The Bigger Point: The Significance of Wellness Initiatives in Health Professions

Highlighting barriers to behavioral health care for healthcare providers has reached a critical juncture. This reader applauds HPHR Journal’s commitment to highlighting topics that impact many communities and individuals regardless of education, career, or socioeconomic status.

There has long been a widely held belief that oral healthcare providers have the highest number of suicides among the health professions. Some will argue the research based on that assumption is inaccurate,¹ while others say it is indeed factual.² Regardless, the awareness of behavioral health conditions has grown, but solutions for facilitating access to care for all healthcare providers have not found a definitive pathway. We have all read the tragic stories of trainees committing suicide, established and seemingly successful providers committing suicide, and everything in between. Whether from lack of resources or fear of stigma, these events have not declined at a pace consistent with the increase in awareness.  The question remains: what are we to do?

While one can never discount pre-existing risk factors, it is essential also to note how strains stemming from training requirements, job characteristics or location, and work environment can exacerbate or even create behavioral health conditions.³ Providers seeking to work in geographically or socioeconomically under-served areas sometimes have the added burden of wearing many hats. Often, these providers must mediate many of the social determinants of health for their patients. That added pressure on top of clinical responsibilities can accelerate burnout and may explain continual provider shortages with marginalized patient populations. That is a level of fatigue that not even the most lucrative loan repayment offers can remedy. There are those, often individuals on the administrative side of healthcare management not involved in direct patient care, who argue that the responsibility should fall onto the provider to seek help. After all, our profession is marked by our decision-making autonomy on numerous levels. This writer would suggest looking at this issue from a different vantage point. Whether there is a higher rate of suicide among oral healthcare professionals compared to their colleagues from other health professions is not the question we should be pondering. Whether health professionals at large have a higher rate of suicide compared to the general population is also not a question to ponder. There is a concerning correlation of suicide amongst healthcare professionals. That alone should warrant this question from institutions, health centers, teaching hospitals, and governing medical bodies at large. Has every effort been made to make abundantly clear all the resources and privacy that providers have access to or should be afforded?

Most healthcare providers would note knowing at least one colleague who has struggled substantially with emotional exhaustion.⁴  In many cases, this presents as various manifestations of depression and anxiety. This writer hopes to re-emphasize the importance of microsystem AND macrosystem level, multidimensional efforts for ongoing improvement of healthcare provider wellness initiatives. From mindfulness activities/events, safe forums to discuss ongoing challenges from the typical strains the different disciplines demand, and asking questions that examine not just the why for tracking “pajama time,” which is the time healthcare providers spend doing work in the in the electronic medical record after hours and at home, but questions to examine how pajama time became a data point to be tracked in the first place.⁵ After all, if one life is spared, wasn’t it worth it?