The mental and physical health of family mental health practitioners during COVID-19: relationships with family violence and workplace practices

Objective: COVID-19 restrictions precipitated rapid work practice changes for family and mental health practitioners, including care via telehealth and secondary exposures to COVID-19 induced violence in client. This descriptive study aimed to examine stress and health among practitioners during COVID-19 restrictions. Method: Participants, recruited via professional networks, were 320 maternal and child health (MCH), child and youth mental health (CYMH) and adult mental health (AMH) practitioners from Victoria, Australia. Participants reported family violence among cases, workplace stress, and mental and physical health problems during COVID-19 restrictions, via an online survey. Results: Rising family violence incidence, including emotional abuse and serious threats against a woman (>25%), child emotional abuse/neglect, and child exposure to family violence were reported. Higher violence was reported by CYMH and AMH than MCH practitioners. We found increases in practitioner stress due to workplace practice changes and exposure to family violence. Highest stress was among CYMH and AHM practitioners. Participants reported worsening mental (63.2%) and physical (51.2%) health. Negative affect was higher among CYMH than MCH participants. Conclusion: Findings demonstrate pressure on family and mental health workforces during COVID-19. Provision of training and support to manage secondary stress from exposures to trauma and changing workplace practices is indicated. What is already known about this topic: (1) Family and mental health practitioners' mental health is below normative levels due to exposure to secondary traumatic stress exposure and associated compassion fatigue. (2) Periods of natural and community disaster elevate pressure and distress among mental health professionals and contribute to risk for workforce attrition and among client families are also associated with increased risks for intimate partner violence due to financial pressures and inadequate and confined housing. (3) Concerns about family violence during COVID-19 lockdown restrictions have arisen from publicly available reports of increases in emergency department domestic violence-related injuries and urgent applications to the Family Courts, but research data pertaining to levels of family violence during COVID-19 are scarce. What this study adds: (1) Family and mental health practitioners, especially those in child/youth and adult mental health sectors, reported increased proportions of caseloads in which incidents of family violence occurred during stage-3 COVID-19 lockdown restrictions in Victoria, Australia, contributing to exposure of practitioners to secondary trauma. (2) Practitioners reported higher workplace stress (due to changed work practices and family violence) during COVID-19 restrictions and greater stress was related to greater negative affect, sleep problems, headaches, and gastrointestinal problems. (3) Urgent attention to training and support of family and mental health workers providing care to distressed families during periods of community and natural disaster is indicated.