June 8, 2023

NIOSH: "Organizational-Level Change" Needed for Well-Being of Healthcare Workers

On May 18, NIOSH Director John Howard, MD, called for action against organizational barriers to healthcare workers’ ability to seek mental health care in a statement issued jointly with J. Corey Feist, JD, MBA, the co-founder and president of the Dr. Lorna Breen Heroes’ Foundation. In their statement, Howard and Feist urge the healthcare profession to take its efforts “beyond encouraging self-care and personal resilience to recognizing the importance of organizational-level change and supporting hospitals as they adjust and create systems that sustain worker well-being.” The Dr. Lorna Breen Heroes’ Foundation is a nonprofit organization dedicated to reducing burnout among healthcare workers and improving their well-being.

The mental health and well-being of healthcare workers has been a concern throughout the COVID-19 pandemic. The U.S. surgeon general issued an advisory for healthcare worker burnout in June 2022. The new joint statement from Howard and Feist stresses that many healthcare workers fear that seeking mental health care may cost them their jobs due to “overly broad and invasive mental health questions that are stigmatizing and discriminatory” in applications for credentials and other documentation. These questions are often added “in good intent,” the statement acknowledges, but “there is no data demonstrating that these questions protect the public.”

The joint statement supports other recent NIOSH actions related to healthcare workers’ well-being. On a new webpage dedicated to the topic, NIOSH shares three steps, developed by the foundation, that hospital administrators can follow to support healthcare workers in seeking care they may need. Hospital staff are advised first to audit all credentialing applications and paperwork, then to change any “invasive or stigmatizing” language related to mental health, and finally to communicate these changes to workers and assure them that they may safely seek care.

A recent NIOSH fact sheet titled Healthcare Worker Wellbeing: Making the System Work for Healthcare Workers (PDF) further explains the need to remove invasive questions from healthcare credentialing as well as the agency’s future actions on the topic. According to the fact sheet and topic webpage, NIOSH will soon launch a national campaign to help healthcare leaders establish quantifiable measures of well-being and implement systemic changes.

The Dr. Lorna Breen Heroes’ Foundation is named for Feist’s late sister-in-law, who worked as an emergency room physician during the peak of the COVID-19 pandemic in New York City. In April 2020, Breen confided to a family member that she had become exhausted and despondent but was afraid that seeking mental health care would negatively affect her career. She died by suicide on April 26, 2020.

The foundation has created a toolkit for removing intrusive mental health questions from credentialing applications (PDF), which includes the three steps outlined above. More information is available on the foundation’s website.

Related: Read “Mental Health in the Workplace: Tips for Supporting Workers’ Mental Well-Being” in The Synergist.