Mental Health Impact of COVID-19 on Military Healthcare Workers: Not All War Is Fought on the Battlefield

Introduction The COVID-19 pandemic challenged healthcare personnel worldwide. This study investigated the mental health of active duty military healthcare workers (HCWs) during the COVID-19 pandemic. Materials and Methods We conducted a retrospective monthly cross-sectional analysis of active duty military enlisted and officer HCWs' mental health encounter data from January 2018 to February 2023. Encounters for anxiety disorders, depressive disorders, reactive stress disorders, and suicidal attempt/ideation (SI) and self-harm were evaluated. Trends and trend changes in monthly rates of these 4 outcomes were evaluated using Joinpoint analysis. Poisson regression models evaluated the effect of time on the rates of these outcomes stratified by enlisted or officer status. Results A total of 171,862 (122,413 enlisted, 49,449 officers) HCWs were included. Mental health utilization by both enlisted and officer HCWs had an upward trend for anxiety disorders, depressive disorders, reactive stress disorders, and suicidal attempt/SI and self-harm during the COVID-19 pandemic. Over the full study period, both enlisted and officer HCWs had significantly higher rates of all 4 outcomes in the second and third years of the pandemic. Female gender and older age were associated with higher rates across all outcomes, with the exception of SI and self-harm where the rates were higher among younger individuals. Discussion Military healthcare providers experienced a significantly increased mental health burden during and following the COVID-19 pandemic. Females and older personnel were particularly vulnerable. These findings emphasize the need for targeted interventions to support these critical personnel during and after crises, such as resiliency training, peer support, and readily accessible mental healthcare services.