The COVID-19 pandemic has resulted in unprecedented and often devastating new circumstances for healthcare providers (HCPs), leading to an increased need for mental health prevention and early interventions efforts to support this critical workforce.
This one-hour event features:
- A research presentation of preliminary findings about the impact of healthcare providers’ role on family and interpersonal relationships during the COVID-19 pandemic
- A panel discussion with mental health researchers who are studying the pandemic’s effects on providers
- An audience question-and-answer period
During this event, we discuss examples of moral distress, moral injury, and other challenges in the work life and home life of healthcare providers during the COVID-19 pandemic. Some moments may be disturbing for you. It’s fine if you wish to stop watching at any point.
If you require wellness support, we encourage you to follow this link.
Hello everybody. Thanks so much for taking
time in your day to be here with us.
My name’s Amy Van Es, excuse me, and I will
be your host and moderator for this session.
I’d like to begin by acknowledging the land
on which McMaster University is located,
which is the traditional territory of the
Haudenosaunee and Anishinaabe nations,
and within the lands protected by the Dish
with One Spoon Wampum Belt.
That wampum uses the symbolism of a dish to
represent the territory and one spoon to represent
that the people are to share the resources
of the land and only take what they need.
We seek a new relationship with the original
peoples of this land, one based in honour
and deep respect.
May we be guided by love and right action
as we transform our personal and
institutional relationships with our indigenous
friends and neighbours.
It is in the same spirit that I welcome all
of you to our second of three town halls.
Today’s event is focused on the impact of
healthcare provider’s role in their families
and relationships during the pandemic.
This event is supported by the Public Health
Agency of Canada as part of their work to
address PTSD and trauma in those most affected
In this town hall, we will be discussing examples
of healthcare providers who have experienced
moral distress, moral injury, and other challenges
in their work life and home life during the
There will be moments that may be disturbing
and it’s totally fine if you wish to excuse
yourself from this event at any point.
So — excuse me — so over the past two
and a half years, we’ve heard so much about
the strain on health,
the healthcare system, and on healthcare providers
due to the pandemic.
And we owe a debt of gratitude to all the
physicians, nurses, therapists, personal support
workers, and public safety personnel, who,
despite facing incredible challenges in their
daily work lives, still found time and courage
to talk to us and share their experiences.
This research project seeks to shine a light
on the impact that
the pandemic has had on the mental health
of all those healthcare providers who have
given so much of themselves to the service
of others and continue to do so.
The evidence-based resources and tools we
are offering to help build mental health,
literacy, support, and resiliency are our
healthcare salute, our way of saying
thank you so much for your service.
One more thing before we get started.
I just wanted to let you know that there will
be plenty of time for our speakers to answer
your questions after the main presentation.
So if you’d like to submit a question, please
use Zoom’s q and a function,
and you can find that in the control panel
just below this video.
And to begin our program today, we’re going
to watch a prerecorded presentation
by Kim Ritchie and Emily Sullo. In the talk,
they’ll be diving into some findings from
their research about the effect of COVID-19
on healthcare providers’ relationships.
So, Dr. Kim Ritchie is a post-doctoral research
fellow in the
Department of Psychiatry and Behavioral Neurosciences
here at McMaster.
She holds a PhD in rehabilitation science
from Queens University and is a registered
nurse with extensive clinical experience in
geriatric mental health and professional practice.
As I mentioned before, Kim is involved in
this research project that’s meant to develop
of the unique and shared lived experiences
and psychological impacts among
healthcare providers resulting from their
work during the pandemic.
This research will contribute to the development
of novel approaches
to address the needs of healthcare providers
and public safety personnel.
We also have with us today Emily Sullo.
Emily is a graduate of the University of Toronto’s
honours Psychology program, and Western University’s
Master of Management of Applied Science in
Global Health Systems.
She has been involved in the field of mental
health for several
years, working on evidence- and community-based
including the development of mobile health
units in rural settings.
As a research assistant in the Trauma and
Recovery Lab at McMaster, Emily has primarily
been involved in the development of knowledge
translation deliverables to disseminate research
focused on understanding the experience of
and public safety personnel during the pandemic.
Thank you both so much for contributing to
the discussion today,
and I think we’re ready to take a peek at
Hello and welcome to our second town hall
Today, we’re going to be talking about the
impact of the healthcare provider’s role on
their family and interpersonal relationships.
My name is Kim Ritchie and I’m here today
with Emily Sullo and we are both very pleased
to present some of our preliminary research
As we know, COVID-19 has impacted all of our
lives in so many different
ways, but for healthcare providers, they faced
additional impacts specifically because of
their role and being on the frontline of the
serving the public over the past two years.
For example, healthcare providers have had
significant changes in the way they work,
including changes to their role, to policies
and to clinical protocols that they follow.
Many healthcare providers have worked significantly
and some with reduced staffing levels, which
has really contributed towards
feeling exhausted and some towards burnout.
Healthcare providers have also had a lot of
fear and uncertainty surrounding the increased
level of contracting and transmitting COVID
due to the
higher exposures they face in the course of
And on top of all of these challenges, there
was this extra
layer of stress related to their role and
the impact it had on their own relationships
with their family, friends, and their colleagues.
During the pandemic, we’ve been conducting
interviews with healthcare
providers from across Canada in order to understand
the impact of COVID-19 on their mental health.
As part of these interviews, we’ve also asked
healthcare providers about the impact of the
role on their relationships with family, friends,
Today, we’ll share some of those results from
that we conducted between February, 2021 and
For the first theme, healthcare providers
told us that during the
pandemic, they felt like their work extended
and had a significant impact on their family.
