Change the System to Assist Medical doctors With Psychological Well being Care | Healthiest Communities Well being Information
For more than a year, the health care workers in our country have been running at full speed. They’re overworked and exhausted while simultaneously treating patients with COVID-19, some of whom have recovered from the virus and some have not – and possibly never. All of that stress, death, and fear have understandably taken a toll on these frontline workers and their families.
For the past 16 months, our family has witnessed the loss of our beloved sister and sister-in-law, Dr. Lorna Breen, mourned, a savvy New York emergency department and director who made headlines last year for reasons that changed our lives forever. Lorna went beyond her limits, treating patients with severe COVID-19 around the clock. She infected herself with the coronavirus, recovered and immediately went back to work. When she returned to the hospital, she was faced with a still overwhelming, relentless number of incredibly ill patients – not to mention inadequate care, too few beds, and too little help.
Like healthcare workers today, many of whom are waging a new battle to save patients from the deadly Delta variant, Lorna needed help. And tragically, she didn’t get it. When she was in the depths of her despair and fear, her priority remained her job. She was convinced that if she spoke to a specialist she would lose her license to practice medicine or be ostracized from the crisis by colleagues because of burnout. Lorna died of suicide on April 26, 2020.
Time and again we retold her story and hypothesized what ultimately led to her decision to put an end to her life. It’s a tragic story – one that, in our opinion, could have been prevented. One way that could have happened would have been for Lorna to learn the facts about the impact of seeking psychiatric treatment on her license in New York. After her death, we learned that the state mental health approval application did not include mandatory reporting. Had she been given the exact information, it might have saved her life.
In the months since her death, we have honored her with the Dr. Lorna Breen Heroes’ Foundation, which researches the causes of burnout in doctors and health workers and what can happen in severe cases if it is not diagnosed and untreated. Statistically, doctors have higher suicide rates than the general population. However, many do not seek psychiatric treatment for fear of negative consequences in the workplace, including retaliation, marginalization, loss of their license, or even their job – the same fears as Lorna. This culture has to change. And with the ongoing pandemic, we have no time to waste.
In our journey to support the well-being of health professionals, we identified six structural barriers that prevent them from receiving and receiving psychological care – the same type of care many of us can receive without professional impact. And they all start with our country’s health system.
Applications for state approval
- As a research letter recently published in JAMA noted, “applications for government medical approvals often ask broad questions about psychological history or its hypothetical impact on proficiency on” which may influence doctors’ decisions not to seek help. “Studies Over the past few years, 32 state medical licensing agencies and 22 nurse licensing agencies continued to raise mental health questions on claims inconsistent with the standards of the Americans with Disabilities Act.
Hospital / Health Systems Eligibility and Proof of Entitlement Applications
- In May 2020, the Health Care Accreditation Organization, the Joint Commission, strongly encouraged health organizations not to ask about a clinician’s history of “mental illness or treatment”. Instead, the commission endorsed the recommendations of the Federation of State Medical Boards and the American Medical Association to limit questions to conditions that would affect a clinician’s current skills.
Commercial insurance card
- Similar to hospital approval, commercial insurance – the application process that enables doctors to be part of the medical pool in a network – is often very intrusive. A HIPAA waiver that gives an institution access to a doctor’s health records has become a standard part of certification packages.
Applications for professional liability insurance
- Doctors required to maintain professional indemnity insurance may face insurance claims that ask similar questions about previous mental health treatment.
Legal Discovery Process During Legal Proceedings
- Doctors are often discouraged from seeking psychological help because they fear that their own mental health records could be disclosed in the detection of malpractice proceedings of which they are a defendant. To protect themselves from unnecessary disclosure of such records, states should adopt the SafeHaven model that Virginia uses, a legally protected, confidential resource that clinicians can use to “seek assistance with burnout, occupational fatigue, and mental health without fear of that they are improperly affecting their medical license. “Michigan is also implementing SafeHaven; many more states should follow suit.
Requirements for the treatment of mental illnesses
- Currently, health workers seeking psychological help can be required by insurance to seek treatment in the same health system in which they work. This forced Dr. Scott Jolley, a Utah ambulance doctor, to seek treatment from his own colleagues in his hospital’s mental health department. His wife, Vox said, recalled that taking care of “the colleagues from whom he tried to hide his mental state was a new and immense source of stress and shame.” Jolley also died of suicide earlier this year.
Health systems and leaders who want to help can take a tangible, important step by joining the ALL IN: WellBeing First for Healthcare initiative – a call to action for health organizations to commit to creating and maintaining workplace cultures that promote wellbeing Put the employee in the foreground. The initiative comes in response to a mental crisis exacerbated by the pandemic as health care workers have spent the past year and a half grappling with heightened anxiety, depression, isolation, post-traumatic stress disorder, and burnout. The organizations that join the initial rollout represent nearly 300,000 frontline workers across the country.
Supported by Arianna Huffingtons Thrive Global, Harvard TH Chan School of Public Health, Johnson & Johnson and the Creative Artists Agency – and with the support of our Dr. Lorna Breen Heroes’ Foundation – ALL IN employees have a mission to make a difference. Together, we provide resources and funding to medical institutions to improve and maintain the mental health and wellbeing of their employees. We are proud to be part of this incredible initiative.
Another valuable resource is the recently launched National Physicians Suicide Awareness Day website, which has essential resources to help prevent doctor suicide.
We urge our country’s health systems to provide the evidence about their facility and to comment on each of the six structural barriers to mental health care for health workers. Knowledge is power and in this case it has life-saving potential. This action is a transparent and measurable way that every health system can and should support its most valuable resource: its workforce.
Together we can all make a difference in the lives of the clinicians who have looked after us.
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