400. That’s the number of physicians that die by suicide each year. Two graduating medical school classes worth of physicians lost to burnout, depression, and the overwhelming pressure of being in medicine. Not only that, there’s an estimated 13% of total physicians that have suicidal ideation. What’s worse, this was before the COVID 19 pandemic. Before our healthcare system was pushed to the absolute brink. Before clinicians had to see record numbers of patients dying. You can imagine how this number can and most likely will spike soon, especially during such troubling times.
Like an increasing number of families of clinicians, my family has seen firsthand the toll of the pandemic on health care professionals. My sister-in-law, Dr. Lorna Breen, was an emergency medicine physician in New York City. She returned from a vacation as her ER was overflowing with COVID patients. The pandemic completely changed the world she knew; Lorna described it as returning to armageddon. Beds lined the hallways with dying patients as they lacked the necessary oxygen, PPE, and supplies to support the influx. Working 12+ hour days and fearing the loss of her medical license, Lorna’s well-being took a turn for the worst. By the time she called my wife Jennifer (her sister) for help, she had gone over a week without sleep and was nearly catatonic.
Lorna had no prior mental health issues or a history of depression or anxiety, yet after these events, she was hospitalized for mental health concerns for 11 days. Five days after discharge, she died by suicide on April 26, 2020.
The intense scrutiny that follows seeking mental health help prevents so many clinicians from raising their hand, which is exactly what happened with Lorna (despite being in a state that does not ask about mental health conditions on state licensure applications). Jennifer and I founded the Dr. Lorna Breen Heroes’ Foundation to reduce burnout of health care professionals and safeguard their well-being and job satisfaction. We envision a world where seeking mental health services is universally viewed as a sign of strength for health care professionals. Now, more than ever, every one of us needs to sound the alarm and raise awareness of the elevated rates of burnout, depression, anxiety, and suicide that our front-line workers face and the absolute necessity of being able to get help when and where you need it. To start, let’s focus on three actions to help respond to the profound stressors that so many are feeling at the clinical front line:
1. Find self-compassion. There are three key elements of having self-compassion: self-kindness, common humanity, and mindfulness. When you know you’re suffering, give yourself understanding, acknowledge that struggling is part of the human experience, and observe yourself non-judgmentally. Also, don’t be afraid to reach out to others, as they are most likely going through similar struggles, and just opening up could help yourself and them.
2. Learn about it and talk openly about it. Opening up to a colleague about personal challenges can help. There’s a stigma in medicine regarding mental health in medicine; clinicians are overworked and see tragedy, and yet are expected to handle this without complaint or support. It’s to the point that this expectation leaves many silent to avoid having to report their challenges during credentialing or licensing or a fear of looking weak. This stigma makes it imperative to l understand health care workers’ burdens. By speaking out, we can diminish this stigma and normalize getting help when it’s needed.
3. If you see something, intervene. Not everyone is going to join this new, pro-mental health movement immediately. There may be people who don’t want to open up or are still too apprehensive to raise their hand. If you see someone who may be struggling, check-in, and see how they are doing with empathy and support. We can’t overlook warning signs when clinicians become short-tempered, withdrawn, or isolating themselves from others. Ask, “I know we are all going through a lot now…how are you holding up?”
We must create places and cultures where we feel safe and live in a world where seeking mental health services is viewed as a sign of authenticity and strength, embraced by their organizations and their leaders. Join us at the Foundation and Practicing Excellence in promoting clinician well-being and making health care safe for providers and patients.
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J. Corey Feist, JD, MBA is the co-founder of the Dr. Lorna Breen Heroes’ Foundation – an organization with a mission to reduce burnout of health care professionals, and safeguard their well-being and job satisfaction. He also serves as the chief executive officer of the University of Virginia Physicians Group, the medical group practice of UVA Health comprised of 1200+ physicians and advanced care providers.