There was a fear of exposing their families
to COVID because
of their higher workplace exposure to the
And they were also working more hours to accommodate
increased number of people who required healthcare,
which meant certain adjustments had to be
made within the family.
Many healthcare providers described having
to physically distance for
periods of time from family and friends throughout
While this occurred primarily in the first
wave of the pandemic,
it also occurred periodically throughout the
remaining time of the pandemic,
due to high exposure at work from increased
hospital admission or community transmission.
And the main reason for this physical distancing
was to protect
their family and friends from COVID-19 as
they felt they were at
higher risk through their work.
And there was a variety of ways that they
physically distanced as described from the
quote on the screen, some moved out of their
house, into hotels at their own expense,
into rented trailers, and some lived in their
Others isolated themselves to a specific area
or room within their own house.
And during these periods, most did not eat,
sleep, hug or interact with
their families, often for many weeks or even
months for periods of time.
This also applied to extended families, where
healthcare providers physically distanced
by not attending traditional family gatherings,
such as birthdays and weddings, even though
they may have occurred without them.
Other healthcare providers were excluded from
these events because the family was fearful
due to their role as a healthcare provider.
And in response to physically distancing,
some healthcare providers tried to stay connected
through alternative means such as virtual
calls, social media, or even a telephone call.
And some of these changes were felt to be
healthcare workers to maintain these relationships,
and others indicated that it really just made
them feel more isolated, because it didn’t
seem to be the same as an in-person visit
And the other way it was impacted, is that
family members had
to take on new roles to accommodate increased
work hours or different schedules.
And also to accommodate periods where the
healthcare workers just felt too exhausted
and burnt out to be able to fulfil usual roles
in parenting or even in household chores.
And this is explained in the quote above where
this healthcare provider’s
husband had to take on additional parental
responsibilities at home to accommodate work
But being able to accomplish these usual home
responsibilities was described by the healthcare
as they felt very guilty because of it, and
like they had even lost their place
within the family for even a period of time.
And then once their work hours reduced or
they no longer had to physically distance,
there was this period of having to adjust
and even renegotiate some of these rules within
Another major theme healthcare providers described
was this overarching
feeling of never-ending caregiving that became
all-consuming during the pandemic.
On the one hand, due to the demands the pandemic
placed on healthcare providers,
they worked more hours and experienced pressure
to place work before their family or themselves.
This problem existed before the pandemic,
but was exacerbated by it due to the added
challenges in the workplace, such as worsened
And on the other hand, typical familial caregiving
responsibilities became more difficult to
due to the added risk placed on vulnerable
groups during this time,
which led to at-home caregiving feeling like
an extension of their occupational role.
And this just made it very difficult to escape
from these overwhelming demands.
When looking at the increased pressure to
prioritise work over family, healthcare providers
describe two main sources of this pressure,
the first being organisations putting an additional
pressure on healthcare providers to work more
often, stay over time, come in on dates off,
and are even denying vacation time because
staff shortages have been exacerbated since
the beginning of the pandemic.
In order to meet the care demand of the pandemic,
healthcare providers are needing to make up
for these gaps.
However, the healthcare provider themselves
also put pressure on themselves to work these
extra hours out of a sense of duty and guilt
towards the public and colleagues.
Healthcare providers experience a contradictory
pressure as well
from family to reduce their work hours.
So for example, some healthcare providers
stated that their families wanted them to
quit their jobs.
But many healthcare providers said that they
were continuing to work despite these pressures,
because they believe it is necessary to continue
in order to
maintain the healthcare system at this time.
And these pressures create internal tension
for healthcare providers,
because they’re feeling guilty towards colleagues
for not taking on additional shifts.
And some of these healthcare providers left
their positions or made a complete role switch,
because of the toll it had on their physical,
emotional and mental health.
Many of these individuals felt it was the
only way for them to balance
work and family, by finding a new role.
However, it was made clear that this was not
an option for everyone.
And so those individuals were stuck in a difficult
The role of caregiver outside of the workplace
was also not a new
responsibility specific to the pandemic.
However, due to the high risk of that COVID
posed to vulnerable loved ones, such as children
and the elderly, health related care needs
of family members and friends fell to healthcare
providers, with the expectation that they
would be able to make the best care decisions
for their loved ones.
And this added responsibility and pressure
to their caregiving role at home created a
double burden of family and work caregiving.
And because of this
caregiving provided outside of the workplace,
became an extension of their professional
role and contributed to the exhaustion and
stress that many healthcare providers are
facing during the pandemic.
The challenges and stressors associated with
the healthcare provider role during the pandemic
also produced a disconnect between personal
life and work life, such that many healthcare
providers felt as though they were living
in two worlds that they were unable to reconcile.
These two worlds that we identified are being
home world and work world in this presentation.
So one of the major relationship impacts that
has come out of this theme of living in two
worlds is an increased connection with colleagues.
And this is due primarily to two reasons.
The first is that colleagues provide effective
So there’s been a change in work relationships
where healthcare providers are turning more
frequently to colleagues for social support
because of their shared experiences during
Other healthcare providers are able to understand
and empathise with the challenges that they’re
being exposed to and are therefore able to
provide much needed and effective support.
Additionally, work exposures have led to a
identity with other healthcare providers who
have similar experiences.
And the other reason is risk of infection.
Many healthcare providers feel a sense of
reassurance by interacting more with other
healthcare providers, because they did not
feel they were putting them at any increased
risk of exposure as everyone is vaccinated
and has similar levels of work related exposure
At the same time, healthcare providers told
us that they were
feeling disconnected from family and friends.
So due to healthcare providers’ exposure to
challenging situations at work, they’re having
a difficult time.
