It’s been one year since COVID-19 applied its cement-like grip on our country. From the beginning, Congress has rightfully extolled the courageous deeds of our brave nurses, doctors, emergency medical technicians, and so many others on the front line of this battle against this horrible pandemic. And we think every American agrees with our elected officials: Our medical personnel deserve the recognition and respect of our entire nation for the sacrifices they have made in caring for the five million-plus Americans who have been afflicted with this virus.
But they deserve so much more than just words and small tokens of gratitude. Action is better.
The record to date in this regard, though, is less than impressive. Despite a sky-high surge among these heroes of mental health issues — from burnout, anxiety and PTSD to substance abuse, depression, and suicide — Congress has yet to pass the Dr. Lorna Breen Health Care Provider Protection Act.
The bill — named for the Charlottesville native and New York physician who took her own life last April after working around the clock treating COVID patients and seeing far too many die from the disease — represents the absolute minimum we must do for those bearing the brunt of the battle. It provides funding for mental and behavioral health awareness and treatment for frontline workers in an attempt to lessen the psychological toll COVID has wrought on them.
The fact is that these valiant men and women are at war against an insidious adversary, and they are coming home with deep-seated emotional scars. Vaccines and other public health measures such as masks and social distancing can protect only against the physiological aspects of COVID-19. But the psychological impact may prove more costly and damaging over the long term.
Consider that a study conducted in December by the American Nurses Association found that nearly 75% of nurses reported feeling exhausted over the previous two weeks; another survey found that 69% of nurses said they put patient health and safety before their own, while only 31% said they felt their employers cared about their mental health. Such findings should give us pause, but they are not even the most alarming problem. In the first national study of its size, researchers at the University of California-San Diego confirmed that nurses are at a significantly higher risk of suicide than the average individual, while other research has shown that physicians die by suicide at a higher rate — about 1.5 times — than the general population.
Exacerbating matters is that medical professionals, and particularly physicians, may turn to self-medication to manage their mental health problems. This includes excessive alcohol consumption and opioid usage. It is estimated that 10%-15% of all medical professionals in the United States will misuse drugs or alcohol at some point during their career. Medical professionals are more likely to abuse prescription medications.
So the Breen Act is not only necessary, but the absolute right first step to help them cope and continue to save lives, including their own.
Until it is fully implemented, though, we need to take immediate action. Having worked with populations prone to post-traumatic stress disorder, such as veterans, mass shooting survivors and 9/11 first responders, we know that if not identified early and treated comprehensively, the mental health challenges our medical professionals are facing will become chronic, life altering, and deadly.
We know, for example, that long-term outcomes are improved with the help of community connections and ongoing access to mental health support. And we know that each of us can also make a difference. Asking our friends, neighbors and peers who are on the front lines direct questions about difficult thoughts and feelings gives us all permission to be human and heal from the stress and trauma of this pandemic together.
Resources such as the Columbia Protocol, a simple suicide prevention tool that anyone can use, are already at our fingertips, and with even wider implementation we can support the healthcare communities before they are in crisis. Of paramount importance, we must also marshal the expertise of the Veterans Administration, as it might have a unique expertise in dealing with PTSD and grief.
Our country — and especially our government — has a collective responsibility to ensure mental health care as part of “business as usual” for front-line health-care workers. Passage of the Breen Act will show Congress takes this responsibility seriously.
Dr. Kelly Posner Gerstenhaber, recipient of the 2018 Secretary of Defense Medal for Exceptional Public Service, is founder and director of the Columbia Lighthouse Project, a national suicide prevention initiative, and clinical professor of child and adolescent psychiatry at Columbia University’s Vagelos College of Physicians and Surgeons.
Dr. Keita Franklin, a Stafford resident and the mother of a front-line nurse, is former director of suicide prevention at the Department of Defense and Veterans Administration and now co-director of the Columbia Lighthouse Project and chief clinical officer for Loyal Source.
Follow them on Twitter at @PosnerKelly and @keitafranklin4, respectively.
Pulse on the Nation’s Nurses COVID-19 Survey Series: Mental Health and Wellness; nursingworld.org
“Suicide among physicians and health-care workers: A systematic review and meta-analysis”; journals.plos.org