Change the system to help doctors get mental health care Healthiest Community Health News
For more than a year, our country’s health care workers have been running at full speed. They are overworked and tired while treating patients with COVID-19, some of whom have recovered from the virus and others who have not – and perhaps never will. All this stress, death and fear has clearly taken a toll on these frontline workers and their families.
Over the past 16 months, our family has mourned the loss of our beloved sister and sister-in-law, Dr. Lorna Breen, an accomplished New York City emergency room physician and leader who made headlines last year for the causes that have forever changed our lives. changed for . Lorna pushes herself beyond her limits, treating patients with severe COVID-19 round the clock. She herself contracted the coronavirus, recovered and went back to work. When she returned to the hospital, she was faced with an even more overwhelming, relentless number of incredibly ill patients—not to mention inadequate supplies, not enough beds, and not enough support.
Like health care workers today, many of whom are waging a new battle to save patients from the deadly Delta variant, Lorna needed help. And sadly he didn’t get it. When she was in the depths of her despair and anguish, her work remained her priority. She was convinced that if she spoke to a professional, she would lose her medical license or face excommunication from co-workers for experiencing burnout from the crisis. Lorna committed suicide on April 26, 2020.
Time and again, we have recounted her story and speculated as to what ultimately led to her decision to end her life. It’s a sad story – we think it could have been prevented. One way it could have been that Lorna could have learned the facts about the effect of seeking psychiatric care on her license in New York. After his death, we learned that there is no mental health reporting requirement in the state’s medical license application. If he had the right information, his life might have been saved.
In the months following her death, we established the Dr. Lorna Breen Heroes Foundation in her honor, exploring the causes of physician and health care worker burnout and what can happen in severe cases if it goes untreated and untreated. be left. Statistically, the suicide rate of physicians is higher than that of the general population. Yet many people do not seek mental health care for fear of negative consequences in the workplace, including retaliation, exclusion, loss of license or even their job – the same fear Lorna felt. . This culture should change. And given the ongoing pandemic, we have no time to lose.
During our journey to support the well-being of health care professionals, we identified six structural barriers that play a role in preventing them from seeking and receiving mental health care – the same type of care that many of us face professionally. can get without. And they all start with the health care system of our country.
state license application
- As a recent research paper in JAMA notes, “state medical license applications often ask broad questions about mental health history or its hypothetical effect on eligibility,” which can influence physicians’ decisions not to seek help. . State medical licensing bodies and 22 Nursing Licensing Boards continue to ask mental health questions on applications inconsistent with standards under the Americans with Disabilities Act.
Hospital/Health System Privileges and Credentials Application
- In May 2020, the health care accreditation organization Joint Commission strongly encouraged health care organizations not to ask about a physician’s past history of “mental health conditions or treatments”. Instead, the commission supported the recommendations of the Federation of State Medical Boards and the American Medical Association to limit questions to conditions that would reduce a physician’s current abilities.
commercial insurance credential
- Like hospital credentialing, the commercial insurance credentialing process—the application process that allows physicians to be part of a pool of doctors in a network—is often very intrusive. A HIPAA exemption granting an institution access to a doctor’s health records has become a standard part of the credential package.
malpractice insurance application
- Physicians required to maintain malpractice insurance may be faced with insurance applications that ask similar questions about prior mental health treatment.
Legal search process during litigation
- Doctors are often prevented from seeking mental health care for fear that their own mental health records may be shared in the discovery process of malpractice lawsuits in which they are defendants. To protect against the unnecessary release of such records, states should adopt the Safe Haven Model Virginia, a legislatively backed, confidential resource through which physicians can “without fear of undue repercussions for their medical burnout, career fatigue.” and mental health support. License.” Michigan is also implementing SafeHaven; Many more states should follow suit.
Mental Health Treatment Requirements
- Currently, health care workers receiving mental health support may be required by insurance to receive treatment in the same health system where they work. That’s why Dr. Scott Jolie, an ER physician in Utah, was forced to be treated by his colleagues in the psychiatric unit at his hospital. According to Vox, his wife recalled that “being cared for by colleagues from whom he wanted to hide his mental health condition was a new, vast source of stress and shame.” Jolly also died of suicide earlier this year.
Health systems and helping leaders can take a concrete, important step by joining the ALL IN: Wellbeing First for Healthcare initiative – a call for health care organizations to commit to creating and developing workplace cultures that help workers Prioritize well being. The initiative comes in response to the mental health crisis triggered by the pandemic, as health care workers have spent the past year and a half dealing with high levels of anxiety, depression, isolation, post-traumatic stress disorder and burnout. The organizations involved in the initial launch represent approximately 300,000 front-line workers nationwide.
Supported by Arianna Huffington’s Thrive Global, Harvard T.H. Chan School of Public Health, Johnson & Johnson and the Creative Artists Agency – and with the support of our Dr. Lorna Breen Heroes Foundation – all partners are on a mission to make a difference. Together, we provide medical institutions with resources and funding to improve and care for the mental health and well-being of their workforce. We are proud to be a part of this incredible initiative.
Another valuable resource is the recently launched National Physician Suicide Awareness Day website, which includes key resources to help prevent physician suicide.
We call on our nation’s health systems to disseminate facts relating to their institution and state on each of the six structural barriers to mental health care for health care workers. Knowledge is power, and in this case, it has life-saving potential. This action is a transparent and measurable way each health system can and should support its most valuable resource: its workforce.
Collectively, we can all make a difference in the lives of the physicians who care for us.
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