Very 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 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.
Four years on, the nation has made progress since those early days of the pandemic, including 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.
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, policies that overreach on mental health care and even some everyday things, like not being able to properly access a patient’s medical history within their own electronic health record system to show potential risk factors.
Things must change.
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.
The fact is that all 6,100-plus U.S. hospitals need actionable guidance on how they can truly address burnout at their own facilities, not to mention the many other places where health care is delivered. 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 such as employee education, peer-support programming and mental and behavioral health treatment.
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 Impact Wellbeing campaign is the first federal campaign to help hospital leaders improve well-being at our nation’s hospitals by providing evidence-informed, customized tools to tackle some of the thorniest root causes.
We know improving the well-being of our health care workforce can and will take time to implement. But it is possible with coordinated, concrete action that is proven to be successful – and in many cases with 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 to accelerate and sustain well-being efforts at their hospitals, challenging the notion that health care worker burnout will always be a problem.
The guide includes six evidence-informed actions that are meant to help hospital leaders anywhere make operational changes to strengthen well-being and build trust between workers and leaders at their hospitals. Each action includes background information and resources to fully equip hospital leaders with the tools they need to lay the foundation for long-term commitment to improving professional well-being.
For instance, Action Three of the guide helps hospitals leaders address one of the most substantial root causes to health care workers’ poor mental well-being: stigma associated with talking about and seeking mental health care, which can be one of the primary drivers 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.
Encouragingly, 12 health systems, including 75 hospitals and 59 urgent care centers, have made these changes to credentialing applications, ultimately benefiting more than 127,000 health care workers. 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.
Hospital leaders can also normalize seeking help by committing to and modeling positive workplace cultural practices, including 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 and establish channels for two-way communication. Leaders can get started by administering NIOSH’s Worker Well-Being Questionnaire (WellBQ) to understand how their workforces are doing, modeling professional wellbeing practices, and fostering a safe work environment by promoting a culture of safety and ensuring adequate staffing.
But this is only scratching the surface. It’s long past time that the millions of U.S. health care workers across the country 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, JD, MBA, is CEO and co-founder of the Dr. Lorna Breen Heroes’ Foundation.
John Howard, M.D., is the director of Centers for Disease Control and Prevention’s National Institute for Occupational Safety and Health.
Dara Kass, M.D., is an emergency medicine physician and was until recently the Regional Director for Region 2 at the U.S. Department of Health and Human Services.
