Tag: anxiety

The Evolving Challenges in Medicine: A Look at the Long-term Impact of the COVID-19 Pandemic

Public Health Notes

By Catherine Colquitt, MD, TCPH Medical Director

This article was originally published in the March/April 2026 issue of  Tarrant County Physician.

The opportunities, rewards, and privileges of practicing medicine are many, but the pressure of practice can at times be stressful or overwhelming. Our colleagues straining to cope may be reluctant to report or seek treatment for depression, anxiety, or substance abuse disorders. Many of these conditions have been exacerbated by the COVID-19 pandemic and its aftermath.

Tarrant County Public Health (TCPH) has for many years offered chronic disease self-management programs which host lay group support programs customized to each participant’s needs. These are facilitated by a trained lay leader with input from the rest of the support group and are tracked to mark progress on the journey toward successful chronic disease self-management, including anxiety, depression, and obsessive-compulsive disorder, among other chronic conditions. However, many physicians and other healthcare workers already feel too over-extended to participate in a time-consuming peer support program such as TCPH offers.

While healthcare worker (HCW) burnout is lower now than at the height of the COVID-19 pandemic, HCW burnout and stress have not returned to the pre-pandemic baseline according to most sources, including a large study of Veterans Health Administration (VHA) HCWs surveyed annually in 140 VA Medical Centers from 2018 to 2023. In response to survey data, the VHA implemented “several system-level programs to revise organizational practices and policies” to reduce or mitigate burnout. These include reducing workloads by hiring more staff, increasing telehealth and telework options, and introducing “whole health practices” in employee healthcare in which much attention is directed at mitigating the mental health impact of medical conditions and stressors at work or home affecting VHA employees.1 

Scientific Reports released a study evaluating anxiety
and depression among HCWs two years after the COVID-19 infection began. A remarkably high percentage (50.8 percent) of their sampled HCWs reported “long COVID,” which authors defined as “persistence of multi-system symptoms for more than twelve months, including fatigue, shortness of breath, brain fog, depression, and anxiety.” The authors used PHQ-9 and GAD-7 scales to assess anxiety and depression in HCWs two years after COVID infection (higher scores indicate more instances of anxiety and depression, while lower scores indicate fewer). They found that students had the highest PHQ-9 and GAD-7 scores, with doctors, nurses, and administrative staff reporting lower PHQ-9 and GAD-7 scores. Authors concluded that “policymakers and healthcare administrators should consider optimizing mental health support systems,” including “implementing regular mental health screenings, providing personalized psychological interventions, offering counseling services, reducing work-related stress, and promoting the use of mental health assessment tools to improve the psychological well-being” of healthcare workers, especially students and those who have long COVID.2 

Center for Infectious Disease Research and Policy summarized a Morbidity and Mortality Weekly Report study of US HCWs surveyed online in 2022 and 2023 in which 26 percent of participants “reported symptoms of mental illness but only 20% sought treatment during the previous year, mainly because of difficulty getting time off from work and worries about confidentiality and cost.” HCWs were surveyed using PHQ-2 and GAD-2 tools and cited work stress, burnout, inadequate staffing, greater workload or job demands, fear of COVID-19, and COVID-19 misinformation as their leading stressors.3 

Like our patients, we physicians escape through connections to our chosen online communities, but perhaps we should more often step out of our comfort zone to ask a colleague how they are doing in a manner which suggests that we really care to know, and this might lead to a colleague expressing concern for our well-being as well. Who among us is at risk for self-harm? According to actuarial data, the typical physician at risk is 45 years old; Caucasian; amid some marital discord or divorced, separated, or single; self-treating with alcohol or drugs; a “workaholic”; and a risk-taker. Our hypothetical colleague may also have chronic pain or some other serious medical comorbidity, is concerned about a looming change in status (financial, professional, social) and may be frankly overwhelmed by the increasing demands of work. Our colleague will likely also have access to medications or firearms with which to act.4,5,6

Psychiatric concerns in physicians are often left unaddressed until far advanced just as we often under-diagnose psychiatric conditions in our patients. Furthermore, we may fear the possible professional repercussions of asking for help with a psychiatric illness, opening ourselves up to the scrutiny and judgment of physician health programs, credentials committees, colleagues, or lawyers.

It is my personal hope that we will all use our training, honed by the COVID-19 pandemic, to minister to those suffering and in pain in the ways unique to our healing arts. COVID-19 has changed us all in ways we don’t yet fully realize.

References:

  1. Debra C. Mohr et al., “Burnout Trends Among US Health Care Workers,” JAMA Network Open 8, no. 4 (2025): e255954, https://doi.org/10.1001/jamanetworkopen.2025.5954.
  2. Lin Zhang et all., “Anxiety and Depression in Healthcare Workers 2 Years After COVID-19 Infection and Scale Validation,” Scientific Reports 15 (2025): Article 13893, https://doi.org/10.1038/s41598-025-98515-w.
  3. Mary Van Beusekom, “1 in 4 US Healthcare Workers Report Mental Distress During COVID, Survey Suggests,” Center for Infectious Disease Research and Policy, January 20, 2025, https://www.cidrap.umn.edu/covid-19/1-4-us-healthcare-workers-report-mental-distress-during-covid-survey-suggests.
  4. Latoya Hill et al., Physician Workforce Diversity by Race and Ethnicity, Kaiser Family Foundation, July 22, 2025, https://www.kff.org/racial-equity-and-health-policy/physician-workforce-diversity-by-race-and-ethnicity/.
  5. Daniel Saddawi-Konefka, Christine Yu Moutier, and Jesse M. Ehrenfeld, “Reducing Barriers to Mental Health Care for Physicians: An Overview and Strategic Recommendations,” JAMA 334, no. 10 (2025): 987–995, https://doi.org/10.1001/jama.2025.12587.
  6. Hirsh Makhija et al., “National Incidence of Physician Suicide and Associated Features,” JAMA Psychiatry, published online February 26, 2025, https://doi.org/10.1001/jamapsychiatry.2024.4816.

