Pandemic Exacts High Toll On Emergency Physicians' Mental Health, Few Ask For Help

The COVID-19 pandemic is taking a huge toll on the mental health of emergency medicine physicians in the United States and many are reluctant to seek help, citing workplace stigma and fear of professional repercussions, according to a new poll.

"Mental health challenges have long persisted in emergency medicine. Our job is hard, even before the pandemic," Dr. Mark Rosenberg, president of the American College of Emergency Physicians (ACEP), said during a press briefing October 26 as part of the ACEP 2020 annual meeting.

"Working in the front lines over the past six months dealing with COVID really increased the crisis. This was not business as usual," Dr. Rosenberg said. "Despite the growing toll that serving on the frontlines is having on emergency physicians, many feel they can't seek the mental health treatment they desperately need."

The poll, a joint effort by the ACEP and Morning Consult, was conducted between October 7-13, 2020 among a national sample of 862 emergency physicians across the country.

Almost 9 in 10 (87%) reported feeling more stressed since the start of the pandemic and 72% reported experiencing more professional burnout.

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Nearly half (45%) of emergency physicians surveyed said they are not comfortable seeking mental health services as needed; male emergency physicians are slightly more uncomfortable seeking mental health treatment than female physicians and those in rural communities report the highest intensity of feeling uncomfortable seeking treatment.

While 71% of emergency physicians rated their ability to access mental health treatment as good or excellent, 73% cited stigma in the workplace as a barrier to seeking help; 57% said they would be concerned about their job if they did seek mental health treatment and more than one quarter (27%) have avoided seeking help in fear of professional repercussions.

More than 80% cited concern for their own health and safety, and the safety of their family and friends, around contracting COVID-19.

Dr. Rosenberg said the numbers from the poll "underscore what we've known on the ground and we've heard from our members. We're glad to have these numbers reinforce our advocacy efforts. The pandemic emphatically underscores our need to change the status quo when it comes to physicians' mental health."

The pandemic is "shining a light on the courage and dedication of our frontline health workers. But we all know, and these statistics confirm, that beneath the surface, these heroes are suffering," Jennifer Breen Feist, sister of Dr. Lorna Breen, a New York City emergency physician who died by suicide in April amid the pandemic, said at the ACEP briefing.

"For the first 49 years and six months of her life, Lorna showed no signs of depression or anxiety," Feist shared. But that changed after COVID hit.

Feist said her sister treated patients with COVID-19 around the clock in New York until she contracted the virus herself. "Lorna was always tough, always smart, very active, always wanted to be an emergency physician in Manhattan. When she was sick, all she could think about was getting back to work. In fact, when she was home, she was too weak to mostly get out of bed. What she was on the phone the whole time, attending meetings virtually, checking on her colleagues," Feist said.

"(We) kept telling her about the airplane analogy - make sure you put the oxygen mask over your mouth before you take care of others - but my sister was just too focused on saving as many people as she could," Feist said.

"With patients overflowing in the hallways, not enough PPE at the time, and minimal supplies, my sister rose to meet the challenges of COVID-19. And we believe that this ultimately cost her her life," she shared. "What we do know is that when she finally did seek mental health treatment, she was so concerned about how she would be perceived; that was her main focus and we believe ultimately was her downfall," said Feist.

In honor of her sister, the family created the Dr. Lorna Breen Heroes' Foundation, which aims to reduce burnout among healthcare professionals and safeguard their well-being and job satisfaction.

"We envision a world where seeking mental health services is universally viewed as a sign of strength for health care professionals," according to a statement on the foundation's website. (https://drlornabreen.org/)

—Megan Brooks

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