Relating to family and friends and vice versa,
which has made this more difficult for healthcare
providers to turn to family and friends for
There’s also the additional fear of sharing
these experiences with family
in case it traumatises them, which produces
further barriers for communication between
And the lockdown restrictions limited healthcare
provider’s exposure to family and friends
contributing to this gap between healthcare
providers and loved ones.
There’s also been increased conflict reported
and friends due to different opinions on vaccinations
masks, government rules, et cetera, leading
to many healthcare providers cutting off or
limiting relationships for their own mental
So just to go over some of the key findings,
the role of healthcare
providers have impacted home life during the
pandemic specifically due to physical distancing
requirements and a need for role changes.
The increased caregiving demands of a healthcare
provider at home and
work during the pandemic, felt all consuming
and contributed to additional stress and exhaustion
on healthcare providers.
The numerous work-related challenges healthcare
during the pandemic have led to them feeling
as though though they are living in two worlds
that they’re unable to reconcile, specifically
the work world and the home world.
With that I would like to thank you all for
your time today.
And also thank our valued healthcare providers,
who have and continue to serve on the front
lines of the pandemic.
Thank you all very much.
Thank you for sharing your research, Kim and
We really appreciate it.
so we’re gonna move into the live discussion
portion of our event today.
This is a chance to really get into the nitty
gritty and understand the complexities and
nuances of today’s topic.
We’re gonna jump right in with a few questions,
but it’s not too late to ask yours.
If you have a question of your own, all you
have to do is pop it
in the chat or the q and a box and I’ll get
I’d like to welcome to the live discussion
today, Margaret McKinnon, Heidi Cramm,
Kelly Hassall, Kim Ritchie and Emily Sullo.
I was hoping each of you could take a moment
to introduce yourselves and tell us a little
bit about your involvement in the project
or you know, through what lens you’re answering
the questions from today.
And Margaret, I was hoping we could start
with you and
perhaps you could pass it to the next person.
Thank you so much, Amy.
So my name is Margaret McKinnon, I’m a clinical
psychologist and I also serve as
a professor in the Department of Psychiatry
and Behavioural Neurosciences at McMaster.
I was incredibly privileged throughout the
pandemic to provide mental health supports
to healthcare workers.
So being on the COVID unit, being on the ICU
and also leading communities of practice for
And I will say, without any reservation that
we heard, I heard repeatedly about the impact
of pandemic service by healthcare workers
on their relationships with families.
And I’m, I’m really pleased that we have the
opportunity to highlight this impact because
I think sometimes it’s missed when we talk
about the impact that this pandemic has had
on those who serve, including healthcare workers,
but also public safety personnel and their
families who really gave services well as
sacrificed during the pandemic.
Maybe I’ll turn it over now to Kelly to introduce
Good morning everybody.
My name’s Kelly Hassall.
I’m the clinical resource leader of respiratory
therapy here at St. Joseph’s Healthcare in
I’m coming at this from the lens of a respiratory
therapist that has been in acute care in the
front lines, and I had an opportunity to work
with respiratory therapists throughout Ontario
and Canada throughout the various phases of
I’m also a mother of two children who have
gone from ages five
to eight, and they are now turning, well,
one was five at the start and was now
eight, and the other one was eight is now
So I’ve had that opportunity as well.
And then, we were very fortunate to be linked
with Margaret and her team,
very early on in the pandemic, to discuss
the concept of moral injury within respiratory
therapists. This was something
that had not been really addressed very much
to date, so we’ve been very, very fortunate
to have that assistance throughout this time.
Maybe I’ll switch to Kim Ritchie now, if I
Thank you so much, Kelly.
So it’s my pleasure to be here.
I think Amy so kindly introduced us at the
beginning too, but I’ll just add
my role has for the project has been, I guess,
mostly lead for the project in
terms of the research part.
And I’ve had the privilege of talking to over
healthcare providers since the beginning of
the pandemic and through each wave.
And so we really, really value all of the
information that’s been shared
But the impact on the family was one of the
really early themes that arose and has
And it really brings home the fact that, you
we all belong to, to — greater than our
and that if things are going on at work, it
impacts our family.
And I think the pandemic really had a profound
impact on healthcare providers
and by extension to their family because of
the types of service that they had and the
amount of work that they actually had to do
in terms of hours during the pandemic
So we are really happy to be here today in
highlight this for the rest of everyone else.
And I’ll pass it over to Heidi.
Hi, I’m Heidi Cramm.
I’m an occupational therapist by training,
but primarily I’ve been a researcher around
families, across populations that really experience
occupational risk and requirement, and that’s
what we’ve been trying to reframe through
the research group.
I’m leading the Families Matter research group
trying to understand the dimensions of lifestyle
that come with certain kinds of jobs.
And so when we think of military, we think
about public safety personnel.
We’ve been building a whole way of understanding
the impacts of families.
With that lens of occupational risk and requirement
because we could see how easy
it extends into the healthcare worker field
and how much there’s blurring of of these
kinds of experiences and how much we can learn.
I will say I was absolutely struck by the
findings and how
much they represent the ongoing experience
in so many ways of the families of public
All of those things become quite amplified
and quite explicit and undeniable — quite
in your face through the risks of COVID, but
also the counter measures and the impact that
that’s had on the day to day functioning of
the family, especially during longer periods
of pay lockdown.
So I’ve got many, many thoughts.
Yes. Thank you.
I’m Emily Sullo and I’m honoured to be here
I’m a research assistant in the Trauma and
Recovery Lab at McMaster,
and I’m coming from this — as being involved
in the project mostly through
creating knowledge translation materials that
are presenting our findings to the public
to spread awareness about what healthcare
providers and public safety personnel
have been experiencing during the pandemic.
