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新冠疫情期间,医护人员的心理健康危机如何解决?

新冠疫情期间,医护人员的心理健康危机如何解决?

Jennifer Breen Feist, Corey Feist 2022-05-22
新冠疫情给医护人员带来了前所未有的压力,但如果他们为自己的心理健康问题寻求帮助,就依然面临被品头论足的风险。

图片来源:JEFFREY BASINGER—NEWSDAY/GETTY IMAGES

两年时间可能让很多事情发生变化。我们通常无法真正理解人生的真谛,直到我们不得不在身体和情感上应对一场改变一切的全球疫情。

对我们的家人而言,变化突如其来。2020年4月,美国纽约市一位优秀的急诊科医生洛娜·布林自杀身亡。她一直奋斗在抗击第一波新冠疫情的前线,夜以继日、争分夺秒地救治每天大量涌入的新冠肺炎患者。

洛娜医生没有精神病史,但不断增多的重症患者,以及严重不足的资源和人手,让她不堪重负。如今,有许多医护人员的遭遇可以证明,有很多人像她一样正在默默忍受着这些压力。

早在新冠疫情爆发之前,洛娜医生就对临床医师们的职业倦怠危机深有体会。早在去世的前几个月,她曾经参与发表过一篇论文,分析了缓解医生压力的必要性。但在她需要帮助的时候,却没有得到任何帮助。洛娜医生曾经告诉我们,她认为如果自己接受心理治疗,就可能面临失去行医执照或者被同事排斥的风险。她的不幸是一场本来能够避免的悲剧,引起了越来越多同行的共鸣。

今年3月,美国总统乔·拜登签署了《洛娜·布林医生医疗服务提供者保护法案》(Dr. Lorna Breen Healthcare Provider Protection Act),这是美国史上第一部旨在减少和防止医疗从业者自杀、倦怠以及心理与行为健康疾病的法案。

过去两年,家人们为痛失洛娜而悲伤不已,为了纪念她,我们成立了一个基金会,旨在保障像洛娜一样的医疗从业者的身心健康和职业满意度。我们希望,未来寻求心理健康治疗可以被普遍视为医疗从业者强大的标志,而不是弱点。

然而,真正理解医疗从业者的需求和打破医疗从业者接受心理治疗所面临的障碍,仍然有很长的路要走,这部法律的出台只是迈出了第一步。许多人与洛娜医生一样,不愿意接受急需的心理健康治疗,因为他们担心在工作场所遭到惩罚或排斥、失去行医执照,甚至失去工作。

目前,在美国的数十个州,医疗从业者在申请行医执照时都会被问到与心理健康有关的侵略性的问题。Medscape最近对13000名医生调查后发现,43%的医生表示由于“不想承担向医疗委员会披露自身精神状态的风险”而没有寻求帮助以缓解自身的职业倦怠或抑郁。

我们认为,这些州的行医执照申请经常提问与心理健康病史有关的侵略性问题,可能违反了《美国残疾人法案》(Americans with Disabilities Act)。最近的法院判决和美国司法部(U.S. Department of Justice)都得出了类似的结论。

《美国残疾人法案》当然适用于医院和医疗体系,因此医疗从业者为什么会经常遇到旨在进一步污名化心理健康问题甚至可能危害其就业的问题?各州医疗委员会和议员有能力改变这种状况。各州监管部门必须从行医执照发放和更新申请步骤着手,为医疗从业者寻求心理健康治疗扫清障碍,这是让临床医生们安心接受治疗的第一步。

为了保证医疗从业者的安全,医院往往会考虑提供防护装备,我们同样需要承认,身心健康同样重要。一名外科医生不会只戴着一只手套走进手术室。医疗从业者已经承受着过重的压力,还要面临人手不足的问题,为了保证他们能够继续为我们提供医疗保障,我们应该为他们提供所有必要的支持和工具。

一个广泛的联盟组织正在合作研究令人激动的新途径,使医疗从业者也可以获得系统性帮助。最近,国家地理(National Geographic)频道的纪录片《第一波》(The First Wave)备受欢迎。这部纪录片记录了新冠疫情初期的混乱以及公众、患者和医护从业者所展现的人性,用讲故事的方式激发了对于支持医护从业者身心健康的讨论,包括鼓励各州医疗委员会在行医执照申请中限制与心理健康有关的问题。

对于整个医疗体系和行业领导者而言,为了做出实质性的改变,“竭尽全力:医疗从业者身心健康优先”(ALL IN: WellBeing First for Healthcare)计划能够帮助培养工作者身心健康优先的职场文化,该计划提供的五个循证措施应该在每个医疗体系内执行,为保障员工身心健康提供支持。

