Public Services International (PSI) recently released a comprehensive report delving into the mental health struggles experienced by healthcare professionals across Liberia, Brazil, Sweden, Australia, and Canada. While disparities exist between healthcare systems in the Global South and the Global North, common issues, including extended working hours, elevated work demands, low wages, and job insecurity, unite health workers worldwide.
People’s Health Dispatch engaged in a conversation with Ruth Ballardie and Vera Weghmann, co-authors of the report titled “Mental Health and Public Sector Healthcare: International Case Studies,” shedding light on the critical messages emerging from their analysis.
PHD: Health workers’ mental health has been a long-overlooked concern. Can you elaborate on the connections between work and healthcare workers’ mental health and how public health budget cuts have shaped this?
Ruth Ballardie (RB): The global decline in healthcare workers’ mental health is a long-standing issue exacerbated by factors such as increased work-related stress. Over the years, work-related stress has surged globally from 33% in 1990 to 44% in 2022. The COVID-19 pandemic further intensified these challenges, particularly for healthcare workers. Understanding the decline necessitates examining changes in their work environment, emphasizing the critical link between work-related stress and psychosocial risks. These risks, influenced by factors like excessive workloads, poor communication, and inadequate professional development, contribute to mental and physical health problems. The underpinning driver of these challenges lies in the implementation of neoliberal policies, funding models, and anti-trade union legislation, resulting in a global healthcare workforce crisis.
PHD: How has the COVID-19 pandemic exacerbated the mental health challenges faced by healthcare workers?
RB: The existing global healthcare crisis was brought to the forefront by the pandemic, shedding light on issues such as underfunding, lack of preparedness, and intensified problems for healthcare workers. During COVID-19, healthcare workers experienced heightened psychosocial risks, with work overload increasing from 5% to 46%. Burnout, fatigue, emotional exhaustion, and PTSD rose significantly. These effects persist, given ongoing patient care demands and backlogs. The pandemic exposed the inadequacies of healthcare systems and worsened the mental health burdens on healthcare workers.
PHD: Have there been any efforts to address the global health workforce shortage?
RB: High-income countries have resorted to aggressive recruitment from low- and middle-income countries rather than investing adequately in their own healthcare systems. The World Health Organization (WHO) has highlighted the detrimental effects of this practice on low-income countries, designating 55 countries as vulnerable to the repercussions of aggressive international recruitment. The WHO emphasizes the need for reciprocal benefits, such as funds for healthcare education and training systems, when recruiting from low- and middle-income countries.
PHD: How does the mental health crisis among health workers manifest differently in high-income and low-income countries?
RB: Each country examined in the report has a unique political, economic, and social context. Sweden, a high-income country, faces healthcare workforce shortages despite its strong occupational health and safety laws. In Liberia, IMF-imposed policies, civil war, and Ebola outbreak aftermath contribute to a severe healthcare workforce shortage, relying heavily on unpaid labor. Brazil exhibits heightened inequalities, with mental health disparities linked to race, class, and gender, exacerbated by long working hours and systemic issues like denialism during COVID-19.
PHD: Based on your report’s findings, what recommendations would you propose to improve mental health among health workers and strengthen health workforce policies?
RB: Recommendations operate on three levels: challenging the neoliberal consensus at the macro level, advocating for actions on wages, job insecurity, and safe staffing levels, and addressing international agencies’ impact on global recruitment. Initiatives should include campaigns against privatization, increased public spending in healthcare, and collaboration with organizations like the International Labor Organization (ILO) to counter aggressive recruitment strategies. Additionally, enhancing training opportunities, occupational health and safety legislation, and empowering trade unions in health and safety initiatives are essential steps toward safeguarding healthcare workers’ mental health.
In conclusion, the report underscores the urgent need for comprehensive, multi-level strategies to address the global healthcare workforce crisis and alleviate the mental health ch