But I also have
been working alongside the team on the research
portion of it, of the project.
And it’s great to be here today.
Thank you everyone.
So I wanna just jump right into it.
So it was mentioned in the presentation that
some healthcare workers felt they’ve lost
their place in the family because they weren’t
able to do normal household duties or the
you know, what was normal before the pandemic,
Ashley in the chat actually beat me to connecting
— [to] making the link between healthcare
providers during the pandemic and military
So Heidi, I know you’ve done extensive research
with military professionals about life after
So what I’m wondering is, can families truly
go back to how it was
And if they can, what is it that they can
do to begin rebuilding?
Thanks for your question, and I mean, I don’t
think any of
us can go back to life truly pre-pandemic,
so I don’t really think it’s an option.
I think that many things have evolved and
changed, and one of the things that we’ve
learned, and it’s been so interesting when
we think about these occupational risks and
requirements in relation to military families
and then in relation to public safety personnel,
there are some differences.
When you work in communities where you live,
it does change
the experience of you in your home and your
connection to your community.
One of the biggest pressures for public safety
personnel and for healthcare workers
are things like shift work.
And the shift work means that you have to
do pretty persistent ongoing transitions in
and out of home and work.
And so we hear, and we’ve heard in your findings,
a maintenance of these two selves that for
you to be adaptive in one context, you may
not be able to be that same self and adaptive
in the same.
And how do you rapidly transition back and
So when we, we look at military families and
how military families adapt to changes in
roles, rhythms, and routines, when their family
members are away for extended periods.
Public safety families, healthcare workers,
do not have
that time pressed in the same kind of way.
They have rapid in out transitions.
This can be extraordinarily draining on both
sides because essentially, and as a fire spouse,
I can speak to this as a very long term experience
How do you actually — as an occupational
therapist, I find it fascinating around roles,
routines, connection, time use, all of these
How do you simultaneously say while you’re
not here, we function this way and we’re capable
and competent and we don’t need you cause
we can’t need you because we have to structure
it a way that that is.
But then as soon as you come back in, we have
and now be able to do that.
And so this has, this plays out in families
in different kinds of ways, depending upon,
say if you have young children, if you have
elder care, if you have a spouse with a career
that competes for kind of resources and time
and flexibility, you see how much those lifestyle
strains can really play out.
So I think one of the, one of the biggest
strains is the
transition in and out.
Oh, Margaret, I see your hand up.
Oh, sorry, I just saw her hand.
I’m just answering hands now.
Now Heidi, I just want to say, you know, I
have the privilege of —
I’m the Homewood chair of mental health and
trauma, and I have the privilege of working
with the Guardians Program at Homewood. And
is one of the things we hear consistently
from public safety personnel, is that that
transition from being at a call, being in
a difficult situation, driving home, and the
second that you open that door, you suddenly
have to be a father, a mother, a, you know,
a spouse, when you’ve just left, for example,
an accident that’s been horrific — and seeing
children who have been injured, or children
who have been killed.
And when I was on the units during the pandemic,
one of those powerful things that I could
say to healthcare workers was that, I understand
that you’re living in a different world right
now, and you could just see, people, how they
react to that.
And then to follow up with that by saying,
I know that
you’re living in a different world than your
family, than your friends, and then people
who are not healthcare providers and your
life experience is different.
What you’re seeing is different.
It’s very hard for other, other people to
know or understand.
For example, proning an older adult where
it takes eight
people to turn over an older adult.
And that may be very painful for the older
adult when that’s happening.
Where it may be the case that, you know, that
that older adult has said, I don’t want further
But families understandably wanting to hold
onto hope are saying, I want my, my mom or
my dad to be treated.
So I really feel that, that belief as well,
you know, if, healthcare workers tell their
stories, which Emily was talking about, that
they may traumatise their family members at
And so they live — and we hear that from
public safety personnel all the time, on the
at Homewood, and in our research that, you
know, if I tell my story, I’m going to hurt
by telling it.
And so you see people cleaving onto other
workers is a way of being able to tell and
share their stories.
They, they are family, much like in public
safety personnel and in the military, those
who you serve with are also your family.
And the word, the word family in the professions
in which we serve, you know, means those who
by whom you related by blood or by adoption,
but also those people with whom you serve.
I know, Kelly, if you’ve thought about that
on your own experience — I know you’ve done
a lot of work around this with your colleagues
in respiratory therapy.
Yeah, and sorry, just because I’m — could
you just reframe
exactly what the question is that you wanted
me to address?
Just cause I’m all over the map now.
I don’t think — yeah, I, I know that we’ve
about, with respiratory therapists, I’ve seen
how your profession holds together as a family.
There’s the impact on your family at home
there’s an impact on your family at work as
And I don’t know, do you have any thoughts
about how the pandemic impacted on that?
Yeah, I think it’s interesting because we
do work as an inter-professional
team, so we do move throughout the organisation
and we do work with all the different teams,
but we all come back to our home base and
this is where we have our safe space,
where we discuss and talk about all the challenges
that we’re having.
And I think that also ties into your commitment
because you don’t want to let your family
down and you know how hard it is if you’re
not going into work the next day.
And at the beginning of the pandemic, there
was a stigma that if
you ended up with COVID and couldn’t come
in to help out your team, it’s because you
did something wrong.
Yep. And, and, and —
you knew that dread and that cycle, and thinking
about if — I know for me, for example,
if I was gonna let one of my children go somewhere
or have someone come in to help, what were
the risks that I was putting on my family?
What were the risks I was technically putting
on my team?
