Photo by Miguel A. Amutio | Unsplash
Nicole Lurie, MD, MSPH, is an expert on the aftermath of catastrophic events. While she was Assistant Secretary for Preparedness and Response at the US Department of Health and Human Services, she studied the Deepwater Horizon oil spill in the Gulf of Mexico, Hurricane Katrina in Louisiana and Mississippi, the Exxon Valdez oil spill in Alaska, and other disasters.
What she learned should be a wake-up call for health care organizations amid the COVID-19 pandemic. “Every major disaster,” she says, “is accompanied by a huge behavioral health crisis.”
Both Lurie — who is now a consultant to the Coalition for Epidemic Preparedness Innovations — and Tyler Norris, MDiv, Chief Executive of Well Being Trust, agree that as COVID-19 places substantial demands on an already overstretched health care workforce, health systems must prepare for the mental health consequences of this global crisis. Lurie and Norris were featured guests on the June 5 IHI Virtual Learning Hour, COVID-19: Caregiver Mental Health and Wellbeing. Close to 400 participants joined the first in a series of webinars, co-produced by IHI and Well Being Trust, to address health care workforce mental health and wellbeing during and after the COVID-19 pandemic.
At a time of massive public demonstrations around the world in response to the killings of George Floyd and others by police, Norris and Lurie both highlighted the connection between the safety and welfare of health care workers and the issues of structural inequities raised by protesters. Norris cited the significant “respect gap” for some health care professionals — including care aides, clerks, and cleaners — who do not often receive the same support, praise, or public appreciation as nurses and doctors for the essential services they provide. Lurie described the racist remarks and stigma some clinicians of color, including those of Asian descent, have endured even as they risk their own lives to care for others. Norris described the current protests as “a referendum on the economic and social policies in the [US] that are leading to pervasive health disparities, inequities, and systems failure.” He added, “There will be no path to health and wellbeing in this nation without addressing equity and social justice.”
Lurie pointed out that every major calamity, whether it’s a public health crisis or natural disaster, inflicts trauma, dislocation, and unemployment “always disproportionately affecting minority populations.” She also noted that the COVID-19 pandemic has the potential to be more devastating than a flood or hurricane for a range of reasons:
Slide from Nicole Lurie
While describing the sober realities of this moment, both Tyler and Lurie were also hopeful about the multiple ways health and health care systems can learn from the past:
- Help build better systems in communities. Norris observed that every hospital system in this US includes “improving the health of the communities we serve” as part of their mission statement. Meanwhile, some leaders in the health care sector are watching as behavioral health care providers around the US close their doors. He asked, “What role [is health care] playing in shaping a country that invests in the conditions for health and wellbeing, living up to our social justice missions, and [moving] from tinkering to being accountable for outcomes?”
- Create a safety net for health care workers. Rather than ignore the potential mental health impact COVID-19 is having and will continue to have on health care workers, Lurie advocated for pulling together the resources and learning from health systems and professional societies to create what she called a “safety net for health care workers.” Said Norris, “I would love to have a conversation about what we [should] do to prepare for the protection and care of the health care workforce.”
- Act now for all of us. “We can’t wait until our patients, caregivers, or anybody else gets sick, dies from despair, or can’t work,” said Lurie. Norris noted that given the stresses of dealing with the coronavirus, “We are all vulnerable. If we’re not suffering from [mental health] conditions ourselves, someone in our life is. Mental health and wellbeing and being a caregiver is about all of us.”
The panelists were realistic about the daunting challenges health care workers face, but also expressed cautious optimism about the potential for making fundamental change. “One of the great things about this whole thing we’ve been going through is we’ve seen leadership in all kinds of places we didn’t expect to find it,” Lurie said. “Let’s get it organized.” Tyler noted, “This is a legacy moment. We can’t change the past, but we can change the future.”
To learn about other recommendations for addressing the mental health and wellbeing of the health care community, watch and listen to the full Virtual Learning Hour. Learn more about IHI’s special series of weekly COVID-19 Virtual Learning Hours.
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