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• W3195074323 abstract "FigureThe COVID-19 pandemic left invisible damage on healthcare workers. Polls find that the majority of healthcare workers experienced increased stress and anxiety during the pandemic and often feared not just for their own well-being, but the safety of the ones they love.1 Grueling, often futile, hours of work among the dying in hospitals was compounded by isolation and hopelessness outside them. And if research from previous outbreaks is any indication, the effects of this stress will stretch far into the future.2 But the pandemic is only the latest salt poured into the festering wound of our workforce's psyche. Long before a deadly virus rampaged throughout the world, mental illness was endemic to healthcare. Despite protective factors like money and education, clinicians have much higher rates of mental illnesses such as anxiety and depression than the general public.3 We are more likely to abuse alcohol and suffer from substance use disorders.4 And we are more likely to harm ourselves.5 The exact reason behind these trends is unclear, but you don't have to reach very far for a guess. We work long hours in stressful, high-stakes environments. We sacrifice our well-being and personal relationships for jobs that have normalized showing up exhausted or even sick. We install hierarchies that enable harassment and often protect the worst offenders in the name of productivity. We craft nebulous terms like burnout to describe what often is a normal human response to a daily existence in a truly toxic environment. But worst of all, when someone commits the sin of being human, we punish them. Healthcare workers live in fear that imperfect mental health will cost them their careers. Despite being at higher risk for mental illness, many healthcare workers say they avoid seeking care—even when experiencing symptoms—for fear of losing their licenses or jobs.6 They dread the specter of a past mental health diagnosis emerging during a credentialing application or job interview. And they are not paranoid. Research in the March 2021 issue of JAAPA highlighted the widespread practice of PA license applications asking deep, probing questions about mental health.7 These intrusive questions do real harm to clinicians and have a paradoxical effect on medical boards' mandate of public safety. Clinicians, well aware of the questions and their implications, avoid the risk of disclosure by never seeking diagnosis or treatment in the first place. In addition to directly threatening the well-being of clinicians themselves, untreated mental illness is much more likely to impair an individual than well-treated disease, raising the possibility of impaired clinicians continuing to practice and putting patients at risk. Although license application questionnaires may be a passive barrier to mental health treatment, other punitive actions against healthcare workers are far more aggressive. A recent Vox article highlighted the story of Justin Bullock, MD, who, as a medical resident, disclosed his history of bipolar disorder and a suicide attempt.8 Despite an excellent performance record, he said his employer subjected him to a hellacious oversight process that “(rips) you of your humanity.” An unforgiving, high-stress work environment combined with a punitive system of addressing illness has created a mental health tinderbox. A global pandemic doused it in gasoline. Now, the most powerful stakeholders in the healthcare industry—government, institutions, and corporations—must decide if they will act or wait until the next wayward spark sets it all ablaze. High-visibility actions can begin to defuse the stigma around mental illness. State licensing boards can rein in overreaching questions related to mental health and offer transparency when clinicians disclose information. Institutions can stop criminalizing mental illness and can replace dehumanizing investigations with programs that focus on supporting employees without damaging their livelihoods. Employers can make systemic changes to improve the conditions of their workplaces rather than merely encouraging employees to develop a tolerance to toxicity. Nothing can reverse the damage that the COVID-19 pandemic inflicted on healthcare workers. But the industry can begin to repay its debt to the people who buoyed its survival by investing in their mental well-being now and for years to come." @default.
• W3195074323 created "2021-08-30" @default.
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• W3195074323 date "2021-09-01" @default.
• W3195074323 modified "2023-10-17" @default.
• W3195074323 title "Healthcare owes us real mental health support" @default.
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• W3195074323 doi "https://doi.org/10.1097/01.jaa.0000769688.98644.ef" @default.
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