And so that
sense there of that commitment sort of is
And then my spouse, for example, is not in
So completely different context, and how much
do you share, do you not share?
And how do you make it — [make] them understand
that that potential commitment that you feel
to this group of people that are being paid
to be there like you are?
We, we would hear often from healthcare workers
that, you know, even to take a break on the
unit — so to take 15 or 20 minutes for yourself
meant letting down the team.
Or to go home and not take another shift,
or to not come in the next day when you were
exhausted, it felt like letting your family
At the same time in going home to your family,
your nuclear family, there’s nothing left.
“I have nothing left.
At this point, I can’t be a mom right now
to my two year old child.
I can’t right now, go home and be a partner
because I have given everything that I have
on this unit, and not wanting to let that
family, that work family down.”
So, Margaret, I’m curious what sort of strategies
healthcare providers can use both at home
and at work.
So I was hoping maybe you could speak to some
strategies they could use at work and perhaps,
Kelly, maybe you have some tips on how they
might be able to cope at home with
that sort of 24 7 demand for caregiving.
I think one thing that we would say, and it’s
a very old adage, but it’s a true one, is
not able to help others until we put the oxygen
mask on ourselves.
And that sometimes we just need to hear that,
We need to hear that we have — we deserve
to be taken care of.
We deserve to have a break.
And taking that time, having self-compassion,
which is very, very hard because so many people
are relying on you as a healthcare worker.
It’s patients, it’s your colleagues, it’s
And just keeping in mind that without taking
for yourself to have a break to heal, you
won’t be able to care for others in the way,
in the most optimal way.
And that’s one really important thing for
us to remember as healthcare workers
to remember that we’re deserving of the very
That we have brought Canadians through to
what we hope will soon be the other side of
That we’ve had the opportunity to serve, and
that reinforces our identity as healthcare
Many of us got into these professions, whether
it be as clinicians, now as researchers, we
came here to serve.
And what we did do during this pandemic was
We — I work a lot, like Heidi, with the
military — and Kim, and you know, there’s
a way that
we honour the military with it: “We salute
We thank you for your service.”
And to healthcare workers, we say the same
We salute you.
We thank you for your service.
And you know, of course, either for some people
it will reach to the point where, you know,
this is really starting the impact, the mental
health impact of the pandemic is impacting,
you know, your daily activities.
It’s impacting your mental health to the level
that you’re experiencing just stress.
And it’s very important to also seek out resources,
mental health resources, again, knowing that
you deserve that care.
And so we have a series of resources here.
But the first place to really start, if you’re
feeling that you know this is, is causing
you a great deal of distress, is impacting
your daily life, is to reach out to your family
physician to book that appointment, to seek
They’ll be able to refer you on to the sources
your community of support to help you out
themselves and really support you.
So that’s also another important lifeline
for healthcare workers.
And really important to reach out.
Kim and Heidi and others, and Kelly, I don’t
what your thoughts are around — and Emily
— thoughts about other ways that people
cope, but I did want to highlight reaching
out for those mental health resources where
I think one of the things that we can see
and we can learn
from the work around these transitions with
other populations is that when people come
home and they may have nothing left in the
tank, they may feel like empty shells and
they’re expected to just kind of transition
in, is that before there’s that kind of an
often, I mean, we’re, we’re well far into
it now, so there’s no before, but thinking
that there often needs to be a transitional
allowance for that individual.
So rather than come in and have, here’s the
updates on everything
with the kids, you need to do this.
And the handover, because so many, especially
when there’s shifts, there’s a baton that
goes between people who are living in the
So now I did my thing, I’m going to work,
you do this thing.
So recognising that for you to be able to
it’s not a decompress, it’s almost like a
recompress, like you, there’s a recombobulation
piece here where people need to find a way
through whatever strategy to be less deplenished.
So that replenishment is so important, right?
But they’re not going to get it if, when they
come in the house, there’s another set of
expectations and they have to do that mental
People talk about the drive is very helpful.
To do that transition and to think about what
are the things that you do in that transition?
It might be that you use that 20 minutes in
the car, that hour in the car, to actually
listen to something that takes your mind completely
out of work and resets you.
It might be something that you do that’s more
meditative or gratitude
based or whatever works for you as a person,
and that there’s also an agreement when you
come home that there’s a transitional plan.
So it might be if you’ve had a really hard
day, there’s something at the door that you
pick up so that your spouse or partner recognises
And not now does not mean it’s you.
So, because it’s so easy to interpret that
kind of difficulty
as behavioural, relational, and interpersonal,
and that just makes things worse after all.
So where are there, like just if I pick up
the pink thing, that means I need 15 minutes.
I’m going in and going into the bathroom,
closing the door.
I need some quiet time, nobody — just give
me 15 minutes.
But those strategies need to be talked about.
workers in a very giving way, are not giving
So that self-compassion that Margaret — you
know, it’s like first responders to our public
safety community, they’re happy to help somebody
But accepting help and seeing that for them
to give help to others, they have to help
self, is such a mind warping concept that
doesn’t feel possible, but it’s beyond foundationally
Without that, they just continue to be, be
like Humpty Dumpty
versions of themselves.
And you know how you think about the, the
impact of trauma and stress on the body.
And so, you know, some of this is in our heads,
but some of it is also in our bodies, right?
So how do we give our bodies that space to
calm down, to lower the arousal, to be present
in the moment?
And I’m thinking as you’re talking about this
period of, for example, sitting in a soft
chair, feeling the chair around you, putting
your feet on the ground, feeling that sensation
of the feet that are on the ground, holding
onto an object like a stress ball, even where
you’re holding it and paying attention and
moving it, and allowing both your mind to
calm down, but also your body to calm down
at the same time.