我们的医疗保健从业者同样是人,他们正在利用现有的资源,竭尽全力应对这场史无前例的全球健康危机。

为了照顾好那些用心照料我们的医护人员,我们需要做出更多改变。随着我们开始理解疫情对心理健康的影响,尤其是对医疗从业者的影响,我们必须接受这个不断变化的新现实,继续为他们接受心理健康治疗扫清障碍。

我们希望明天更加美好,医疗从业者可以感受到他们得到了重视和支持,让他们重新找回治病救人的快乐。(财富中文网)

本文作者詹妮弗·布林·菲斯特(Jennifer Breen Feist)和J·科里·菲斯特(J. Corey Feist)是洛娜·布林医生英雄基金会(Dr. Lorna Breen Heroes’ Foundation)的联合创始人。

译者:刘进龙

审校:汪皓

两年时间可能让很多事情发生变化。我们通常无法真正理解人生的真谛,直到我们不得不在身体和情感上应对一场改变一切的全球疫情。

对我们的家人而言,变化突如其来。2020年4月,美国纽约市一位优秀的急诊科医生洛娜·布林自杀身亡。她一直奋斗在抗击第一波新冠疫情的前线,夜以继日、争分夺秒地救治每天大量涌入的新冠肺炎患者。

洛娜医生没有精神病史,但不断增多的重症患者,以及严重不足的资源和人手,让她不堪重负。如今,有许多医护人员的遭遇可以证明,有很多人像她一样正在默默忍受着这些压力。

早在新冠疫情爆发之前,洛娜医生就对临床医师们的职业倦怠危机深有体会。早在去世的前几个月,她曾经参与发表过一篇论文,分析了缓解医生压力的必要性。但在她需要帮助的时候,却没有得到任何帮助。洛娜医生曾经告诉我们,她认为如果自己接受心理治疗,就可能面临失去行医执照或者被同事排斥的风险。她的不幸是一场本来能够避免的悲剧,引起了越来越多同行的共鸣。

今年3月,美国总统乔·拜登签署了《洛娜·布林医生医疗服务提供者保护法案》(Dr. Lorna Breen Healthcare Provider Protection Act),这是美国史上第一部旨在减少和防止医疗从业者自杀、倦怠以及心理与行为健康疾病的法案。

过去两年,家人们为痛失洛娜而悲伤不已,为了纪念她,我们成立了一个基金会,旨在保障像洛娜一样的医疗从业者的身心健康和职业满意度。我们希望,未来寻求心理健康治疗可以被普遍视为医疗从业者强大的标志,而不是弱点。

然而,真正理解医疗从业者的需求和打破医疗从业者接受心理治疗所面临的障碍,仍然有很长的路要走,这部法律的出台只是迈出了第一步。许多人与洛娜医生一样,不愿意接受急需的心理健康治疗,因为他们担心在工作场所遭到惩罚或排斥、失去行医执照,甚至失去工作。

目前,在美国的数十个州,医疗从业者在申请行医执照时都会被问到与心理健康有关的侵略性的问题。Medscape最近对13000名医生调查后发现,43%的医生表示由于“不想承担向医疗委员会披露自身精神状态的风险”而没有寻求帮助以缓解自身的职业倦怠或抑郁。

我们认为,这些州的行医执照申请经常提问与心理健康病史有关的侵略性问题,可能违反了《美国残疾人法案》(Americans with Disabilities Act)。最近的法院判决和美国司法部(U.S. Department of Justice)都得出了类似的结论。

《美国残疾人法案》当然适用于医院和医疗体系,因此医疗从业者为什么会经常遇到旨在进一步污名化心理健康问题甚至可能危害其就业的问题?各州医疗委员会和议员有能力改变这种状况。各州监管部门必须从行医执照发放和更新申请步骤着手,为医疗从业者寻求心理健康治疗扫清障碍,这是让临床医生们安心接受治疗的第一步。

为了保证医疗从业者的安全,医院往往会考虑提供防护装备,我们同样需要承认,身心健康同样重要。一名外科医生不会只戴着一只手套走进手术室。医疗从业者已经承受着过重的压力,还要面临人手不足的问题,为了保证他们能够继续为我们提供医疗保障,我们应该为他们提供所有必要的支持和工具。

一个广泛的联盟组织正在合作研究令人激动的新途径,使医疗从业者也可以获得系统性帮助。最近,国家地理(National Geographic)频道的纪录片《第一波》(The First Wave)备受欢迎。这部纪录片记录了新冠疫情初期的混乱以及公众、患者和医护从业者所展现的人性,用讲故事的方式激发了对于支持医护从业者身心健康的讨论,包括鼓励各州医疗委员会在行医执照申请中限制与心理健康有关的问题。

对于整个医疗体系和行业领导者而言,为了做出实质性的改变,“竭尽全力:医疗从业者身心健康优先”(ALL IN: WellBeing First for Healthcare)计划能够帮助培养工作者身心健康优先的职场文化,该计划提供的五个循证措施应该在每个医疗体系内执行,为保障员工身心健康提供支持。

