At the end of 12-hour shifts treating patients who have tested positive for COVID-19 at NYC Health + Hospitals/Lincoln in the Bronx, Dr. Ma Carla Angela Evangelista goes home to her husband and three young children, ages 8, 3 and 1.
Upon walking through the door, she tells her kids to go to their rooms. She then undresses, putting her scrubs in a plastic bag that goes into an empty hallway closet, to be washed later.
Immediately, she showers. Only after putting a fresh mask on does she tell her kids they can come out of their rooms. She cleans every object she touches in her home. “I think I’m a walking bug,” she says.
That’s how Evangelista has been interacting with her husband and kids amid the coronavirus pandemic. She didn’t want to live away from them, as some front-line workers have done during the pandemic, but she compares her thoughts to an endless roller coaster. “As a mom, you always worry,” she said.
With the pandemic exacting a significant toll on the well-being of caregivers, psychiatrists argue that female staff are likely going to be in most need of mental health resources and support given their heightened stressful duties at home and at work.
Health systems—particularly those hit hard with coronavirus patients over the last few months—are offering free counseling, support groups, mental health hotlines and other resources for their employees. The hope is that by addressing emotional well-being, fewer employees will get burned out and retention levels won’t suffer.
While health systems don’t target a gender when offering these resources, women are probably more vulnerable to experiencing trauma, depression, burnout and anxiety as a result of the pandemic compared with their male counterparts because of their magnified personal responsibilities and will likely use the resources more, according to psychiatrists and researchers.
Evangelista’s main fears are getting sick, forcing her to isolate from her family or risk giving the virus to her husband and kids. “At the baseline as a doctor, you have to be cautious of bringing stuff home but because this virus is so new, there is extra stress on my part of taking care of my patients, myself and my family,” she said.
NYC Health + Hospitals recognizes the toll the pandemic is taking on its caregivers and has established wellness rooms and assigned behavioral health personnel to units so they’re available to talk to staff.
Evangelista said they don’t pry, but she likes the idea of being able to talk to someone if she needs it.
“For now, it has gotten better … but if we experience a second wave or there are things that come up, it’s not a problem for me to approach one of them,” she said.
“Women take on extra burden in these times—child care, home schooling,” said Dr. Jessica Gold, an assistant professor of psychiatry at Washington University in St. Louis. “I think the extra burden of those unpaid responsibilities is going to be conducive to mental health challenges.”
There is little or no data in the U.S. to support such a hypothesis, but a recent study published in JAMA shows that in China, where the coronavirus outbreak first emerged, women and nurses were more likely to report higher levels of depression, anxiety, insomnia and distress than men and physicians. Although the majority of study participants were women, which can skew the results, researchers and psychologists argue there might be compounding factors at play.
In addition to the environment and work responsibilities becoming more stressful during the pandemic, there is strong evidence showing that women continue to take on the majority of household responsibilities such as child care, grocery shopping, cooking and caring for elderly parents. Home life now has added stress points with children unable to go to day care or school due to stay-at-home orders and concerns about spreading the virus to family members.
“There are moms who are working as doctors and have someone sick at home,” said Dr. Christina Mangurian, professor of clinical psychiatry at UCSF School of Medicine. “The stresses on women and mothers are real.”