The World Health Organization declared the coronavirus outbreak a pandemic on March 11, 2020. Infection by the SARS-CoV2 virus leads to the COVID-19 disease which can be fatal, especially in older patients with medical co-morbidities. The impact to the US healthcare system has been disruptive, and the way healthcare services are provided has changed drastically. Here, we present a compilation of the impact of the COVID-19 pandemic on psychiatric care in the US, in the various settings: outpatient, emergency room, inpatient units, consultation services, and the community. We further present effects seen on psychiatric physicians in the setting of new and constantly evolving protocols where adjustment and flexibility have become the norm, training of residents, leading a team of professionals with different expertise, conducting clinical research, and ethical considerations. The purpose of this paper is to provide examples of "how to" processes based on our current front-line experiences and research to practicing psychiatrists and mental health clinicians, inform practitioners about national guidelines affecting psychiatric care during the pandemic, and inform health care policy makers and health care systems about the challenges and continued needs of financial and administrative support for psychiatric physicians and mental health systems.

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Objective Role misidentification among hospital staff is common. Female resident physicians are more likely to be misidentified as non-physicians. This study utilized a pre-post examination to determine if the usage of a “doctor” badge by resident physicians at a Veterans Affairs Medical Center influences role identification, gender-based aggressions, and workplace experience. Methods Twenty-six psychiatry residents at the Veterans Affairs Boston Healthcare System participated in a voluntary, anonymous electronic pre-survey in December 2020 and post-survey in March 2021 to report their experiences with role identification and gender-based aggressions before and after the implementation of a “doctor” badge. Results Females were significantly more likely than males to report role misidentification ( x 2 (1)=10.8, p =0.001). Females were significantly more likely to experience gender-based aggressions compared to males ( x 2 (1)=19.5, p <0.001). Compared to pre-intervention, females who wore the badge were significantly less likely to be misidentified ( x 2 (1)=9.6, p =0.002). There was no significance when comparing males who were misidentified pre- to post-intervention ( x 2 (1)=1.1, p =0.294). Compared to pre-intervention, females who wore the badge were significantly less likely to experience gender-based aggressions ( x 2 (1)=17.3, p =<0.001). Compared to pre-intervention, there was no significant change in gender-based aggressions for males who wore the badge ( x 2 (1)=1.05, p =0.306). Conclusions Female residents were more likely than male residents to report role misidentification. Usage of the “doctor” badge resulted in improved role identification and a reduction in gender-based aggressions for females, but not males. “Doctor” badges can improve role identification, gender-based aggressions, workplace experience, patient communication, and care.