Mental Health in Medicine: A Call to Lead

President’s Paragraph

By Cheryl Hurd, MD, TCMS President

This article was originally published in the January/February 2026 issue of  Tarrant County Physician.

Hello everyone, my name is Cheryl Hurd, and it is my honor and privilege to serve as the 2026 TCMS president. I am a psychiatrist who has been in active practice for nearly twenty-five years, but I have also been a medical educator for the majority of that time. (I am also an English Lit major, so the “President’s Paragraph” is likely to become much longer than a paragraph. . . .) I want to thank the many presidents before me who have written articles and stories that have amused, enlightened, and inspired me. I admire the passion (and compassion) as well as the courage of my predecessors. I can only hope to aspire to the same level of dedication to my theme as they did to theirs.

My mission has always been to provide the highest quality and evidenced-based care to patients while training the next generation of physicians in best practices. Easy buzzwords to write, but they’re sincere nonetheless. As a psychiatrist, mental health is at the forefront of my mind. Mental health has long been marginalized, treated as secondary to physical illness, and burdened by stigma. Yet the evidence is clear: Mental health is inseparable from overall health, and its neglect undermines our patients, our communities, and ourselves.

I have chosen to make mental health advocacy the defining theme of my tenure. This is not just a matter of professional responsibility; it is a moral imperative. TCMS should be among those leading the way in ensuring that mental health is recognized as a cornerstone of care in this county and throughout the great state of Texas.

Millions of people struggle with depression, anxiety, trauma, and substance misuse; this includes us as physicians. Suicide remains a leading cause of death among young people, and burnout continues to erode the well-being of healthcare professionals. We still lose as many as 400 attending physicians to suicide a year.1 Residents and medical students are facing the same challenges. These realities are not just statistics—they are the lived experiences of our patients, colleagues, families, and ourselves.

The pandemic further exposed the fragility of our mental health infrastructure. The sequelae of the pandemic included an explosion in mental health disorders across our country. Demand for services surged, yet access remained uneven despite the adoption of telepsychiatry. Rural communities, marginalized populations, and children bore disproportionate burdens. I was president of the medical staff at JPS from the beginning through the height of the pandemic, and I saw firsthand the devastation that was wrought on the physical and mental well-being of the healthcare workforce. My most important service as medical staff president during that time was to bolster our physicians and other providers, provide resources, give updates, and instill hope when despair seemed to overwhelm us. The infrastructure could not meet the demands, and it often still doesn’t.

So, I would like to focus on expanding equitable access to care for all; integrating mental health into primary care, schools, and workplaces; and leading a conversational shift that normalizes open discussions about mental health across our practices and communities. Through advocacy we can advance reforms that treat mental health with the same seriousness as physical illness, expand the workforce with training and support for all physicians (not just mandate PHQ-9 and GAD-7 questionnaires at every visit), strengthen school partnerships to provide early intervention, invest in community clinics, expand telehealth to close gaps in underserved areas, and promote research and innovation that drive evidence‑based solutions.

As physicians, we still carry unique credibility in shaping public discourse. When we speak openly about mental health—whether in clinical settings, community forums, policy debates, or even podcasts—we dismantle stigma and inspire change.

We must also look inward. Physician burnout and moral distress remain pressing concerns that negatively impact physician well-being. By prioritizing mental health within our own profession, we model resilience and compassion for the broader healthcare system. TMA, our state medical association, has developed many resources in service of our members for these very issues. Many county societies have done the same, as have we at TCMS. I encourage everyone to visit the Physician Wellness website and learn more about our efforts: https://www.tcam.org/physician-wellness.

I know that I am asking a lot of all of you, and it won’t be easy. There are many financial constraints and competing interests that limit the expansion of services. We have a workforce shortage that hinders access, and the stigma of mental illness persists (particularly when it is related to substance use disorders). Differences in healthcare policies and funding priorities can complicate efforts to expand mental health services, but collaboration can help bridge these divides. These challenges are not insurmountable. With advocacy, innovation, and determination, we can overcome them.

Mental health is about people. It is about the child struggling with anxiety, the veteran coping with trauma, the parent balancing stress, and the physician facing burnout. By focusing on mental health, we confirm that every individual’s well-being matters.

As president of our medical society, I call upon each of you—physicians, educators, researchers, and advocates—to join me in this work. Together, we can elevate mental health, ensuring that it is recognized as a fundamental component of healthiness and a shared responsibility of the medical community.

“What mental health needs is more sunlight, more candor, and more unashamed conversation.” —Glenn Close

References:

  1. John Matheson, “Physician Suicide,” American College of Emergency Physicians https://www.acep.org/life-as-a-physician/wellness/wellness/wellness-week-articles/physician-suicide#:~:text=Each%20year%20in%20the%20U.S.,and%20alcohol%20and%20substance%20abuse;.
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