Commentary: Healthcare workers keep going because we have to, but we don’t have to do it alone

Doctors undergo rigorous training to ensure we have the mental and physical stamina required for whatever challenges come our way. Many of us develop the endurance to carry out the Hippocratic Oath during the most trying times, with the understanding that our work will be demanding. Yet while our job is to care for others, we have traditionally been discouraged from speaking openly about our own mental health.

The COVID-19 pandemic shined a spotlight on this, illuminating problems like staffing shortages and burnout rates. In one study, 66% of nurses said they were considering leaving the healthcare profession altogether.

We are in a much better place than we were during the height of the pandemic, but the issues it laid bare have not been eliminated. Healthcare workers’ mental health continues to suffer. As healthcare leaders, we must continue to show them that they are not alone and provide the support they deserve.

I have spoken with countless nurses, doctors and advanced practice providers who are struggling with their mental health but refuse professional help—not because of pride, but fear of what disclosure could do to their careers. This fear is reasonable: Nearly 70% of states still ask about mental health history on licensure applications for physicians.

I am not the first to decry this problem. Last year, Jennifer and Corey Feist outlined the structural barriers that prevent healthcare workers from seeking help in an opinion piece after their sister and sister-in-law, NewYork-Presbyterian’s Dr. Lorna Breen, took her own life. I applaud the doctors and health systems that have responded to this systemic issue. Dr. Peter Bolo at Atlantic Health System, for example, has pivoted from his patient-care work to providing staff care, serving as a “resiliency advocate” to ensure the healthcare workers at his organization receive the support they need.

Ultimately, however, the current system still reinforces the idea that doctors and nurses need to be superhuman, leading better, healthier lives than the patients we provide care to. But we are only human. We also need help when we fall down.

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What drew me to workforce well-being was attending my medical school reunion nine years ago and learning that two of my colleagues had ended their own lives. Sadly, I know many others have a similar story.

Telling these stories is critical, but it can’t be the sole responsibility of healthcare workers to start these difficult conversations. Medicine often attracts people who are full of self-doubt and feel guilty about prioritizing self-care. Therefore, those at the top must lead by example. Instead of shaming doctors through licensing and credentialing questions about mental health, leaders must encourage conversation. Leaders must do more to acknowledge the problem.

I have tried to lead by example. In August 2020, I noticed I was languishing; it’s the month my son Bennett was born and around the time he passed away due to a brain tumor. That time of year is always difficult, but 2020 felt worse—for all the obvious reasons. I decided to seek help, and it made all the difference.

When it came time to send out our office’s quarterly report later, I shared that story. Not for sympathy, but because I knew I was not the only one. I wanted the other healthcare workers reading my note to know they were not the only ones either. As healthcare workers, we keep going because we have to, but we do not have to do it alone.

Countless people replied to my email. They said they finally felt safe to share their own stories, that they were going to seek help. The encouragement from a leader made a tangible difference.

These discussions are how change is made. I believe we are heading in the right direction as more healthcare workers speak out. But internal conversations are just as important as external ones.

To change the culture within healthcare systems, more conversations must take place there—between doctor and doctor, hospital CEO and entry-level healthcare worker, and everyone in between. Those at the top have a responsibility to begin these conversations and foster them to ensure they continue.

In my role leading the Office of Professional Well-Being at Ochsner Health, we’ve made immense progress to change our health system for the better. I hope leaders at other health systems strive for the same. By encouraging conversations and sharing resources, we can fundamentally change outcomes for medical professionals around the world. Silence has been the status quo; we must work together to change that.