新冠疫情期间，医护人员的心理健康危机如何解决？

A lot can change in two years. These days it’s often impossible to fathom life before we had to contend–physically and emotionally–with a global pandemic that has changed everything.

For our family, that change came suddenly. In April 2020, Dr. Lorna Breen, an accomplished NYC emergency room physician working on the frontlines of the first wave of COVID-19, died by suicide after treating the daily deluge of coronavirus patients she faced minute after minute, shift after shift.

Lorna, who had no history of mental illness, had grown overwhelmed by the unending surge of severely ill patients, not to mention being severely under-resourced and understaffed to treat them. As so many healthcare professionals can attest to today, she was far from alone in silently enduring these stresses.

Lorna was fully aware of the burnout crisis among clinicians even before the pandemic. She co-authored a study on the necessity of reducing those stresses months before her death. But when Lorna needed help, she didn’t receive it. As she told us, Lorna thought she would risk losing her medical license or being ostracized by colleagues if she sought treatment. Her death was a preventable tragedy that is resonating with more and more of us with each passing day.

In March President Joe Biden signed the Dr. Lorna Breen Healthcare Provider Protection Act, a first-of-its-kind legislation that aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals.

Over the past two years, as our family has grieved the loss of Lorna and through the foundation, we’ve established in her honor, we’ve fought to safeguard the well-being and job satisfaction of healthcare professionals like Lorna. We envision a world where seeking mental health services is universally viewed as a sign of strength, not weakness, for healthcare professionals.

However, this law is only a first step in understanding and breaking down the barriers to care that healthcare professionals face. Like Lorna, many don't seek the mental health care they need for fear of retribution or exclusion in the workplace, loss of license, or even their job.

Currently, dozens of states have invasive questions regarding mental health on medical licensure applications. A recent Medscape survey of 13,000 physicians found that 43% said they had not sought help for burnout or depression because they “don’t want to risk disclosure to the medical board.”

We believe that these state medical license applications, as they often ask intrusive questions about mental health history, may violate the Americans with Disabilities Act (ADA). Recent court decisions and the U.S. Department of Justice have drawn similar conclusions.

The ADA clearly applies to hospitals and health systems, so why are healthcare workers often met with questions intended to stigmatize mental health further and potentially jeopardize their employment? State Medical Boards and legislators have the power to change this. Regulators at the state level must remove disincentives to mental health care on licensing and renewal applications as a first step to allowing clinicians to feel safe seeking care.

Just as hospitals consider the protective equipment medical professionals need to do their jobs safely, we have to recognize that well-being is equally critical. A surgeon wouldn’t head into the operating room with just one glove. We should provide all the support and tools needed to an already overburdened and understaffed healthcare workforce to ensure they can continue taking care of us.

A broad coalition of groups has been working together in new and exciting ways to make the system work for healthcare workers, too. The recent, acclaimed National Geographic documentary “The First Wave” captures the chaos and the humanity facing the public, patients, and healthcare providers during those early days of the pandemic and uses the power of storytelling to spark conversations about supporting the well-being of healthcare workers, including encouraging State Medical Boards to limit questions regarding mental health on licensure applications.

For health systems and leaders looking to make tangible change, the ALL IN: WellBeing First for Healthcare initiative helps cultivate workplace cultures that prioritize worker well-being, and provides five evidence-based actions every health system should be taking right now to support the well-being of their workforce.

Our healthcare workforce is made up of humans who, like us, are doing the best they can with the resources they have, all during an unprecedented global health crisis.

A lot more change is needed to ensure we take care of those who care for us. As we begin to comprehend the mental health impact of the pandemic—and especially the effects on the healthcare workforce—we must continue to remove barriers to care that reflect this new and evolving reality.

Let’s hope for a brighter day when health care workers feel valued and supported so they can recover the joy they once found in practicing medicine.

Jennifer Breen Feist and J. Corey Feist are the co-founders of the Dr. Lorna Breen Heroes’ Foundation.