Lack of sick days, inflexible schedule among tough job conditions that can seriously affect mental health, report shows

By Deidre McPhillips, CNN

Certain work conditions — including inflexible or late-night schedules and lack of paid sick leave — can have a significant effect on mental health, according to a new report from the US Centers for Disease Control and Prevention.

In 2021, about 1 in every 37 working adults experienced serious psychological distress, or negative feelings that were severe enough to impair social and occupational functioning and to require treatment, the report shows. The findings were based off of a representative sample of adults ages 18 to 64 who responded to the National Center for Health Statistics’ National Health Interview Survey.

The responses, collected during the second year of the Covid-19 pandemic, showed that about 1 in 17 people who had to work when they were physically ill reported serious psychological distress — three times more than those who didn’t have to work when sick.

Rates of serious psychological distress were significantly higher among workers who did not have paid sick leave than among those who did.

Late-night shifts and less-flexible schedules also had a significant effect on workers’ mental health. People working the night shift were twice as likely to report serious psychological distress than people working the day shift.

Inconsistency in schedule and pay also had negative effects, according to the report. People who worked a rotating shift were more likely than average to report serious psychological distress, as were those whose earnings changed month to month and those who anticipated losing their job within a year.

A lack of control is at the heart of many of these work conditions linked to poor mental health, experts say.

“People need to have a sense of agency in order to avoid having a stress response,” said Dennis Stolle, a social and personality psychologist who was not involved in the report. “When people don’t know what’s going to happen and they don’t have any control over what’s going to happen, it can lead to anxiety and to increase levels of stress.”

Striking a balance between consistency and flexibility is key, he said. And it’s critically important with work because of the significant amount of time and energy it takes up in our lives.

“People need to have a schedule that is predictable enough that they don’t feel like their life is out of control and they can be called in to work at any moment. On the flip side, they also have need to have enough flexibility that they feel they have enough control to be able to deal with the emergencies that come up in life,” said Stolle, who is senior director for applied psychology with the American Psychological Association.

In October, US Surgeon General Dr. Vivek Murthy released a report outlining the “foundational role” that workplaces can play in supporting mental health for workers and how the Covid-19 pandemic may have affected that relationship.

The surgeon general’s report cited data highlighting the significant increase in the prevalence of mental health challenges during the pandemic years, as well as recent surveys that found that a workplace condition had a negative effect on the mental health of more than 80% of workers.

Another report published this month found that about 100,000 registered nurses in the US left the workplace due to the stresses of the Covid-19 pandemic. Most said their workload increased during the pandemic, and a majority said that they felt emotionally drained at work.

Other research has highlighted the toll that the pandemic has taken on many disadvantaged groups, particularly Black and Hispanic workers, who were more likely to bear the burden of frontline work.

The pandemic “sparked a reckoning among many workers who no longer feel that sacrificing their health, family, and communities for work is an acceptable trade-off,” Murthy wrote in an introduction letter to his report in October.

Conversations on this topic have been building for years, and they were accelerated by the pandemic as the circumstances around work got more complicated, Stolle said. Now, people are proactively seeking to minimize the effects of those complications and uncertainties.

“Some of our American Psychological Association survey research has shown that people are increasingly placing a value on having mental health protections in the workplace, and this is something that they want to seek out when looking for new employment,” he said. “I don’t think that is just a fad.”

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