June 3, 2024
COLUMBUS, Ohio – Rates of burnout and workforce shortages in the United States are on the rise and so is the need for the health care industry to foster healthy work environments. This is the message of a new science advisory on psychological safety by the American Heart Association and chaired by Laxmi Mehta, MD, a cardiologist, chief well-being leader and faculty director of the Gabbe Well-being Office at The Ohio State University Wexner Medical Center.
A workplace that is psychologically safe allows individuals and teams to feel included and safe to learn, collaborate and challenge without the fear of embarrassment, judgment or retribution. 
“Creating and maintaining psychological safety can be challenging in health care because of the complex, fast-paced and high-stakes nature of the work environment. Nevertheless, it’s critical to cultivate a safe culture to avoid adverse effects on patients, health care workers and teams,” Mehta said. Nkechinyere Ijioma, MD, an interventional cardiologist and clinical assistant professor in Ohio State’s College of Medicine, is co-author on the advisory.
A study cited in the advisory shows more than 60% of full time U.S. workers reported at least one symptom of a mental health condition such as anxiety or depression in 2023, and 31% said their work or workplace environment negatively affects their mental health. The advisory also cited data showing a higher risk of suicide among registered nurses, health technicians and health care support employees compared with non-health care workers. Physicians reported higher rates of occupational distress, including higher burnout than the general workforce.
In 2019, Mehta and other researchers conducted a nationwide survey of cardiologists that found 28% reported a mental health condition.
“There are many stressors in cardiovascular medicine, including an aging cardiovascular patient population and workforce, and a decrease in cardiologists entering the field because of insufficient fellowship positions despite the rising demand. This contributes to workforce shortages, additional stress and potential for burnout among cardiovascular health professionals,” said Mehta, who is the Sarah Ross Soter Endowed Chair in Women's Cardiovascular Health Research.
To meaningfully address these stressors at the system level, the American Heart Association science advisory detailed ways organizations can create a psychologically safe workplace and strategies to promote mental health and reduce suicide. Published in the AHA’s Circulation, the advisory is supported by the American Foundation of Suicide Prevention.
Some of the public health and policy recommendations include:
- Creating zero tolerance for workplace hostility by other health care professionals and by patients and their families
- Having local, state and national policies include measures to reduce the stigma of mental health conditions
- Increasing insurance coverage for mental health and substance use disorders
- Conducting more research to help establish minimal physician and workforce staffing standards
- Creating an organizational response to suicide to help facilitate healthy grieving and mitigate the risk of suicide contagion.
- Ensuring easy and stigma-free access to confidential peer support and counseling resources following adverse events is another key aspect of creating and maintaining a psychologically safe work environment.
“We know the types of situations that tend to be especially impactful on the health care workforce. If we can be proactive in our response as a system when these difficult things happen, it normalizes human reactions to difficult circumstances and conveys the message that it’s okay to talk about it. Accessing support helps to reduce isolation, improve coping and mitigate risk for burnout,” said Arianna Galligher, LISW-S, director of the Stress, Trauma and Resilience (STAR) Program at Ohio State.
“It’s important that individuals know how to access crisis resources such as the National Suicide Prevention Lifeline (available by calling 988), which offers an additional critical layer to the safety net. If you or someone you know is struggling, don’t hesitate to reach out,” Galligher said.
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