Concurrent Pandemic: Mental Health & COVID-19 Workplace Safety

June 30, 2022

Recent findings from the NSC SAFER Workforce Trend Indicator Surveys suggest feeling unsafe at work, physically or psychologically, is associated with negative mental health outcomes. People at the most risk of workplace COVID-19 transmission most frequently report depression and anxiety symptoms.

NSC SAFER surveys have identified a significant, but not surprising, link between workplace safety and mental health. Recent survey respondents who felt unsafe at work were two to three times more likely to experience symptoms of depression and anxiety disorders all or most days within the past two weeks, meeting one of the criteria for clinical depression or anxiety disorders. COVID-19 may contribute markedly to this trend, as more frequent anxiety symptoms were strongly associated with how unsafe a person felt about their risk of catching COVID-19 at work.[i]

There has been a well-known link between job conditions and mental health for decades, but the COVID-19 pandemic heaped an unprecedented amount of job, financial, societal, health and safety stressors on the general population. SAFER data indicates the associated mental health impact disproportionately affected those whose job puts them at the highest risk for COVID-19 infection and COVID-19-related increases in job pressure. Those most affected tend to be workers in essential, in-person job roles, especially those who work in education and healthcare.[ii]

Our findings suggest the impact of COVID-19-related stress may be reduced for people who worked from home during the pandemic. This is consistent with findings from other studies of work-from-home arrangements and mental health. NSC SAFER survey respondents who work from home had the lowest frequency of depression and anxiety symptoms. People who work in education and healthcare settings reported the most frequent symptoms, and felt the least safe at work about their risk of catching COVID-19 on the job, second only to those who work in public-facing roles.

Depression symptoms and safety

Depression symptoms were significantly correlated with lower feelings of physical safety, but especially lower psychological safety at work.[iii] The strongest predictors of depression symptoms were these aspects of psychological safety: fear of being judged, feeling that their opinions and contributions aren’t valued by coworkers and feeling that their supervisor does not encourage them to speak up when they have a concern.[iv]

Anxiety symptoms and safety

Anxiety was strongly correlated with physical safety, COVID-19 safety and most strongly with psychological safety at work.[v] The strongest predictor of higher scores on the measure of anxiety (the GAD-7) was from the psychological safety measure, feeling they had to worry about being judged by coworkers, followed by feeling generally unsafe at work and feeling their input at work was not valued. 

Employer observations and impact of mental health on workplace safety

In an earlier survey of organizations with at least 10 employees, we asked if any effects of mental health and substance misuse were noticed among workers during the pandemic. At the time, 40% of employers reported an uptick in mental health or impairment-related absences, incidents and accidents. Of employers with an employee assistance program (EAP), two-thirds had expanded EAP offerings during the pandemic in response to these types of observations and requests from workers. 


Clinicians and mental health researchers agree the development, exacerbation and prognosis of new or existing mental health disorders are affected by psychosocial and environmental factors, and that diagnosis and treatment should be considered in the context of these aspects of a person’s life. There is evidence that the societal impact of the COVID-19 pandemic is similar to that of other widespread disasters, such as war or civil unrest, and is predicted to have a significant effect on mental health. 

The general population is faced with this primary impact of the pandemic on society, but COVID-19 has caused a variety of other psychosocial and environmental problems. For example, severe illness or death of a close friend or family member, unemployment, financial strain, new or increased caretaking responsibilities, upheaval of many aspects of home life and work-life balance, deterioration of one’s own health — the list goes on. These data collected by SAFER illustrate the negative impacts of unsafe working conditions — both physical and psychological — on mental health have likely been exacerbated by the COVID-19 pandemic with differential impacts across industries and occupations. 

Poor mental health outcomes can result in burnout, absenteeism, presenteeism, low morale and higher healthcare costs, among other negative impacts on organizations, workers and their families. It is estimated that every dollar invested by employers in mental health initiatives has a four-fold return on investment.[vi] Supporting workers with mental health begins with ensuring physical and psychological safety, and fostering an environment where workers have access to support through EAPs, health insurance coverage of mental health care and preventative wellness programs, for example. In order to implement the most effective initiatives, SAFER suggests surveying workers (anonymously and confidentially) to gather information on specific needs and concerns among your workforce.


Survey Method

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