I think that’s excellent advice, Heidi.
Sometimes it’s when you come home, the first
thing you do
is take the dog out for a 15 minute walk,
and then you have the pet, you have the nature,
you have the physical activity, and you have
also a, a routine way to then switch — because
otherwise it’s, it, it becomes quite too much.
And that plays out in the family, in, in all
kinds of ways
that aren’t positive for either the, the,
the worker or the family members.
Kim, did you have something to add?
I see you’ve unmuted yourself.
One of the things that we’ve had quite a few
healthcare providers tell us over the
last number of months is having somebody just
to check on them, just to ask them how they’re
doing and, and to go past kind of that surface
answer of everything’s fine and then to, to
really an authentically want to engage into
a discussion with them: like, you know, how
are you really doing?
Like, I’m here to listen to you.
And whether that person is a family member,
a friend, a colleague, a manager, supervisor,
like just creating that space of knowing that
you have somebody to go to, that somebody
you can really talk to and, and receive support
— be heard first and have that space
and then receive their support.
They, we’ve heard that’s been invaluable.
So a lot of people who have that have created
these sort of support little
groups so they know they have somebody to
go to when they need to talk.
But that’s not everybody of course.
And so just I think one of the other things
in terms of things that recommendations
is to find ways to reach out to healthcare
providers, whether you’re a family member
or, you know, in a workplace.
How can we help support that and create those,
safe groups to support each other?
I have one more comment too.
Amy, one thing that we’ve certainly heard
in the research is that Kim’s been leading
is that, you know, we hear this from public
safety personnel, from military members as
well, often people are looking for coping
resources when they go home, and so those
coping resources can take very healthy forms
and they can sometimes take on unhealthy forms
So, increased use of alcohol, for example,
which is that we’re hearing a lot about that
and the research that we’re doing, particularly
among healthcare workers and just being aware
of and sensitive to, to knowing, have I increased
the number of drinks I’m having after work?
Is it having an impact on my relationships?
Is it having an impact on me?
I think being aware of that is really important
because, unfortunately, people often want
to numb out and not be present.
It’s a way of escaping inescapable stress,
and so can we find healthy coping mechanisms
to help take the place of some of those more
unhealthy coping mechanisms that can creep
in during stressful periods like this.
And again, when that is becoming problematic,
shame and reaching out for help, it is actually
in fact very courageous and brave to seek
out the help that you need.
And you’re setting a beautiful example for
your children and for others when you seek
out help for your mental health concerns,
That is true bravery and courage.
We have another audience question that I would
direct to Emily.
And the question comes from Ashley, and it
is, I know you mentioned there were tensions
around views and values related to vaccination
and public safety measures within families.
What kind of impact did this politicisation
of pandemic measures have on healthcare workers?
They say that they’re thinking specifically
of protests outside hospitals as well as the
outpouring of support for healthcare workers.
Yeah, it’s a great question.
And so we already kind of covered that in
the presentation when talking about how
the political views were a major contributor
to this distancing between healthcare workers
and their loved ones, because it just created
extra tension within those relationships that
made it difficult for healthcare providers
to interact with them.
And so they felt the need to kind of create
of these boundaries on conversations or to
just restrict relationships altogether.
But we did through this analysis on family
we started looking at a little bit about what
healthcare providers were saying
with their relationship to the greater public
and how they’re feeling with the media,
the government, et cetera, kind of those larger
And one of the biggest things that kind of
came out of that, or comments that came
out of that were feeling like they had to
shoulder the blame of these mandates and
restrictions that are being placed.
So not, not just with the public, but also
direct comments from loved ones as well
as, you know putting that blame on the healthcare
providers when they really didn’t
have so much say in what was being put in
And so there was a lot of hurt and confusion,
that, you know, outpouring of support for
healthcare providers at the beginning
of the pandemic where everyone’s saying they’re
heroes and celebrating their
role and contributions to the community.
But then the shift kind of later into the
pandemic towards you know, you’re
causing this and having those protests outside
of hospitals where you know,
that support kind of disappeared.
And the other comments that we kind of heard
that they’re carrying the burden of maintaining
safety within the community.
So they went to extremes to ensure that their
you know, taking care of their loved ones,
restricting their interactions with
others so that they weren’t putting them at
exposed risk — extra risk —
because of the risk associated with their
But as everyone else kind of once the restrictions
lifted, were able to continue maybe going
out and felt a little bit more comfortable
doing the, having those social interactions
Healthcare providers were struggling to find
out how to do that within their
own homes as well, without putting their loved
ones at risk.
And this is all kind of compounded then by
the media and,
you know, feeling like they’re being misunderstood
or maybe misrepresented or not being represented
very well in the, in the media.
And so it’s just difficult for family, friends
in the public to then relate to what
they’re going through.
And so it’s just all these compounding factors
to create this distancing and the — that
two worlds kind of disconnect.
And Heidi, did you want to add to that?
Because from the family’s perspective, this
we know from the different sectors and the
— we’ve done four different syntheses on
trying to understand the experiences and
the impacts of the families across sectors.
And one of the things that comes that really
plainly is this
construct of identities is very complex.
And there is a social kind of conference of
expectations, responsibility and blame on
And so sometimes that can be like a positive
social capital, and sometimes that can actually
be quite negative, aggressive, antagonistic.
And what it does
is takes families who are already kind of
out of sync with the kind of nine to five
folk because of the nature of shift work often
— and it certainly through COVID, through
the, you know, extreme workloads for healthcare
workers — so they’re already feeling
that out of sync.