我们的医疗保健从业者同样是人,他们正在利用现有的资源,竭尽全力应对这场史无前例的全球健康危机。

为了照顾好那些用心照料我们的医护人员,我们需要做出更多改变。随着我们开始理解疫情对心理健康的影响,尤其是对医疗从业者的影响,我们必须接受这个不断变化的新现实,继续为他们接受心理健康治疗扫清障碍。

我们希望明天更加美好,医疗从业者可以感受到他们得到了重视和支持,让他们重新找回治病救人的快乐。(财富中文网)

本文作者詹妮弗·布林·菲斯特(Jennifer Breen Feist)和J·科里·菲斯特(J. Corey Feist)是洛娜·布林医生英雄基金会(Dr. Lorna Breen Heroes’ Foundation)的联合创始人。

译者:刘进龙

审校:汪皓

A lot can change in two years. These days it’s often impossible to fathom life before we had to contend–physically and emotionally–with a global pandemic that has changed everything.

For our family, that change came suddenly. In April 2020, Dr. Lorna Breen, an accomplished NYC emergency room physician working on the frontlines of the first wave of COVID-19, died by suicide after treating the daily deluge of coronavirus patients she faced minute after minute, shift after shift.

Lorna, who had no history of mental illness, had grown overwhelmed by the unending surge of severely ill patients, not to mention being severely under-resourced and understaffed to treat them. As so many healthcare professionals can attest to today, she was far from alone in silently enduring these stresses.

Lorna was fully aware of the burnout crisis among clinicians even before the pandemic. She co-authored a study on the necessity of reducing those stresses months before her death. But when Lorna needed help, she didn’t receive it. As she told us, Lorna thought she would risk losing her medical license or being ostracized by colleagues if she sought treatment. Her death was a preventable tragedy that is resonating with more and more of us with each passing day.

In March President Joe Biden signed the Dr. Lorna Breen Healthcare Provider Protection Act, a first-of-its-kind legislation that aims to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals.

Over the past two years, as our family has grieved the loss of Lorna and through the foundation, we’ve established in her honor, we’ve fought to safeguard the well-being and job satisfaction of healthcare professionals like Lorna. We envision a world where seeking mental health services is universally viewed as a sign of strength, not weakness, for healthcare professionals.

However, this law is only a first step in understanding and breaking down the barriers to care that healthcare professionals face. Like Lorna, many don't seek the mental health care they need for fear of retribution or exclusion in the workplace, loss of license, or even their job.

Currently, dozens of states have invasive questions regarding mental health on medical licensure applications. A recent Medscape survey of 13,000 physicians found that 43% said they had not sought help for burnout or depression because they “don’t want to risk disclosure to the medical board.”

We believe that these state medical license applications, as they often ask intrusive questions about mental health history, may violate the Americans with Disabilities Act (ADA). Recent court decisions and the U.S. Department of Justice have drawn similar conclusions.

The ADA clearly applies to hospitals and health systems, so why are healthcare workers often met with questions intended to stigmatize mental health further and potentially jeopardize their employment? State Medical Boards and legislators have the power to change this. Regulators at the state level must remove disincentives to mental health care on licensing and renewal applications as a first step to allowing clinicians to feel safe seeking care.

Just as hospitals consider the protective equipment medical professionals need to do their jobs safely, we have to recognize that well-being is equally critical. A surgeon wouldn’t head into the operating room with just one glove. We should provide all the support and tools needed to an already overburdened and understaffed healthcare workforce to ensure they can continue taking care of us.

A broad coalition of groups has been working together in new and exciting ways to make the system work for healthcare workers, too. The recent, acclaimed National Geographic documentary “The First Wave” captures the chaos and the humanity facing the public, patients, and healthcare providers during those early days of the pandemic and uses the power of storytelling to spark conversations about supporting the well-being of healthcare workers, including encouraging State Medical Boards to limit questions regarding mental health on licensure applications.

For health systems and leaders looking to make tangible change, the ALL IN: WellBeing First for Healthcare initiative helps cultivate workplace cultures that prioritize worker well-being, and provides five evidence-based actions every health system should be taking right now to support the well-being of their workforce.

Our healthcare workforce is made up of humans who, like us, are doing the best they can with the resources they have, all during an unprecedented global health crisis.

A lot more change is needed to ensure we take care of those who care for us. As we begin to comprehend the mental health impact of the pandemic—and especially the effects on the healthcare workforce—we must continue to remove barriers to care that reflect this new and evolving reality.

Let’s hope for a brighter day when health care workers feel valued and supported so they can recover the joy they once found in practicing medicine.

Jennifer Breen Feist and J. Corey Feist are the co-founders of the Dr. Lorna Breen Heroes’ Foundation.

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