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Healthcare Heroes Need Healing Too

Before the COVID-19 pandemic, many medical workers already struggled with mental health crises. Now more than ever, its time to make mental health and self-care a priority.

WHAT IS A HERO?

In mythology and folklore, it is a person of superhuman qualities and often semi-divine origin. We hear the word "hero" a lot these days, typically about front-line health care workers: doctors, nurses and emergency medics who bravely show up every day to fight the novel coronavirus, often at great peril to both their and their family's health. For too many of them, however, the greatest threat posed by COVID-19 is to their mental well-being.

Nightly applause, online discounts, promotional tchotchkes and an ice cream truck in front of the hospital scooping complimentary sweets are nice things to receive, but they do not address the immense pressures that medical workers face during this pandemic. Many are treating sick and dying patients at an unsustainable rate in apocalyptic scenarios.

Before the COVID-19 pandemic, many medical workers already struggled with mental health crises. More than half of U.S. physicians suffered from work-related burnout or depression, with acute care specialties such as emergency medicine being among the hardest hit. A combined third of U.S. nurses reported feeling unengaged or burned out at work, and emergency medical services workers developed post-traumatic stress disorder at up to nearly double the rate of the rest of the population. It's estimated that every year, 300 to 400 physicians die by suicide, a number equal to a doctor a day.

The circumstances and unprecedented demands of the pandemic on front-line medical workers have amplified existing mental distress. I am a physician at Elmhurst Hospital Center in Queens, New York. During the most challenging weeks, my colleague rescued a patient from dying in the corner of a crowded emergency department only to find out days later that the patient fell through the cracks of an overwhelmed system and didn't survive. The same colleague took extra evening shifts to don full personal protective equipment and hold an iPad in front of patients so they could see their families, get affairs in order and say goodbye.

Research on health care workers caring for patients with COVID-19 shows alarming rates of depression, anxiety, burnout and insomnia. Stigma is what prevents us from asking for help.

The culture of medicine dictates that doctors suppress any emotions that don't match the stoic and unflappable image we are taught by example to maintain. As a result, many physicians do not seek professional help for mental health issues. In addition to the stigma, doctors, nurses and emergency medics fear career repercussions for seeking mental health counseling. Repercussions can range from being considered weak by colleagues to hiring discrimination and loss of their medical or nursing license based on state board questions about mental illness.

This fear around seeking mental health treatment causes some to drive hours to see a therapist outside their state, pay in cash and use a fake name to avoid a paper trail. The fear causes many to hide the very thing that makes us human.'

The stresses of the pandemic have led to tragic consequences, including the recent deaths by suicide of front-line workers Dr. Lorna Breen and EMT John Mondello. Ironically, Breen published a paper last year exploring whether emergency department team care could decrease clinician burnout. Following her death, a flood of health care workers shared their personal stories of mental health on social media, seeking to normalize the issue and fight the stigma of asking for help.

Those on the medical front lines should not have to ask for help in the first place. Under normal conditions, they endure a psychological toll. With COVID-19, their daily responsibility for the lives and deaths of others has intensified and led to hopelessness and psychological trauma. Their need for psychological support should be obvious. In fact, "help" should be mandatory.

If doctors and nurses fighting the COVID-19 pandemic were required to have at least one hour of counseling with a therapist every two weeks, they would be better equipped to serve the public and preserve their careers and mental health.

Public health officials and hospital administrators should take the initiative now to assign a mental health provider to every single front-line worker whether they want one or not. We know that many who need help will not ask for it. But if mental health care were mandated for everyone, the stigma would lose its power and mental health assistance would be part of a health care worker's normal professional process.

Undoubtedly, some medical professionals would reject being required to receive mental health support, confident in their ability to handle the stress. But instead of relying on a worker's resilience and ability to bounce back from the stress on their own, we should address the issues that keep them from seeking mental health support in the first place. One way is to normalize it by requiring it for everyone.

In ancient mythologies and Hollywood films, a hero always receives help for their journey. This can come in the form of supernatural items such as Black Panther's vibranium suit, Wonder Woman's bracelet and lasso, and Thor's hammer. When the hero is an ordinary person, they receive a set of allies, as Frodo did before setting out on his journey to Mordor, and a mentor, like Obi-Wan Kenobi, who guided Luke Skywalker on how to use the Force. These support systems enable heroism.

Front-line health care workers are heroes in the truest sense of the word. They are brave and strong during times of fear. They overcome obstacles thrown in their path and put the well-being of their patients before their own. The least we can do is provide support through mental health care that will help them journey through this current crisis and beyond.

Original article by usnews.com.

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