., 2024).

However, most of these studies do not capture the emotions behind these data—the way it feels when you are living a mental health crisis. The way your hands shake after a particularly difficult case. The way you lie awake at 3 AM, replaying every decision you made during your shift, is unnoticed.

Dr. Lorna Breen was the head of emergency medicine at NewYork-Presbyterian Allen Hospital. She served as Site Director of the Allen Hospital Emergency Department since 2011 and was a respected educator and physician. She died by suicide in April 2020 after treating COVID-19 patients. Dr. Breen died on April 26, 2020, while taking a break with family in Charlottesville, Virginia. In the weeks prior, she had worked long hours treating COVID-19 patients, contracted the virus herself, and returned to work before her death. Her death has forced us to confront something we had been avoiding: mental health in times of crisis is not just about stress—it can be a matter of life and death.

The Dr Lorna Breen Health Care Provider Protection Act represents a landmark federal effort to address burnout and improve mental health among US healthcare professionals but requires broader systemic changes to effectively tackle workplace causes and stigma (Sindhu and Adashi, 2022).

Research shows that healthcare workers experiencing burnout are twice as likely to make medical errors (Panagioti et al., 2018) It is not that we stop caring—if anything, we care too much, but when your mental health is compromised during a crisis, your ability to provide the care you want to give becomes impaired.

A 2025 survey by the Medical Defence Union (MDU) found that 35% of doctors reported that tiredness or sleep deprivation had impacted their ability to treat patients safely, up from 26% in 2022. This means that roughly one in three doctors acknowledge that being so tired affects their patient care. When you combine that level of exhaustion with the emotional toll of crises, mental health in times of crisis becomes a perfect storm.

The Domino Effect Nobody Wants to Acknowledge

Studies indicate that burnout-related turnover is costing the healthcare system billions annually (Muir et al., 2022) (Khullar, 2023) (Dyer, 2019).The real cost is not financial—it is human. It is the experienced nurse who cannot bring herself to come to work anymore. It is the doctor who questions every decision because their confidence has been shattered. It is the respiratory therapist who has panic attacks in the supply closet.

During COVID, Mental Health America found that 93% of healthcare workers were experiencing stress, with three-quarters reporting complete exhaustion (Howard and Houry, 2024). Those are not just numbers—they represent people like your colleagues, like you, like the woman crying in the hospital parking garage because she does not know how to keep going.

What Helps (Spoiler: It is Not What You Think)

What makes a difference? Real, systemic changes that acknowledge care providers are human beings, not machines. The Mayo Clinic has figured this out better than most. They have implemented programs that address the root causes of mental health struggles during crises, not just the symptoms. They have created peer support networks where people can talk honestly about their struggles without fear of professional consequences (Kelsey, 2023).

One of the most effective interventions is Psychological First Aid training. Instead of pretending that trauma is not part of our job, PFA gives us practical tools for processing difficult experiences and helping our colleagues when they are struggling (Schoultz et al., 2022) (Peng et al., 2024). It acknowledges that mental health in times of crisis requires active management, not just hoping people will “tough it out.”

The Small Things That Save Lives

Some of the most powerful interventions for mental health in times of crisis are not complex or expensive. Some care facilities could bring in therapy dogs twice a week. Sounds silly, right? “Decompression rooms“—quiet spaces where one can go between difficult cases to just breathe for a few minutes. It is not much, but when you are dealing with mental health challenges during a crisis, sometimes five minutes of silence can make the difference between breaking down and keeping going.

A brief debriefing session where the carers can talk through what happened. Not for legal reasons or quality improvement—just to acknowledge that what we experienced was difficult and that it is okay to feel affected by it. This simple recognition of our humanity can improve mental health outcomes more than any formal program we have tried.

