Synopsis: Due to a combined lack of crisis preparation by a hospital administration, a “suck it up” culture among hospital medical staff, when a time of relentless exposure to trauma provoked a mental health crisis for an emergency physician, her fear of being stigmatized ended in suicide. Since then, a movement has evolved to remove systemic and discriminating barriers to mental health help-seeking among healthcare workers and to create healthcare workplace environments that promote a holistic approach to well-being.
Dr. Lorna Breen had always dreamed of being an emergency room physician in New York City, and had dedicated her life to that goal. In 2011, Lorna was made head of the emergency department at New York-Presbyterian Allen Hospital in Upper Manhattan, where her colleagues knew her to be passionate about patient care, and constantly seeking ways to improve the patient experience. She was also known for her infectious optimism and clear-sighted problem-solving capacity.
Lorna died by suicide on April 26, 2020.
In the weeks leading up to her death, Lorna is reported to have worked a stretch of back-to-back 12 and 15-hour shifts treating an onslaught of COVID-19 patients, before contracting the virus herself. When she returned to work, still exhausted and unwell, she was given oversight of a second emergency department at a hospital five miles further south and had to learn a new EHR system that had barely launched by the time COVID-19 hit. Many of the records entered by her overwhelmed staff and colleagues, she found, were incorrect; she spent hours correcting them. Lorna’s father eulogized her saying she was devastated by the number of people “she could not save.”
Further, she and her colleagues were ill-equipped for the sudden chaos COVID-19 had created. They had inadequate personal protective equipment, insufficient medical supplies, and an unrelenting influx of critically ill patients who often died in the ambulance or in hospital hallways before they could be properly admitted.
On April 9, 2020, Lorna called her sister, Jennifer. She hadn't slept in over a week and was, she told Jennifer, unable to get up out of her chair. Jennifer has since recounted that Lorna’s voice was different, distant, and detached, as though Lorna were in shock. Jennifer arranged to bring Lorna to the family home in Virginia where she was admitted to a psychiatric facility.
Jennifer and others also recounted later to the New York Times that Lorna could not shake the sense that she had suffered a “shameful fall from grace” at a time when her city and her staff needed her most. “She was certain her career would not survive it,” the Times reported.
Despite her family’s protestations to this, saying that she had no history of mental health issues and that the circumstances were extraordinary and harsh for everyone, Lorna insisted she had failed. She told her sister she was “embarrassed” she’d had a breakdown. “Everyone knows I’m struggling,” she told her sister, sure that her career would not survive the cultural prejudice about mental health that existed in the medical community.
Many state medical licensing boards and hospitals require disclosure of mental health care, and while revocation of a physician’s license is illegal under the Americans with Disabilities Act, many physicians who have disclosed their mental health concerns have faced subsequent investigations.
Lorna stayed in the inpatient psychiatric facility for 11 days. She took her own life shortly after being discharged. Despite her not having had mental health concerns before her death, Lorna’s life did present her with one significant risk factor: being a physician. It was only after her passing that Lorna’s family learned about the high suicide rates among physicians, particularly female and emergency medicine doctors.
While this tragic outcome happened in 2020, during a great upheaval in our healthcare system, many of the struggles of shame, unbearable systems, and fear of discrimination remain the same.
By the Numbers:
86% of healthcare workers report experiencing anxiety.
76% reported exhaustion and burnout, leading to high turnover rates.
In 2022, 44% of the healthcare workforce indicated an intention to leave their jobs.
Only 13% of frontline healthcare workers have received behavioral health services.
The risk of patient mortality increases in settings with high nurse burnout.
Male doctors have suicide rates up to 40% higher than the general population, while female doctors have rates up to 130% higher.
Compared to non-healthcare workers, registered nurses, health technicians, and healthcare support workers in the US are at an increased risk of suicide.
The Lorna Breen Heroes Foundation has issued a call to action for systemic change in the healthcare industry to address the significant mental health challenges faced by healthcare workers. foundation emphasizes the need for continued and increased funding for the Dr. Lorna Breen Health Care Provider Protection Act, which aims to provide mental health resources and support for medical professionals.
Key actions promoted by the foundation include:
Addressing Licensing and Credentialing Issues: The foundation advocates for removing intrusive mental health questions from medical licensing applications, which currently deter healthcare workers from seeking help due to fear of professional repercussions.
Implementing Well-Being Solutions: The foundation calls for the adoption of evidence-informed strategies to reduce burnout and improve the well-being of healthcare workers. This includes training and educational programs tailored to the unique challenges faced by medical professionals.
Raising Awareness and Reducing Stigma: A critical aspect of the foundation’s mission is to change the culture around mental health in healthcare, promoting it as a sign of strength rather than a weakness.
By addressing these areas, the foundation aims to create a more supportive environment for healthcare workers, ultimately leading to better patient care and a more sustainable healthcare system.
We support this effort and also seek ways to create and sustain a cultural shift away from systemic barriers and discriminating practices that prevent healthcare workers from seeking mental health support.
Next week, we will examine the root causes of the systemic barriers to mental health help-seeking among medical personnel.
(2020, July 11). ‘I Couldn’t Do Anything’: The Virus and an E.R. Doctor’s Suicide Dr. Lorna Breen was unflappable — Until she faced a new enemy. The New York Times. https://www.nytimes.com/2020/07/11/nyregion/lorna-breen-suicide-coronavirus.html?unlocked_article_code=1.2k0.r0z2.7uDQP7KNDhrJ&smid=url-share
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