Prioritizing Mental Health of Healthcare Professionals is a Must

Every day, healthcare workers are under extreme stress, and the recent COVID-19 pandemic put additional strain on the profession—exacerbating this issue. The continued pressure on healthcare workers can result in mental health issues ranging from anxiety to depression and suicide. For healthcare systems to operate efficiently and improve patient results, it is critical that we prioritize the mental health of healthcare professionals (HCP).

Traditionally, the healthcare culture has expected professionals to hide when they are struggling and not seek help. This has fostered the perfect storm for mental health disruption. Physicians are trained from the beginning to have zero tolerance for mediocre care but also to not bother senior leaders as asking for help is seen as a sign of weakness. They learn that they must be self-sufficient and not demonstrate any doubts or insecurities. When they feel ill, they are told not to complain and keep working, because if they miss work, it will burden their team members. This ethic is so pervasive in medicine that many physicians have never called in sick to work, and this trickles over to their wellbeing. As such, most physicians and other HCPs are extremely reluctant to ask for mental health support. Furthermore, physicians are universally concerned there will be a stigma attached to seeking help, signaling to others that they are inferior and cannot meet the rigors of the medical field. The concern doctors and trainees have for establishing a reputation as someone with the mental toughness needed to perform their job leads to reluctance to ask for help, even when it is available.

High-risk scenarios, prolonged stress

This culture has been engrained in all facets of the healthcare system. There are many factors that promote stress, including the rigors of medical education and the financial pressures related to obtaining medical training. Demanding hours often lead to physicians and healthcare practitioners spending significant time away from loved ones as well as experiencing chronic sleep deprivation. In addition, some HCPs experience bullying, hazing and sexual harassment during training. These conditions can lead to feelings of isolation, loneliness and inadequacy. This cauldron of pressure, along with the friction placed on personal relationships results in a pattern of HCP susceptibility to mental health issues.   

Once training is complete, many practitioners are left with financial debt and experience the added stress of feeling they need to know everything to safely manage complex medical problems without the support of their professors and mentors. All of this is in the background as HCPs must be efficient and perform countless hours of remedial tasks, such as electronic medical records management rather than direct patient care.

Furthermore, the COVID-19 pandemic has significantly amplified many of these stressors. It has added concerns of contracting COVID-19 on the job, initially dealing with an emerging disease with little known information, becoming overwhelmed with patients, and having colleague HCPs become infected, pulled out of the workforce and in some cases dying.

Addressing physician mental health to reduce patient medical harm

Medical errors are a critical issue noted as the third leading cause of death in the United States by the Patient Safety Movement Foundation (PSMF), whose goal is to reduce preventable medical harm to zero by 2030. When the mental health of HCPs suffers, it can increase the number of errors they make. Sleep deprivation and other stressors can decrease cognitive clarity needed to identify errors or correct them before they reach and harm patients. While no one goes to work in the morning with the intent to harm a patient, mental stress can cause individuals, who are otherwise very caring and careful, to lose sight of the details related to patient care, such as selecting the wrong type or dose of a medication, putting patients at risk of irreversible medical harm or even death.

Compassionate culture

Implementing a compassionate culture can markedly help decrease the stress, fear and anxiety experienced by healthcare workers. Numerous published studies have demonstrated higher compassion and empathy are associated with lower burnout and greater well-being. A piece published by The Journal of Positive Psychology showed that Emory University reported positive results from the implementation of a training program that developed compassion, while decreasing depression symptoms of the residents in training. Another pilot randomized clinical trial at the Mayo Clinic looked at the Stress Management and Resiliency Training (SMART) program. The results published in the Journal of General Internal Medicine found the “SMART program led to enhance resilience and decrease stress among physicians.”

Compassionate self-care programs for HCPs should be a priority for healthcare leadership. As HCPs learn to become aware of their mental state, they can deliver higher quality care. These programs can include mindfulness, self-acceptance and a sense of a common healthy bond with others. Programs can be simple to implement such as offering a “Code Lavender” impromptu meeting. “Code Lavender” is a confidential debrief held shortly after an adverse event for the HCPs involved and supported by trained, compassionate-care peer volunteers. These allow HCPs to practice mindful speaking and acceptance, which can relieve stress and feelings of burdensome guilt and shame that would have otherwise dangerously accumulated. Indoctrinating compassionate self-care wellness programs into the culture needs to become the norm in the healthcare industry.

The pressure to provide safe care for patients in a complex environment coupled with environmental factors such as reimbursement reporting regulations and the repercussions of COVID-19 speak loudly to the critical need to implement a compassionate culture of safety, which places providers’ mental health as a priority. The quality of care of patients depends on the compassionate self-care of its providers. If embraced by healthcare institutions, evidence indicates that physicians, nurses and hospital administration will be more encouraged to speak out about mental health issues and address the urgency required to make the cultural shift that includes self-compassionate care by HCPs.

Bernadette M. Wilson, MBA, CMC, CNC serves as an advisory board member at the Patient Safety Movement Foundation. She is also the CEO of Cognitive Performance and co-founder of the BrainFIT Institute.