Moving Forward Without Losing Ourselves

Mental health in times of crisis for healthcare workers is not going away. If anything, it is getting worse as our healthcare system is exposed to increasing pressures, and our society still faces issues. It is not that we will face these issues—it is about how we respond to them. For patients and families, having your caregivers suffer as well does not mean you are getting substandard care. It means you are getting care from human beings who are giving it their all in atrociously difficult circumstances. A bit of compassion and understanding go much further than you can imagine when someone’s mental health is worn thin. For medical administrators, spending on mental health care is not just the ethical thing to do—it is smart business for an efficient healthcare system. When you address mental health during times of crisis directly, you prevent burnout, reduce turnover, and ultimately provide better patient care. And, doctors and nurses who might be reading this while fighting with your mental health during these tough times—you are not alone, you are not weak, and you are not failing. It is not surrendering to reach out for assistance; it is investing in yourself so that you can continue to care for others. The reality is that crisis mental health will always be a part of healthcare practice. But it does not have to destroy us. With the proper support, open communication, and recognition of our shared humanity, we can overcome these challenges without losing ourselves in the process. Because at the end of the day, taking care of our mental health in crisis is not selfish—it is how we ensure that we can continue showing up for the people who need us most.

References

1. Dyer, O., 2019. Physician burnout costs US $4.6bn a year, study finds. BMJ l2361. https://doi.org/10.1136/bmj.l2361
2. Harvey, S.B., Epstein, R.M., Glozier, N., Petrie, K., Strudwick, J., Gayed, A., Dean, K., Henderson, M., 2021. Mental illness and suicide among physicians. The Lancet 398, 920–930. https://doi.org/10.1016/S0140-6736(21)01596-8
3. Howard, J., Houry, D., 2024. Protecting the Mental Health and Well-Being of the Nation’s Health Workforce. Am. J. Public Health 114, 137–141. https://doi.org/10.2105/AJPH.2023.307475
4. Huang, J., Huang, Z.-T., Sun, X.-C., Chen, T.-T., Wu, X.-T., 2024. Mental health status and related factors influencing healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLOS ONE 19, e0289454. https://doi.org/10.1371/journal.pone.0289454
5. Kelsey, E.A., 2023. Joy in the Workplace: The Mayo Clinic Experience. Am. J. Lifestyle Med. 17, 413–417. https://doi.org/10.1177/15598276211036886
6. Khullar, D., 2023. Burnout, Professionalism, and the Quality of US Health Care. JAMA Health Forum 4, e230024. https://doi.org/10.1001/jamahealthforum.2023.0024
7. Muir, K.J., Wanchek, T.N., Lobo, J.M., Keim-Malpass, J., 2022. Evaluating the Costs of Nurse Burnout-Attributed Turnover: A Markov Modeling Approach. J. Patient Saf. 18, 351–357. https://doi.org/10.1097/PTS.0000000000000920
8. Panagioti, M., Geraghty, K., Johnson, J., Zhou, A., Panagopoulou, E., Chew-Graham, C., Peters, D., Hodkinson, A., Riley, R., Esmail, A., 2018. Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Intern. Med. 178, 1317–1331. https://doi.org/10.1001/jamainternmed.2018.3713
9. Peng, M., Xiao, T., Carter, B., Shearer, J., 2024. Evaluation of system based psychological first aid training on the mental health proficiency of emergency medical first responders to natural disasters in China: a cluster randomised controlled trial. BMJ Open 14, e078750. https://doi.org/10.1136/bmjopen-2023-078750
10. Schoultz, M., McGrogan, C., Beattie, M., Macaden, L., Carolan, C., Dickens, G.L., 2022. Uptake and effects of psychological first aid training for healthcare workers’ wellbeing in nursing homes: A UK national survey. PLOS ONE 17, e0277062. https://doi.org/10.1371/journal.pone.0277062
11. Sialakis, C., Sialaki, P.A., Frantzana, A., Iliadis, C., Ouzounakis, P., Kourkouta, L., 2023. Prevalence of anxiety and depression of health care workers during COVID-19 – a systematic review and meta-analysis. Med. Pharm. Rep. 96, 246–253. https://doi.org/10.15386/mpr-2579
12. Sindhu, K.K., Adashi, E.Y., 2022. The Dr Lorna Breen Health Care Provider Protection Act: A Modest Step in the Right Direction. JAMA Health Forum 3, e223349. https://doi.org/10.1001/jamahealthforum.2022.3349