Healthcare workers' mental health trails the national average. Here's what leaders can do.

Health systems ask employees to make accurate, high-stakes decisions while managing frustrated patients and families, tight budgets and shift work. A new measure of workforce mental health suggests many of those employees are under strain.

The healthcare and social assistance sector scored 69.0 out of 100 in the June 2026 TELUS Health Mental Health Index, slightly below the national score of 70.1. The overall U.S. workforce improved for the second consecutive period, recovering from a four-year low in September 2025, while health care slipped from 69.2 in February.

The industry's middle-of-the-pack standing should concern leaders because of what the work demands, said Paula Allen, global leader of research and insights at TELUS Health.

"I would feel much more comfortable if health care was above [average] and increasing," Allen said. "You have to look at the support that's necessary based on the need."

Accuracy, highly consequential decision-making and interpersonal skill "are all the things that are damaged, or at least blunted, when you don't have optimal mental well-being," she said. That, she said, is why healthcare needs better-than-average support.

TELUS Health, which provides health and well-being services to employers in more than 180 countries, surveyed 5,000 U.S. workers for the index. Scores from 50 to 79 fall in its "strained" range.

Incivility and the role of managers

Frontline workers already face the existing stresses of consequential work, funding changes and shift work. In addition, rudeness appears to be on the rise — and it can elevate to physical confrontation and risk, even with proper protocols, particularly in emergency departments and in care for older patients, Allen said.

"My biggest concern for any worker in healthcare is the increased cynicism and the lack of civility that we have in the general population," Allen said.

She recommended that organizations track incidents of incivility as well as violence, study the patterns for systemic or procedural fixes and repeat de-escalation training.

Frontline managers need training on how to respond after an incident, she said, because a supervisor who interrogates an employee can leave that person "retraumatized," while one who offers empathy and support builds strength.

Employee assistance programs can provide de-escalation training, as well as crisis support for groups and individuals after an incident, she said.

Leaders of teams need to understand "that part of their job is to do no harm and to make things better in difficult situations," Allen said.

Caregiving pressures are coming

About a third of the working population has some level of elder care responsibility, Allen said, adding that she expects that share to grow. The index found workers who care for or financially support aging parents scored 63.0. In a predominantly female workforce, she said, that burden falls disproportionately on women.

Employers that don't prepare will see the effects "in employees dropping out of the workforce, moving to part time, going on disability leave because of the strain, and reduced productivity if people don't feel supported," Allen said.

Working from home isn't an option for most clinical staff, but more controlled approaches to managing shifts, plus backup and emergency options, can help, she said.

Stigma and high performers

Licensing and credentialing concerns still discourage clinicians from seeking care, Allen said, though professional associations are moving in the right direction. Many licensing boards and a growing number of hospitals have dropped invasive questions about mental health on applications.

Still, self-stigma is another barrier when people in helping professions believe their knowledge should let them solve their own problems, she said.

"People have to feel comfortable getting help. And when you get help, the earlier that you get it, the less likely you are to have any kind of life or work impact," Allen said.

High performers face particular risks, Allen said. Their identity is often wrapped up in their profession, so work is the last thing to suffer, while relationships and personal health decline first.

"Your superpower then becomes your deficit," when physicians and other clinicians put too much emphasis on the personality traits that make them capable performers in the first place, she said. Driven people are also more likely to seek quick fixes, which "tend to be drugs, alcohol, they're things that actually create problems long term."

People "have to be aware that just because you are in a helping profession doesn't mean that you are not vulnerable," Allen said.

The index found younger workers struggling most: Those ages 20-29 scored 60.5, compared with 75.4 for ages 60-69. Being more open about mental health doesn't fully protect them, Allen said, "because your environment tells you whether it's safe to talk."

Allen compared the moment to earlier changes in physical health, when driving more, exercising less and eating more poorly forced people to counter those habits consciously. "The same thing is happening right now for mental health," she said.

Trust in the employer

Across the U.S. workforce, the index found:

• 23% of workers have a high mental health risk.
• 21% say their mental health is hurting their productivity.
• 61% believe their employer cares about both their well-being and their productivity, while 20% believe it cares more about productivity. Those groups scored 75.0 and 60.1, respectively.
• 49% would feel comfortable telling a manager about a mental health issue, and those who wouldn't scored nearly 12 points lower.
• Managers scored 71.7, compared with 69.0 for non-managers.
• Workers at organizations with more than 10,000 employees scored 71.2.