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Objective: The aim of the study is to describe mental health impacts of the COVID-19 pandemic and identify roles that predict distress among Canadian healthcare workers (HCWs)., Methods: Using data from three cross-sectional Canadian surveys, we compared 799 HCWs to demographically matched controls and compared HCWs with and without COVID-19 patient contact. Participants completed validated measures of depression, anxiety, trauma-related stress, alcohol problems, coping self-efficacy, and sleep quality., Results: Non-HCWs reported more depression and anxiety in Fall 2020 and more alcohol problems in Fall/Winter 2021 than HCWs. In Winter 2020-2021, HCWs reported more trauma-related stress than non-HCWs. As of early 2021, HCWs with direct patient contact reported worse symptoms across nearly all measures than HCWs without., Conclusions: Although Canadian HCWs did not report worse mental health than demographically similar peers, mental health supports are needed for HCWs providing direct patient care., Competing Interests: Conflict of interest: T.P. also received funding from the Canadian Foundation for Innovation, the Weston Foundation, and NDRIO-Portage. N.L. has received financial support from the University of Victoria Speaker’s Bureau, WellIntel Talks, and Wise Mind Centre., (Copyright © 2023 American College of Occupational and Environmental Medicine.)