Mental Health Is Lab Health

Clinical laboratory professionals play a vital part in health care of all kinds—but they frequently report high rates of work-related stress, burnout, and poor mental health. Appreciation for laboratorians is often low even among healthcare providers, exacerbating the impact of these difficult roles on the people who perform them. Completing this concerning picture is a global workforce shortage that the American Society for Clinical Laboratory Science has described as “approaching crisis levels.” 

As laboratory operations continue to seek stability after the deep impacts of the COVID-19 pandemic, how is lab professionals’ mental health faring—and what can be done to improve it? 

Burnout: A perpetual problem

The American Society for Clinical Pathology (ASCP) conducted a comprehensive set of surveys to evaluate well-being and burnout in the lab. The findings? Although pathologists and laboratory medicine professionals generally find high satisfaction in their work, stress and burnout are significant across all lab professions. 

Almost half of pathologists (47.1 percent) reported feeling a lot of stress in their work, with most of the remainder (48.1 percent) reporting a little bit of stress. The most common causes of stress among pathologists were workload and call duties (67.6 percent). 

Among non-pathologist laboratory professionals, almost all report feeling a lot (53.4 percent) or a little (42.7 percent) stress, with workload again topping the list of causes (74.6 percent). 

Overall, a staggering 71.4 percent of pathologists and 85.3 percent of other lab professionals reported having experienced burnout. Published in 2020, the surveys were based on data collected in 2018—before COVID-19 testing altered the landscape for the clinical lab. 

Another pre-pandemic survey conducted in 2018 discovered that burnout causes differed by job role (see Figure 1), with key drivers including workload, work atmosphere, and time available for documentation.

         

Pandemic pressures

Since the onset of the COVID-19 pandemic in 2020, the pressure on laboratories has only increased. From relieving ongoing backlogs to addressing growing staffing shortages, clinical lab professionals are struggling with stressors—and they’re having a serious impact on work-related mental health.

A 2022 review of literature on medical laboratory professionals’ mental health at the height of the pandemic revealed frequent reports of burnout and work-life conflicts, especially among non-physician professionals. Particularly concerning were feelings of being forgotten or unappreciated, which increased absenteeism, job dissatisfaction, and people’s desire to leave the profession. 

However, pandemic-specific factors—such as laboratorians’ omission from pandemic pay programs for frontline workers or media statements indirectly blaming lab staff for COVID-19 test shortages—added to existing pressures impacting wellbeing. 

A further study that evaluated workplace psychosocial risk among medical laboratory technologists, technicians, and assistants showed that numerous factors were a greater concern after the onset of the pandemic than before (see Figure 2).

         

Further research reveals that many of these factors are key to maintaining job satisfaction and resilience in the clinical lab. For instance, for medical laboratory technologists, workplace community, meaningful work, and recognition contributed to higher job satisfaction. 

Medical laboratory technicians and assistants also valued community but also considered social support from supervisors, vertical trust, and security of both jobs and working conditions important. 

Conversely, high levels of stress were associated with lower job satisfaction—vital knowledge because job satisfaction among laboratorians is a protective factor against burnout. Additional protective factors include higher self-rated health, younger age, and higher educational attainment.

Relieving stress

The common stressors faced by clinical laboratory professionals seem clear—high workloads, staffing shortages, lack of appreciation, and concerns around workplace relationships. 

How can these pressures be alleviated, especially given the increasing shortfall of professionals to fill vacancies and lighten the load?

One option is to seek support from new technologies: As testing volumes—particularly in disciplines such as molecular pathology—increase, automation and artificial intelligence may take on time-consuming tasks like sample preparation, cell counting, or preliminary slide categorization. 

Not every lab can make the move to increased automation or digitization, though, especially in resource-limited contexts—and doing so may require hiring or training staff to ensure that the new technologies are used and maintained appropriately.

Another option is to increase recruitment and retention efforts. 

In the ASCP’s 2022 vacancy survey, laboratory personnel reported issues with compensation (pay and benefits), workload, and opportunities for advancement—so labs hoping to stand out in a competitive field could consider reviewing salaries and bonuses, offering additional or nonstandard benefits, providing clear progression plans for new and existing staff, and ensuring easy access to professional development. 

To recruit more skilled professionals, however, people must first be encouraged to consider a career in the clinical lab. For this, outreach efforts are needed to raise awareness of lab careers and dispel negative stereotypes about laboratory medicine professionals.

How to address the current crisis

Behdin Nowrouzi-Kia, an occupational science and occupational therapy expert who currently holds the University of Toronto Emily Geldsaler Grant Early Career Professorship in Workplace Mental Health, has studied the problem of stress and burnout among laboratory professionals for years. 

In a recent study, he and his colleagues offered recommendations for addressing the current lab workforce crisis.¹³ The recommendations spanned several categories:

• Mental health: Create a positive workplace culture, and provide access to counseling and programs to support mental health and stress management.
• Leadership: Focus on person-centered leadership with an emphasis on communication, collaboration, and recognition of efforts and achievements—and when offering awards or incentives, ensure that equity is maintained throughout the organization.
• Communication: Implement digital tools such as electronic health records to facilitate communication between providers and minimize the likelihood of error.
• Recruitment and retention: Raise awareness both publicly and within the healthcare environment of the key role and importance of laboratory professionals in providing quality patient care.

Workplace well-being is multifactorial—and multifaceted problems require multifaceted solutions. Only by elevating existing lab professionals, continually improving systems and supports, and actively seeking out the next generation can the clinical lab strengthen its members’ mental health and hope to extinguish burnout.