Association of perceived leadership effectiveness and mental health symptoms in health system staff and faculty: a cross-sectional survey study

Background While leadership effectiveness has been linked to occupational well-being among healthcare workers (HCWs), the relationship of specific leadership behaviours with mental health outcomes such as depression and anxiety remains less clear. To address this gap, we investigated associations between perceived effective leadership behaviours and symptoms of depression and anxiety in a large cohort of faculty and staff employed within an urban healthcare system. Methods Anonymous online surveys were distributed to medical faculty and staff at a large urban healthcare system in New York City. The surveys included demographic questions, the Mayo Leadership Index to measure perceived leadership effectiveness and validated mental health assessments (Patient Health Questionnaire-2 (PHQ-2), Generalised Anxiety Disorder-2 (GAD-2)). Multinomial logistic regression was used to examine associations between leadership effectiveness (standardised as a z-score) and mental health outcomes. Results Survey response rates were 26.1% (1482/5684) for staff and 43.5% (1635/3761) for faculty. The final sample with completed data included 2335 participants (62% above the age of 40, 45% White, 65% female; 46% staff and 54% faculty, including physicians/providers and researchers). Each SD increase in leadership index score was associated with 31% lower odds of anxiety (p<0.001), and 47% lower odds of comorbid depression and anxiety (p<0.001). Conclusion These findings underscore the potential role of leadership effectiveness in the mental health of HCWs. Organisational strategies that strengthen leadership effectiveness may be critical components of broad efforts to enhance well-being and promote mental health in the healthcare workforce.