#JamesDonaldson on #MentalHealth – Could #COVID-19 #Pandemic Increase #Physician Burnout, #Suicide?

— “This entire culture has to change,” said Jennifer Feist, sister of #LornaBreen, MD, who died by #suicide

by Shannon Firth,

On September 17, MedPage Today, recognizes #NationalPhysicianSuicideAwarenessDay.

If you or someone you know is considering #suicide, call the #NationalSuicidePreventionHotline at 1-800-273-8255.

#Physicians have one of the highest rates of #suicide among all other professions. Approximately 65% of emergency #physicians experience burnout during their careers and 74% of medical residents have met the criteria for burnout.

Research also suggests that about 6,000 emergency physicians thought about taking their own lives in 2018, with nearly 400 attempting #suicide.

The #COVID-19 #pandemic has undoubtedly put more #stress on #physicians, #nurses, and other #healthcareworkers, and is likely to exacerbate these problems, noted #physicians and advocates who participated in a livestream discussion focused on clinician burnout, hosted by U.S. News and World Report, on Tuesday.

Clinicians, advocates, as well as many hospital and health system leaders are pressing for change.

“On April 9, my sister called me because she couldn’t get out of her chair,” said Jennifer Feist, JD, a lawyer in Charlottesville, Virginia, whose sister, Lorna Breen, MD, the medical director of the emergency department at NewYork-Presbyterian Allen Hospital, died by #suicide on April 26. Feist spoke out about her sister’s death and the need to address #mentalhealth #stigma.

Breen had had her first “#COVID-19 shift” on March 14, and saw right away how unprepared hospitals were for the pandemic, Feist said.

Over a period of roughly 3 weeks, Breen treated patients with #COVID-19, became ill with the #virus, recovered, and began working again. Once she’d been fever-free for 3 days, Breen called the hospital and said she was ready to go back to work, Feist recalled.

Breen and her colleagues worked hard and faced huge stressors from limited personal protective equipment to even a shortage of beds, Feist remembered. “She told me patients were dying in the waiting rooms and hallways.”

Often Breen and her colleagues would continue working for 18 hours at a time, “to try to help as many people as they could,” Feist said.

But, she said of her sister, “the work didn’t stop and it didn’t slow down, and she kept going back, day after day, for her 12-hour shifts, until she could literally no longer stand.”

Feist brought her sister back from New York City to Charlottesville, Virginia, where she was eventually hospitalized at the University of Virginia.

Breen had no prior history of “known or suspected” #mentalhealthissues, and Feist said she also believes that the #virus may have impacted her sister’s brain. (There have been multiple studies about the neurological impacts of #COVID-19.)

Whatever the cause of the mental problems, Feist said Breen feared asking for help.

She worried about losing her medical license or being ostracized by her colleagues. Breen, who co-authored a study in 2019 on clinician burnout in emergency departments, was aware of the phenomenon but did not want her own colleagues to know she was suffering from burnout, Feist said.

Corey Feist, MD, Jennifer’s husband, who also spoke during the webcast, noted that more than one #physician dies from #suicide each day.

He said he knows his sister-in law was one of many clinicians suffering from these challenges and worries that others will continue to “suffer in silence” and not get the help they need, because of professional #stigma and fearing judgment from their family and friends.

Jennifer Feist said that what she learned from her sister’s death is that #stigma is “learned” in medical school, “reinforced” in residency, and “solidified” through the types of questions that physicians are asked in licensure and credentialing forms.

“We believe this entire culture needs to change,” she said.

#JamesDonaldson notes:

Welcome to the “next chapter” of my life… being a voice and an advocate for #mentalhealthawarenessandsuicideprevention, especially pertaining to our younger generation of students and student-athletes.

Getting men to speak up and reach out for help and assistance is one of my passions. Us men need to not suffer in silence or drown our sorrows in alcohol, hang out at bars and strip joints, or get involved with drug use.

Having gone through a recent bout of #depression and #suicidalthoughts myself, I realize now, that I can make a huge difference in the lives of so many by sharing my story, and by sharing various resources I come across as I work in this space.  #http://bit.ly/JamesMentalHealthArticle

“Our expectation that the #healthcareproviders be superhuman with no needs, no fears, no family, and no need for rest has to change as well. These are humans before heroes,” Feist said.

Victor Dzau, MD, president of the National Academy of Medicine, who also participated in the webcast, echoed these feelings.

Dzau recently co-authored an editorial in the New England Journal of Medicine that highlighted key steps for what he calls preventing a “parallel #pandemic.”

In the editorial, Dzau and two colleagues called for establishing anonymous reporting systems at the facility level to ensure clinicians’ “psychological safety” by enabling them to reach out with concerns for themselves or others without fear of punishment, maintaining and growing well-being programs, and integrating chief wellness officers or leaders or clinician well-being programs into the “#COVID-19 command center” or other decision-making bodies for as long as the #pandemic lasts.

Dzau also suggested earmarking federal funds to create a “national epidemiologic tracking program” that would assess clinician well-being and report the results of interventions meant to address the problem.

He also called for allocating funding to help treat clinicians who suffer mentally or physically as a result of their work during the #COVID-19 #pandemic.

He likened such a fund to the compensation fund created to support victims and emergency responders after 9/11.

In July, Sen. Tim Kaine (D-Va.) introduced the “#Dr.LornaBreen Health Care Provider Protection Act,” which would establish funds to help educate students, residents, or other healthcare providers in “evidence-informed strategies to reduce and prevent #suicide, burnout, #mentalhealthconditions, and substance use disorders.”

The bill would also include grants for peer support programs, mental and behavioral health treatment, evidence-based awareness campaigns, and a comprehensive study of healthcare professionals mental and behavioral health, and burnout, including the impact of #COVID-19 on all aspects of their health.