Health care professionals experience high work stress under normal circumstances, but the COVID-19 pandemic placed additional pressure on clinicians and the health care system, resulting in an even greater risk for psychological distress.
These statistics give a glimpse into COVID-19’s impact on clinicians:
- Mental health visits increased by more than 35 percent.
- Fifty percent of health care workers reported feeling anxious and depressed.
- Forty-two percent of clinicians described feelings of hopelessness and failure.
- There was a marked increase in clinician self-reporting for substance abuse.
Not only that, but 33 percent of clinicians considered changing careers during COVID-19, 64 percent said they knew someone personally who lost their battle with COVID-19, and around 8 percent of health care workers with mental health disorders had thoughts of self-harm.
Sadly, some members of the health care community went a step further.
Lorna Breen, MD
Perhaps the most widely reported story was about the death of Dr. Lorna Breen, an emergency medicine physician in New York.
Dr. Breen passed away by suicide on April 26, 2020, due to feeling guilt-ridden by her inability to save COVID-19 patients.
The New York Times reported that according to her father, Dr. Breen did not have a history of mental illness but seemed detached when he last spoke with her, and he could tell something was wrong.
“She had described to him an onslaught of patients who were dying before they could even be taken out of ambulances,” the Times said.
As a result of her tragic death, in March 2022, Congress passed H.R. 1667, the Dr. Lorna Breen Health Care Provider Protection Act, which provides federal funding for mental health education and awareness aimed at protecting the well-being of health care workers.
Scott Jolley, MD
Salt Lake City, Utah physician Dr. Scott Jolley died by suicide on February 19, 2021.
He was undergoing psychiatric treatment for PTSD and reported feelings of hopelessness. After being admitted to the same facility where he worked, Dr. Jolley expressed anxiety about the stigma associated with mental illness and wondered what his colleagues would think.
Dr. Jolley’s death inspired the Utah state legislature to pass H.B. 278, requiring insurance companies to cover out-of-network mental health care for medical caregivers.
Daniela Trezzi, RN
Daniela Trezzi, a 34-year-old Italian ICU nurse, passed away by suicide on March 25, 2020. She had contracted COVID-19 and suffered “heavy stress” that she might be responsible for infecting others.
Like many, Trezzi worked in the ICU under quarantine after her diagnosis, feeling like she couldn’t leave her colleagues to fight alone.
Second Victim Syndrome
Many health care workers experience a phenomenon called second victim syndrome, which KevinMD defines as the suffering a health care provider experiences because of a traumatic patient care event like COVID-19.
“The emotional effects of second victim syndrome should not be understated,” KevinMD cautioned. “Symptoms of anxiety, depression, guilt, and loss of confidence are commonplace.”
Those who have suffered traumatic personal events are more prone to second victim syndrome. Risk factors to watch for include a history of anxiety and depression, substance abuse, and prior feelings of helplessness related to patient care.
Clinicians may feel judged by others for perceived failure, fear the stigma associated with mental health as a clinician, and fail to deal with traumatic life events.
KevinMD sounded this warning: “Ultimately, this is a recipe for physician burnout. While the hospital organization is diligently performing root cause analyses and identifying the prevention of future errors, the physician is left in solitude.”
The Journey to Wellness
What can the health care community do to change the narrative and prevent future tragedies?
If you look inside and see issues like those discussed here, the first step is to forgive yourself. Despite all your years of training and experience, there is only so much you can do to help your patients.
“Understanding the need to take care of your own mental health before you can care for the health of others is crucial to taking ownership of your recovery and ensuring your patients get the care they need,” stated Jill Hunt, PA, SCP Health Vice President of NP/PA Services.
“As clinicians, it’s not only okay to make your own mental health a priority, it’s a must because your patient’s life may depend on it.”
Instead of feeling guilt-ridden, follow the mental health advice from Dr. Stephen Nichols, Chief Clinical Innovation Officer, and Chief Medical Officer for the Virtual Clinical Medical Group. He recommends that clinicians strive to rediscover meaning in their work, learn what work-life balance looks like, find joy in daily tasks, and make a habit of behaviors that bring fulfillment.
Also, don’t be afraid to reach out to others. You are not alone and don’t want others to feel alone. There is strength in the community.
Be a Force for Change
Work against the mental health stigma in health care. Share your story with others and utilize available community and colleague resources. Most of all, celebrate successes, not just the losses.
Read our related article, World Mental Health Day – Physician Suicide Awareness and Prevention, for other steps to prevent physician suicide.
We in the health care community must work together to change the story. It starts with being there for our colleagues, recognizing the risks, listening to the stories of those undergoing trauma, and being willing to help. We must dedicate ourselves to taking care of clinicians and other health care workers so they can care for the patients who need them most.