The pandemic spotlighted the mental health crisis facing health care workers. It’s time we give them the support they need. Early on, during some of the darkest days of the COVID-19 pandemic, Dr. Lorna Breen became the face of our nation’s other epidemic: health care worker burnout and their mental health crisis. But Lorna was so much more. She was our sister, our friend, our colleague. And she was also a physician – an occupation that poses a significant risk factor for suicide.
A Growing Mental Health Crisis
A 2023 survey by the Physicians Foundation shows that more than half of physicians today know of a physician who has considered, attempted, or died by suicide – a number that has grown for the past two years. And it’s not only physicians who are at risk; nurses are more at risk of suicide compared to the general population. According to the latest Vital Signs report from the Centers for Disease Control and Prevention, health care workers across the board (including clinicians and those in mental health, public health, long-term care, and other support roles) have experienced increases in poor mental health that persist today.
Progress and Legislative Advances
Four years on, the nation has made progress since those early days of the pandemic. This includes improving our understanding of health care workers’ and hospital leaders’ day-to-day struggles and enacting the first-ever federal legislation, named in honor of Lorna, to prevent suicide and fight burnout among health workers.
Persistent Challenges in Health Care Settings
And yet, in hospital hallways and departments across the country, among various job titles and positions, too many things have stayed the same. These are the things that aren’t necessarily made-for-television material or grabbing headlines in the same way that health care heroics do. They include administrative red tape and policies that overreach on mental health care. Additionally, there are everyday challenges, such as not being able to properly access a patient’s medical history within their own electronic health record system to show potential risk factors.
The Need for Change
Addressing Workplace Policies and Practices
The workplace policies and practices that stand in the way of health care workers’ well-being must change. We can no longer let health care worker burnout be a fact of life.
All 6,100-plus U.S. hospitals need actionable guidance on how they can truly address burnout at their own facilities. This is crucial, considering the many other places where health care is delivered across the country. Moreover, the Dr. Lorna Breen Health Care Provider Protection Act, signed into law in 2022, gets us on our way to provide this guidance by establishing grants to implement evidence-informed best practices for reducing and preventing suicide and burnout among health workers. These practices include employee education, peer-support programming, and mental and behavioral health treatment.
Federal Initiatives and Campaigns
Additional federal COVID-era stimulus funding provided dedicated money for a national campaign to improve health care worker well-being. For example, the National Institute for Occupational Safety and Health’s (NIOSH) Impact Wellbeing campaign is the first federal campaign. It helps hospital leaders improve well-being at our nation’s hospitals by providing evidence-informed, customized tools to tackle some of the thorniest root causes.
A Roadmap to Improvement: The Impact Wellbeing Guide
Real-World Tools for Hospital Leaders
We know improving the well-being of our health care workforce can and will take time to implement. Coordinated, concrete action has proven to be successful in many cases, often utilizing existing resources. That’s why NIOSH, in partnership with the Dr. Lorna Breen Heroes’ Foundation, released the Impact Wellbeing Guide: Taking Action to Improve Healthcare Worker Wellbeing. It’s a real-world tested guide with tools and resources for hospital leaders. These resources aim to accelerate and sustain efforts to enhance well-being at their hospitals. They aim to challenge the idea that healthcare worker burnout will always persist as a problem.
Evidence-Informed Actions for Lasting Change
The guide includes six evidence-informed actions. These resources aim to assist hospital leaders anywhere in making operational changes to strengthen well-being and build trust between workers and leaders at their hospitals. Each action includes background information and resources. These tools fully equip hospital leaders to lay the foundation for long-term commitment to improving professional well-being. Action Three of the guide helps hospital leaders address a significant root cause of health care workers’ poor mental well-being. It specifically targets the stigma associated with discussing and seeking mental health care. This stigma is known to contribute significantly to the risk of suicide among the health care workforce. Some health care workers fear losing their job if they pursue mental health care. Hospital leaders can eliminate such concerns by removing overly broad and invasive mental health questions on their credentialing applications.
Success Stories and Legislative Progress
Encouragingly, 12 health systems, comprising 75 hospitals and 59 urgent care centers, have implemented these changes to credentialing applications. This initiative has positively impacted over 127,000 health care workers, enhancing their professional experiences and well-being. Additionally, state legislatures in Virginia and Illinois passed laws to establish state-wide requirements to change or remove mental health questions in applications. More states have started to explore this route, including Michigan and Delaware, where legislators have proposed similar bills.
Fostering a Supportive Workplace Culture
Hospital leaders can also normalize seeking help by committing to and modeling positive workplace cultural practices. These practices include implementing supportive supervision, normalizing conversations about seeking mental health services, and making safety a core value. NIOSH is in the midst of hosting a virtual workshop series to provide leaders with a deeper understanding of the Impact Wellbeing guide to encourage its adoption and use. Other campaign resources include tools and tips to help hospital leaders communicate with their staff in inclusive, non-stigmatizing ways. Additionally, these resources assist in establishing channels for two-way communication. Leaders can initiate by administering NIOSH’s Worker Well-Being Questionnaire (WellBQ) to assess the well-being of their workforces. They can also model professional well-being practices and foster a safe work environment by promoting a culture of safety and ensuring adequate staffing.
A Call to Action
But this is only scratching the surface. It’s long past time that the millions of U.S. health care workers across the country, supported by initiatives like those of NAS that deeply care about helping health care workers navigate the mental health crisis they are facing, have all the things they need – and deserve – to deliver quality patient care in safe, healthy, and sustainable workplaces for those being treated and those delivering the treatment.
Corey Feist, John Howard and Dara Kass (May 16, 2024) Burnout and Suicide Threaten America’s Health Care Workers. They Deserve Better. https://www.usnews.com/opinion/articles/2024-05-16/burnout-and-suicide-threaten-americas-health-care-workers-they-deserve-better
