ROLE OF CULTURE

Superhuman effort. The front lines. Our nation’s safety net. Heroes. The words we use to describe our Healthcare Workforce evoke resilient, powerful people who rise to meet the challenge of caring for our communities. So why is our healthcare workforce struggling? In a word, stigma.

The healthcare Workforce is one of the most resilient groups of people around. However, when we define the prerequisite condition of a job as heroism on a daily basis, we are setting up an entire workforce to fall short of that expectation. You should not have to be a hero, putting others first even at your own peril, to do your job. In addition, the expectation of heroic behavior leaves little room for clinicians to be human, and to seek help when needed. Help, which includes counseling to process the traumas of providing health care or formal treatment for mental health challenges such as depression, anxiety and substance use.

In addition to the cultural aspects of stigma, there are institutionalized sources of stigma against receiving mental health care. A critical part of professional well-being relies on the removal of institutionalized sources of stigma. These sources include questions about a history of any diagnosis or treatment of mental health conditions asked on applications for state licensure,Hospital credentialing and peer reference forms, personal and malpractice insurance applications and payer participation. Our licensing and credentialing toolkit provides a 3-step process for organizations interested in auditing, changing and communicating changes to their licensing and credentialing applications to free them from stigmatizing language. On May 18, 2023, we issued a Joint Statement with NIOSH encouraging all hospitals to use our toolkit and remove intrusive mental health questions from hospital credentialing applications.

We’ve known for years that psychological safety is a critical component of healthy teams, and that a culture of safety, where health care workers are empowered to speak up and problem solve to improve systems, is critical for quality patient care. Clinicians who are empowered to seek mental health care and counseling without fear of professional stigmatization experience increased psychological safety in their organizations and are empowered to care for themselves…a critical action for patient safety.