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A team of investigators from several institutions including CUNY SPH conducted a study on a crucial but nearly invisible workforce, home health aides (HHAs). HHAs provide essential personal, medical, and emotional support to a growing population of older patients who choose to “age in place.” Despite their significant role, HHAs are a vulnerable workforce, frequently experiencing poor mental health due to low wages, lack of health insurance, and marginalization in the healthcare industry. In partnership with the 1199SEIU Training and Employment Fund, Associate Professor Emma Tsui and colleagues conducted a study assessing the mental health and well-being of 28 HHAs from various home care agencies in New York City.
The team conducted focus groups and interviews with the study participants, focusing on HHAs at risk for poor mental health and well-being, including those with depressive symptoms, stress, and loneliness. The study aims were to explore HHAs’ attitudes toward mental health and well-being, learn how their job impacts these, and to gather their perspectives on potential interventions to support their emotional needs.
The investigators found that HHAs’ attitudes towards mental health are shaped by personal and cultural factors, including stigma around mental health. Predictably, their relationships with patients significantly impact HHAs’ mood, both positively and negatively. Challenges include dealing with difficult patients or their families and facing racial biases. Structural and organizational aspects of the job, alongside the COVID-19 pandemic, have significantly contributed to HHAs’ stress. Issues include long working hours, inadequate compensation, and poor communication from agencies.
HHAs reported using various strategies to manage their emotions, including prayer, meditation, physical activity, and compartmentalization of difficult work situations. They
expressed a need for programs and supports to improve their mood and mental health. Suggestions included peer coaching and educational courses on mental health and wellness.
“Home care aides are a hugely important force for societal health, and yet maintaining a strong workforce is challenging due to the low pay, difficult working conditions, and particular stressors associated with this work,” says co-author Associate Professor Emma Tsui. “This paper highlights the need for interventions to bolster aides’ mental health, and I’m excited to be working with this team to test a mental health-focused peer support intervention for home care aides here in New York City.”
