Economic strain is also at play. While most of the attention for mental health vulnerabilities has focused on those directly treating coronavirus-positive patients, some health systems have responded to thinner margins by laying off staff or cutting hours, which can also jeopardize emotional well-being, Gold said.
Layoffs can exacerbate the gender pay gap in healthcare, said Kellie McElhaney, founder of the Center for Equity, Gender and Leadership at the University of California at Berkeley. Research shows workers who re-enter the workforce after a period of unemployment earn 4% less than someone who hasn’t had a career disruption.
“There is a likelihood we will come out of this pandemic and we would have taken several steps backward in the gender equity space,” said Dr. Shikha Jain, an oncologist at Rush University Medical Center in Chicago who co-founded the Women in Medicine Summit.
Jain, who has a 6-year-old and 2-year-old twins, said she gets her work done between 8 p.m. and 1 a.m. because during the day she’s busy trying to home-school her daughter and run the household. Her husband, a gastroenterologist, helps when he’s there but at one point he isolated at a family home after exposure to a COVID-19 patient.
“I have experienced mom guilt more in the last three months than in my entire time of being a mom,” Jain said. “This is such uncharted territory.”
Women in medical academia face another issue. Professional journals in other fields are reportedly seeing fewer paper submissions from women, while those from men are rising amid the pandemic. This is likely because women are taking on homeschooling and other caretaker responsibilities with their children at home, said Dr. Nicole Sandhu, an internist at Mayo Clinic and president of the American Medical Women’s Association.
Such a phenomena can have long-term effects on the advancement of women in medical academia, McElhaney added. To receive tenure, an expected amount of published research is typically required.
Physicians also aren’t immune to intimate partner violence, which can escalate during times of crisis and stress such as this pandemic, said Dr. Kim Templeton, professor of orthopedic surgery at the University of Kansas and co-chair of the physician wellness initiative of the American Medical Women’s Association.
Since stay-at-home orders have been in effect, increases in calls to domestic abuse hotlines have been reported.
There are already signals that women are using the mental health resources offered by their employers more than men. Henry Ford Health System in Detroit experienced a surge of coronavirus patients, and in response, the system began hosting virtual support groups for employees. They’re intended to allow caregivers to share their experiences during the pandemic in a safe environment.
Dr. Lisa MacLean, a psychiatrist and director of physician wellness at the system, said most participants are women. Calls to the 24/7 mental health hotline staffed by psychologists at Henry Ford have also been largely women. Additionally, most using the hotline aren’t physicians but other clinicians such as nurses and the nonclinical workforce.
“We definitely see more utilization (of those resources) by women, but is that because women are just more vulnerable? Is it because they are suffering more? Is it because they are just the majority of the workforce? We don’t know,” MacLean said.
There is also evidence that women generally express feelings of trauma or stress by sharing with others, more often compared with men, which might be another reason why women are more likely to participate in such support groups, said Dr. Katherine Gold, a family medicine physician and mental health researcher at Michigan Medicine.
“I have been running informal groups for faculty to just talk about what is going on for them during this pandemic and it’s predominantly women who participate in that,” she added.
In addition to mental health resources, organizations are addressing the stressors brought on by the pandemic in other ways, such as offering hazard pay, childcare services, free meals and transportation.
Although the resources aren’t directed specifically at women, those with household responsibilities are likely benefiting from them, said Dr. Samantha Meltzer-Brody, chair of the psychiatry department at UNC School of Medicine. UNC Health has offered childcare and opened a food market where employees can shop after long shifts.
“We are absolutely trying to think as holistically as possible,” she said.