Both the Senate and the House of Representatives passed a bill to “improve the mental and behavioral health among health care providers” that President Biden signed on Friday. As an emergency medicine physician who worked through the darkest days of the Delta and Omicron surges, I can personally attest to the need to prioritize the mental health of medical professionals and fight burnout. But this bill is fundamentally flawed in its approach and is unlikely to achieve its desired effects.
The Dr. Lorna Breen Health Care Provider Protection Act is named after Lorna Breen, a New York City emergency medicine physician who died by suicide in April 2020, as Covid-19 raged across the city and the country. By all accounts a tireless worker, she was ultimately overwhelmed by what she experienced during those dark early days of the pandemic.
Even before the coronavirus pandemic, health care institutions were struggling with maintaining the wellness of their workforces. Rates of burnout, depersonalization, and emotional exhaustion were all significantly higher among health care workers than in the general population. Even more alarming, physicians and nurses complete acts of suicide at rates significantly higher than workers in other professions. In fact, according to a systematic review conducted by the American Psychiatric Association, physicians are more than twice as likely to complete acts of suicide as the general population.
The pandemic added fuel to this fire, as health care workers fought to provide care to legions of sick patients amid staffing and equipment shortages. Before the pandemic, approximately 40% of health care workers reported feeling burnt out. Now, between 60% and 75% of U.S. health care workers report feeling emotionally drained and depressed.
Clearly, something has to change. With the Breen bill, Congress hopes to halt this tragic wave of depression and burnout among health care workers by providing grants to hospitals and other health care organizations to “promote mental health and resiliency among health care providers.” It also directs the Department of Health and Human Services to “conduct a campaign to (1) encourage health care providers to seek support and treatment for mental and behavioral health concerns, and (2) disseminate best practices to prevent suicide and improve mental health and resiliency among health care providers.”
I applaud Congress for shining a spotlight on this issue. The alarming rates of mental health challenges observed in the health care profession certainly deserves a full-fledged effort to find long-term solutions. Yet the solution the Breen bill proposes will not lead to meaningful change. Giving hospitals money to “promote wellness” will not magically heal health care workers. I know this because hospitals already try to promote wellness, though the way they choose to do so is often laughably misguided.
Ask any health care worker if their institution has already tried to promote wellness and you will probably hear a snort of derision. During the pandemic, hospitals across the country put up signs lauding their workers as heroes. Though hospital administrators may have given themselves pats on the back for such efforts, the signs meant little to those of us working without adequate personal protective equipment, or telling family members they could not visit dying loved ones, or wondering if we’d bring Covid home to our families and friends. The signs haven’t stopped scores of workers from leaving the health care field.
One of my favorite examples of misguided “wellness” initiative is from Stony Brook University Hospital. In an effort to show their resident physicians how much they were appreciated for their efforts fighting Covid-19, hospital administrators gave them each a bottle of water and can of Pringles chips. And the can of chips wasn’t even a full can; it was a mini-can!
Clearly, giving physicians who have worked through the worst of Covid a mini-can of Pringles (and not a raise) is absurd. But it illustrates what many institutions think counts as a wellness initiative: short-term, material things instead of addressing the root causes of burnout.
I worry that the Breen bill will lead to more of the same, though perhaps Stony Brook can give afford to give its residents full cans of Pringles with a taxpayer-funded government grant. I believe this bill will lead to more gimmicky and even more cringey wellness initiatives that do not even come close to addressing the root causes of the current mental health crisis afflicting health care workers.
If Congress is serious in its desire to help combat burnout among health care workers, I have a few suggestions for what it could do. It could pass the Resident Physician Shortage Reduction Act, which would increase the number of training spots for medical school graduates and add more physicians to the workforce to alleviate the burden of caring for the sick on those currently working in health care. Passing the Workplace Violence Prevention for Health Care and Social Services Workers Act, which has been approved by the House and warrants attention from the Senate, would require hospitals to take a more proactive approach to combat the alarming rates of workplace violence experienced by health care workers. Finally, Congress could raise the salary of resident physicians, providing more equitable pay to perhaps the most overworked and under-compensated physicians. Any of these actions would do more to address the root causes of physician distress than giving away money to promote “wellness.”
Having a health care workforce that is mentally well is imperative for the U.S. So far, hospitals and the health care field at large have failed in this endeavor. I’m glad Congress recognizes this and is trying to help engineer a solution. But the Dr. Lorna Breen Health Care Provider Protection Act is not it. This will only lead to more of the same. Health care workers don’t need snacks. We need real changes that address the root causes of mental distress and burnout.
Greg Jasani is an emergency medicine physician who lives in Baltimore, Md.
If you or someone you know is considering suicide, contact the National Suicide Prevention Lifeline at 1-800-273-8255 (Español: 1-888-628-9454; deaf and hard of hearing: 1-800-799-4889) or the Crisis Text Line by texting HOME to 741741.