Some people are vaguely aware of the story of Dr. Lorna Breen. Among physicians and frontline caregivers, she has become the face of health care workers overwhelmed by Covid-19.
We know her as a loving sister and sister-in-law. A dedicated emergency medicine physician. An avid snowboarder, salsa dancer, cello player, and the “cool aunt” to eight nieces and nephews. Despite the fact that there were a million reasons not to, she drove a convertible sports car in Manhattan because it made her happy. She was known for her cheery attitude and her dedication to improve the health care experience for patients.
Lorna cared for countless Covid-19 patients at New York-Presbyterian Allen Hospital before contracting the coronavirus herself. After recovering, she once again donned personal protective equipment and went back into the fray to help fight this plague. But as happened with so many frontline workers, the sea of patients and the overcrowded hospital began to take a toll on Lorna. As a healer, she was unable to heal. She became consumed with fear of the professional stigma of not being able to keep up in a pandemic and worried that she could not get support to address her deteriorating mental health without losing her medical license.
On April 26, 2020, she succumbed to suicide.
Many health care workers share her struggle with Covid-related mental health issues, ranging from anxiety and depression to post-traumatic stress disorder.
As the country starts to examine the pandemic’s long-term impact on mental health, once-whispered concerns that the health system must protect its workforce have grown louder.
In the U.S. Congress, a bipartisan group led by Senator Tim Kaine (D-Va.) and Rep. Susan Wild (D-Pa.) have answered the call to help by introducing the Dr. Lorna Breen Health Care Provider Protection Act. This first-of-its-kind legislation aims to prevent suicide and burnout among health care professionals and mitigate their mental and behavioral health conditions. It also contains a provision for a comprehensive study aimed at understanding the factors contributing to burnout and the mental health conditions of health care professionals and barriers for their access to care, including stigma and concerns about licensing and credentialing.
The federal Health Resources and Services Administration has begun to award grants for health care provider mental health support in the $1.9 trillion Covid-19 relief package known as the American Rescue Plan Act. But the Dr. Lorna Breen Act still needs to be passed to ensure ongoing support for the health care workforce long after the pandemic is over.
Even before Covid-19 hit, physicians had the highest death rate by suicide of any profession in the country. Now, nearly 60% report experiencing burnout, a surge that suggests worrisome trends for health care workers. A recent poll from the American College of Emergency Physicians found that 73% of emergency physicians said they were concerned about stigma if they sought mental health support, and 57% reported they would be concerned about losing their jobs if they sought mental health treatment. Like Lorna, many physicians are worried that seeking support will lead to the perception that they are unfit to care for patients. Physicians say they are anxious about reporting requirements on job applications or medical licensing applications/renewals in certain states. Despite being a violation of the Americans With Disabilities Act, some state medical license applications ask broad questions about mental health history.
If passed, the Dr. Lorna Breen Act will provide a roadmap for the $140 million allocated in the America Rescue Plan to train health care professionals in strategies to address suicide, burnout, and mental and behavioral health conditions. It also provides grants and directs the Centers for Disease Control and Prevention to carry out an awareness campaign to encourage health care professionals and first responders to seek mental health support.
Most importantly, the legislation establishes ongoing support to identify and disseminate evidence-informed best practices to reduce and prevent suicide, burnout, and mental and behavioral health conditions among health care professionals long after the pandemic has faded away. Hospitals and clinics will need this guidance to boost mental health support for their workers.
The act also examines whether questions about mental health in physician recertification processes are a disincentive to seeking help.
The Senate Health, Education, Labor, and Pension Committee is set to consider the Dr. Lorna Breen Act. The legislation, which is supported by more than 70 leading medical societies and mental health advocacy groups, needs to be taken up by Congressional committees of jurisdiction as soon as possible. Passing the act would make history: the first legislation of its kind to address the mental health of our nation’s health workforce.
The U.S. needs a health system that does not leave its frontline caregivers unprotected and unsupported. We call on Congress to honor health care workers by advancing the Dr. Lorna Breen Health Care Provider Protection Act and making a down payment on addressing this growing crisis.
Jennifer Breen Feist is a Virginia-based attorney. Corey Feist is the chief executive officer of the University of Virginia Physicians Group. They are the cofounders of the Dr. Lorna Breen Heroes’ Foundation.
Listen to Corey Feist talk more about physician mental health in an episode of the “First Opinion Podcast.”