And then they’re, you know, we’ve heard families
talk about feeling like they’re pariahs
and that they become kind of an extension
So it’s a very
fascinating concept to try to get our heads
around and it’s so important because, you
know, one of the things that we know is protective
for people is social support and social support
where you really feel like someone’s got your
Not like if you feel like you go to the, the
you know, someone accosts you because your
spouse is a healthcare worker and you
have a different set of rules and expectations
that everybody else is free from.
So there’s so many layers, and so to Margaret’s
you know, you know, there’s so many similarities
around this from military veteran public safety,
and one of the things that we’ve come to really
see is that families are serving alongside
and taking up all these consequences.
And if we want people who are in these jobs
risk and requirements to be retained, we have
to support the families, not only to support
that person, but also to support themselves.
Because families matter in their own right.
And we need, we need that explicit attention.
Yeah, Heidi, I couldn’t agree more.
And you know, our own research suggests that
one in two Canadian healthcare workers are
considering leaving their clinical positions
And that tells us, we know about staffing
shortages, we know that we don’t sometimes
even have ambulances to send right now.
And we really need to hold onto this vital
workforce that just underpins our society.
How do you know?
Heidi and I were at an event last week and
you know, the speaker opened by saying, we
as Canadians, we just always knew that somebody
was coming, that the ambulance was coming,
or that the hospital doors were open and that
if we went to ER, you know, we would be taken
And we’re in a situation right now that is
perilous across the country.
This simply is not the case.
In some parts of Canada, it’s not.
Right, including, you know, including in our
capital, where the paramedic service has gone
to code zero, which means there are no ambulances
And so we really do need to do everything
we can to support this workforce.
We’d also say, you know, the term hero has
very, very difficult.
For some people that’s a very painful term
to hear, and I think as Canadians we
need to be cautious in how we use that term
because hero assumes things about people that
they don’t necessarily want to hear about
And so I just always say in using the word
hero to be cautious.
I mean, how we use that and to, and to recognise
bravery and service, but maybe sometimes to
not use that word, that can be very difficult
for some people to hear.
And Margaret, I’m just wondering, we have
I would like to be
conscious of time, but perhaps if we could
take sort of two minutes to address this question
that’s come up more than once in the chat.
And it’s sort of, to me it’s the elephant
in the room, which is a lot of these issues
are actually at a systems level.
And I’m just going to read one of the participant’s
because I feel they framed it perfectly, which
is they require a systems level response,
not an individual response, right?
So by telling individuals their only action
is to work on things at an individual level,
it feels like it’s putting the responsibility
on them for larger systemic failures.
And I’m just wondering if you could speak
to that a little bit.
What can healthcare institutions do to begin
to relieve some of this pressure
that they’re feeling.
I’m going to make one quick comment.
I’m going to turn over to Kim because I know
she has a lot of experience around this and
the work that she’s been leading.
You know, oftentimes, when we talk about the
health impacts of the pandemic on healthcare
workers, what we talk a lot about is the levels
of PTSD, depression, anxiety, increased use
of alcohol, and so on.
And that can be very shaming for healthcare
workers because it talks — it’s really saying
you as an individual have developed a mental
health condition and some people will feel
as if, you know, “I’m weak.
Other people didn’t experience this.
Why have I experienced this?”
And it, as you say, it ignores those broader
system levels issues, which have given rise
to increases in PTSD and depression and anxiety
and alcohol use among healthcare workers.
And we really, it’s, as the audience members
have said, we need to focus on those system-levels
And we have to be very cautious when we talk
about mental health impacts as a pandemic
at the individual level because again, it
ignores those broader system level issues
that have led to, in many instances, this
rise in mental health conditions.
And I’ll just turn it over to Kim, cause I
know again, Kim, you have a lot of experience
around this…with the healthcare workers.
Yeah, I appreciate the question because we’ve
— this has really emerged as one of
the biggest things that we’ve learned through
the course of our research.
And, you know, as we said, we’ve had a lot
of interviews and everybody pretty much
has spoken to this same thing.
And what we’ve heard is that healthcare workers
they’re, they really feel that a lot of the
a lot of the things that may have worked
prior — so self help through, you know,
various means of things for themselves, such
as meditation that may have been given through
a program at work or, you know, some of the
types of pizza parties and stuff like that
we’re always really sort of well received,
but that isn’t enough.
And that’s not helping right now.
And so they’re really looking to have the
next level, to
have the org — things reconstructed at the
systems level and at the organisation level.
And that the organisation takes on the the
added responsibility for caring for their
employees’ mental health and prioritising
it even, so that healthcare providers — you
know, they put their patients before themselves.
They put their families before themselves
and they don’t think of themselves.
And so when we talk to them about self-compassion,
you can see it’s uncomfortable for them.
But you know, we talk about how important
But what they really want is to have that
caring come from the organisations so that
the organisations have the structures embedded
within it to care for them.
And the ways that they’re saying that they
cared for is by having a lot more mental health
So for example, having somebody they could
call who is a formal mental health
support on the units or in the building so
that they can go there during the course
of their work and just sit down and talk with
someone so that they’re not having to make
time in their home time to talk to someone
or through, you know, additional expenses
and so on.
They want somebody readily available.
And I think we really have a responsibility
to recognise that healthcare providers, similar
to military and, and public safety, as we
said, their jobs themselves, take a toll on
their mental health.
So there is a responsibility now to recognise
at a systems level, it’s not — and not put
the responsibility on the person.
It’s the responsibility of the system.
I’ll just very quickly jump in.
I will say one lesson that we learned certainly
at St. Joseph’s Healthcare in Hamilton and
at St. Mary’s Hospital in Kitchener, is that
having mental health supports directly on
the units is very valuable.
Sometimes healthcare workers don’t have time
to go to the library.
