“I just believe that we need to take good care of our health care workers, so that they can take good care of other people.”
— Isobel R., NYC, NY / Psychiatry Resident
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Help end stigma and prioritize mental health for frontline health care workers
Frontline health care workers, including health care providers and first responders, face mental health challenges while caring for others. Whether it’s called “burnout,” “moral injury” “compassion fatigue” or any other name, the experience of distress among physicians, other health care providers and first responders is increasingly common.
This doesn’t only interfere with their well-being, but it also affects the quality of care they provide, and everyone loses with burnout — the individual, staff, patients and community.
Factors that impact the well-being of health care professionals
Work inefficiencies and burdens
Much of what drives distress has nothing to do with personal resilience but rather with things such as inefficient documentation systems and requirements, rapid changes in health care that too often do not involve frontline staff and staffing schedules that fail to recognize predictable absences. All of these factors can be major contributors to erosion of well-being in health care.
Cultural factors that de-prioritize well-being
Misaligned values, expectation of superhuman performance and fear of sharing struggles related to licensure, employment or reputational concerns. All of these aspects of the culture of health care can impact well-being.
Factors related to the nature of medical care
- Moral injury — Feeling powerless to help related to limitations outside of your control.
- Second victim effects — Errors that cause harm and unexpected complications not only impact patients; they can have long-lasting effects on health care workers.
- Compassion fatigue — Giving more compassion than receiving leaves many feeling drained. You can’t pour from an empty cup.
- General fatigue — Long hours worked; low staffing; being on call; working evenings, nights and weekends; lack of sleep; or disruptions in sleep all play a role.
Personal resilience
Like everyone, health care professionals need to use self-care and effective coping strategies to manage the high stress of this work.
And it’s not just burnout
These same factors injure mental and emotional health, too. They increase the risk for mental health conditions, like anxiety, depression, PTSD, substance use disorders and more.
In a survey of 1,100 health care works in 2020:
93%
report high stress
86%
report anxiety
76%
report exhaustion
41%
report loneliness
The conspiracy of silence
The most dangerous word when it comes to mental health is silence. All too often suffering in silence can be related to pride, expectations, responsibilities and stigma. For many frontline workers, they may also worry about their reputation or their career if they disclose their mental health condition or struggles. It’s important to address that talking about mental health struggles is NOT a sign of weakness. We can all help normalize speaking up.
Consequences of suffering in silence
- Over half (52%) of nurses have considered leaving clinical practice.
- Burnout related registered nurse turnover costs $9 billion per year.
- Physician burnout increases medical errors by 2.22 times.
- Of 13,000 physicians across 29 specialties:
- 1 in 10 considered or attempted suicide in 2021.
- More than 1/3 never discussed thoughts of suicide with anyone.
Supporting frontline worker’s mental health benefits everyone
By addressing stigma, providing resources and fostering a culture of care, we can help frontline heroes continue their vital work while maintaining their well-being.
Ways to help end stigma and burnout by prioritizing mental health for frontline workers:
Organizational level
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Raise awareness about the mental health toll on frontline workers. Launch a Make It OK campaign in your workplace.
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Foster organizational-wide change: Create the cultures and practices that prioritize mental health, normalize talking about it, reduce burnout and promote well-being. Learn more.
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Improve work efficiencies: Improve electronic medical record systems to maximize time with patients and minimize screen time.
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Involve frontline staff in improving their work: Not only does this often produce better outcomes, it can reduce burnout.
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Increase understanding of symptoms and connect to mental health benefits and resources for care and support: Provide training and resources for frontline workers to recognize signs of burnout and compassion fatigue. Signs of burnout can include disengagement, withdrawal, doubt, fatigue, missing work, being quick to anger and more.
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Implement peer support: Establish peer support groups or check-ins where colleagues can share experiences and coping strategies.
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Give recognition: Publicly acknowledge the value and hard work of frontline professionals. Positive reinforcement can boost morale and help reduce stigma.
Individual
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Normalize self-care: Self-care isn’t selfish. It’s “putting on your own oxygen mask first” so you have more to give to your patients, colleagues, community, family and friends. Find Tools to Thrive
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Check in with one another: Ask your team members “How are you doing?” and actively listen. Leaders, be open about your own mental health. When staff see leaders openly having these conversations it helps them feel more comfortable talking about it themselves and with their patients or family. It Makes It OK to talk about it and ask for support.
Keep Learning, Talking and Sharing
Learn:
Advance well-being in your organization.
Assess:
Assess your level of burnout and professional fulfillment. Take a self-assessment.
>Listen:
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Belonging, Burnout and the Importance of Well-Being. Listen now: Off the Charts: Examining the Health Equity Emergency
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Examining the Health Equity Emergency: Reducing Stigma in Mental Health.
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>Health Care Disparities Among Black, Indigenous and People of Color