Stigma is ‘common thread’ among clinician suicides

Key takeaways:

• Questions about prior mental health on licensing and credentialing applications may prevent HCPs from seeking care.
• The Dr. Lorna Breen Heroes’ Foundation offers free resources to improve clinician well-being.

Health care professionals are more likely to experience mental health issues than other workers in the United States, but the stigma they face often deters them from seeking treatment, leading to tragic outcomes, a speaker said.

At the Ending Clinician Burnout Global Summit, J. Corey Feist, JD, MBA, CEO and co-founder of the Dr. Lorna Breen Heroes’ Foundation, discussed how health care leaders can address this stigma and remove barriers to mental health care for their employees.

The Dr. Lorna Breen Heroes’ Foundation is named after Lorna Breen, MD, FAEP, a New York-Presbyterian Allen Hospital clinician who took her own life in April 2020.

Breen died days after being discharged for her first and only inpatient admission for mental health. Before her death, she had expressed “deep concerns” of the stigma surrounding her treatment and how it could negatively affect her medical license and credentials, according to Feist, who is married to Breen’s sister.

Feist said that Breen represents many other health care professionals (HCPs) who “hide their mental health needs.”

“The common thread between all of these stories is this incredible stigma against help seeking. It really prevents people from getting help when they need it,” Feist said. “We should not be losing health care professionals to suicide because of things that we can control.”

There are at least six instances where HCPs disclose prior mental health treatment, representing barriers to care, Feist said. They include:

• licensing for state and specialty boards;
• hospital credentials;
• malpractice insurance applications;
• commercial insurance applications;
• malpractice cases; and
• health plans, as some health systems require employees to receive care at their facilities.

The Dr. Lorna Breen Heroes’ Foundation developed a “Caring for Caregivers” model that helps health systems improve their policies for normalizing health care seeking, Feist said. The model draws from the “Impact Wellbeing Guide,” which was developed through a partnership with the foundation and the CDC and National Institute for Occupational Safety and Health.

There are three main components of the Caring for Caregivers model:

1. take action by assembling an interdisciplinary well-being team and having members participate in an on-demand course to determine what changes are needed to improve well-being;
2. remove barriers to care by eliminating questions on prior mental health in credentialing applications; and
3. integrate well-being techniques into the health system’s infrastructure.

The Dr. Lorna Breen Heroes’ Foundation offers a free toolkit to help health care organizations remove “intrusive mental health questions” on their credentialing applications, Feist said.

Within 1 year of introducing the Caring for Caregivers model in Virgina, Feist said the foundation awarded 75% of hospitals in the state with a “Well-being First Champion Badge” for updating their credentialing applications. The foundation also worked with legislatures to pass a law in Virgina that removed prior mental health questions on the state’s medical license applications.

The impact of the Dr. Lorna Breen Heroes’ Foundation has since expanded nationwide. To date, 29 state medical boards and 19 health systems have updated their licensing and credentialing applications, Feist said.

The foundation’s toolkit and other resources are funded through the Dr. Lorna Breen Health Care Provider Protection Act, which is set to expire soon. Feist said the foundation is pushing to reauthorize the law for another 5 years. Those who are interested in advocating for an extension to Congress can submit their request here.

Aside from the foundation’s resources, Feist highlighted other available tools, including the American Foundation for Suicide Prevention’s online interactive screening program that can help health systems identify HCPs who are at risk for suicide.

Anyone who is in a mental health crisis can contact the 988 Suicide & Crisis Lifeline by texting or calling 988 or reaching out online at 988lifeline.org.

“If you take nothing else from this talk, please write down 988 and share it with someone today,” Feist said.

References:

• All in: Caring for Caregivers. https://drlornabreen.org/caring-for-caregivers/. Accessed Aug. 26, 2024.
• Impact Wellbeing Guide. https://www.cdc.gov/niosh/docs/2024-109/pdfs/2024-109revised072024.pdf?id=10.26616/NIOSHPUB2024109. Published July 2024. Accessed Aug. 26, 2024.
• Online interactive screening program. https://afsp.org/interactive-screening-program/. Accessed Aug. 26, 2024.
• Remove intrusive mental health questions from licensure and credentialing applications. https://drlornabreen.org/removebarriers/. Accessed Aug. 26, 2024.
• Support the reauthorization of the Lorna Breen Act. https://drlornabreen.org/reauthorizelba/. Accessed Aug. 26, 2024.