They don’t have time to go downstairs.
At one point I sat in the storage room when
nurses and other healthcare workers on
the unit changed their masks because it was
the only time they had to talk to someone
about the difficulties that they were facing,
the mental health difficulties.
I was there for nearly 36 hours with those,
And so having mental health supports directly
on the units — that is as simple as going
and sitting at the at the nursing station
and just saying, “I’m here.
I recognise you’re living in a different world.
I’m here to talk to you.”
And that may just be a two-minute or five-minute
conversation, but it’s helpful to know
that the organisation cares and that there’s
somebody right there on the unit for them
in the moment, to support them wherever that
So with that, I’m conscious of time, so I
I am going to end the panel discussion.
Thank you so much to all the panelists.
That was so insightful.
I personally approached today’s topic from
a learner’s perspective.
So I’m not a healthcare provider or a researcher
in this field.
I have family who are.
But I thank you so much today, panelists and
This town hall really helped me begin to put
myself in healthcare provider’s shoes and
understand more what they’ve gone through.
And I think that’s just all what we need a
little more of right now is empathy.
So thank you so much.
And with that, I would love to pass the mic
to Margaret for, for
our closing remark.
You know, I just want to end on a very positive
note in thanking healthcare workers
for their service.
We salute you.
We thank you.
We recognise the impact on your life and on
the lives of your family.
And we know you’ve made — you and your families
have made tremendous sacrifices during this
And we just
want to continue to honour you, as we know
all Canadians do.
And to thank you for your service.
Dr. Margaret McKinnon, Homewood Chair in Mental Health and Trauma; Professor, McMaster University
Dr. Margaret McKinnon is Full Professor and Associate Chair, Research in the Department of Psychiatry and Behavioural Neurosciences at McMaster University, where she holds the Homewood Chair in Mental Health and Trauma. She is also the Research Lead for Mental Health and Addictions at St. Joseph’s Healthcare Hamilton and a Senior Scientist at Homewood Research Institute.
Work in Margaret’s unit focuses on identifying the neural and behavioural correlates of PTSD and trauma-related illnesses and on translating this knowledge to the development and testing of novel treatment interventions aimed at reducing the cognitive and affective sequelae of these conditions.
A licensed clinical psychologist and clinical neuropsychologist, Margaret has a special interest in military, veteran, and public safety populations (including healthcare providers), and has worked with these groups clinically and in her research program. She has published or in press nearly 150 scientific works.
Under Margaret’s leadership, the Trauma & Recovery Research Unit is supported by federal and provincial funding from the Public Health Agency of Canada, Canadian Institutes of Health Research, the Canadian Institute for Military and Veterans Health Research, Veterans Affairs Canada, Defence Canada, the PTSD Centre of Excellence, MITACS, and the Workers Safety Insurance Board of Ontario; by a generous donation to Homewood Research Institute from Homewood Health Inc.; and by generous gifts from private foundations including True Patriot Love, the Cowan Foundation, the Military Casualty Support Foundation, the FDC Foundation, and the AllOne Foundation.
Margaret is a frequent commentator in the media on matters related to PTSD, moral injury, and the impact of trauma on special populations.
Dr. Heidi Cramm, Associate Professor, School of Rehabilitation Therapy, Queen’s University; Research Lead, Families Matter Research Group; Research Advisory, Canadian Institute for Military & Veteran Health Research
Trained as an occupational therapist, Dr. Heidi Cramm is an Associate Professor in the School of Rehabilitation Therapy at Queen’s University. Her program of research involves the mental health of military families, veterans and their families, and public safety personnel; health system access and navigation for military families and veterans; and trauma.
Kelly Hassall, Clinical Resource Leader, Respiratory Therapy, St. Joseph’s Healthcare Hamilton
Dr. Kim Ritchie, Research Associate, Homewood Research Institute
Dr. Kim Ritchie is an Assistant Professor at Trent University and holds an Adjunct position in the Department of Psychiatry and Behavioural Neuroscience at McMaster University. Since 2020, she has been co-leading a national study examining the mental health impacts of COVID-19 on healthcare providers.
In addition, Kim is a Registered Nurse with over 20 years of experience in direct care and clinical leadership roles, primarily focusing on mental health and geriatric mental health. She completed a PhD in Rehabilitation Science from Queen’s University, and currently conducts research on PTSD, trauma, and moral injury in military/veterans, healthcare providers, and public safety personnel.
Emily Sullo, Graduate Student (MMASc), Trauma & Recovery Research Unit, McMaster University
Emily Sullo is currently a research assistant in the Trauma and Recovery Research Unit and will be beginning her PhD in Clinical Psychology at McMaster University in Fall 2023. She received her Honours Bachelor of Science in Psychology from the University of Mississauga (’20) and her Master of Management of Applied Science in Global Health Systems at Western University (’21).
Prior to joining the research unit, Emily was involved in the development of evidence- and community-based mental health and addictions projects, including the development of mobile health units in a rural setting. Currently, Emily has primarily been involved in research focused on understanding the experiences of healthcare workers and public safety personnel during the COVID-19 pandemic and in the development of knowledge mobilization deliverables.
Amy Van Es, Founder, Gooder
Amy Van Es spent the first decade of her career as a digital growth strategist, helping media and tech companies rapidly scale their online presence. But she’s since resolved to spend the next decade fixing what she helped break: the internet. She’s obsessed with this mission.
When she’s not interneting with Gooder, Amy enjoys hiking, sewing, and big bowls of pasta. She dislikes push notifications, peas, and writing in the third person.
With gratitude to McMaster University Faculty of Health Sciences: Continuing Professional Development for broadcasting this event’s video feed.