Healthcare professionals have long-suffered high levels of stress, exhaustion and burnout. The COVID-19 pandemic exacerbated this existing problem and escalated the urgency to address it. While caring for patients, many health workers are also continuously traumatized by patient and colleague fatalities and constantly fearing for their own and their families’ health and safety. Yet, the intense stigma and scrutiny surrounding mental health often prevents them from accessing the support they urgently need.
On April 26, 2020, as New York City was trying to survive the first wave of the pandemic in the U.S., emergency medicine physician Dr. Lorna Breen died by suicide. Dr. Breen had spent the three weeks before her death recovering from her own COVID-19 infection while working 12-16 hour consecutive shifts treating patients with COVID-19.
Her story and commitment to her profession are memorialized in the Dr. Lorna Breen Health Care Provider Protection Act (H.R. 1667). The legislation passed with broad bipartisan and bicameral support and passion, and was signed into law by President Biden on March 18, 2022. Endorsed by more than 70 leading healthcare organizations, including the American Medical Association, American Nurses Association, American College of Emergency Physicians and American Hospital Association, the law is designed to reduce and prevent suicide, burnout, and mental and behavioral health conditions among healthcare professionals.
A family’s immeasurable loss becomes a mission to support the nation’s healthcare professionals
Dr. Breen’s brother-in-law Corey Feist and his wife Jennifer Breen Feist co-founded the Dr. Lorna Breen Heroes’ Foundation in her memory. The Feists remember Dr. Breen’s passion for her work as an emergency medicine physician, and share their powerful story in See You Now Podcast Episode 65: Sending Out An S.O.S., joined by Senator Tim Kaine (D-VA), who introduced the legislation.
When Dr. Breen joined a family trip on March 10, 2020, she was visibly anxious about COVID-19. The virus was beginning to overtake New York City hospitals and Dr. Breen was eager to get back to work. Shortly after returning to New York City, Dr. Breen contracted the virus and was convalescing at home as hospitals were only admitting the most critical patients. Throughout this period, she was unable to sleep and felt a very intense need to return to her patients. Following her first feverless 24-hour cycle, Dr. Breen asked to be put back on the schedule.
Her first day back at work was April 1. She called her family worried that, while still recovering from COVID-19, “everyone can tell I can’t keep up at work and this is going to impact my career.” What her family also remembers is Dr. Breen describing what was happening in her hospital as “Armageddon”—not enough staff, not enough protective equipment, patients dying in waiting rooms waiting to be seen. Even as a seasoned doctor who had conducted research on mental health challenges facing emergency room physicians, the volume of death and dying was overwhelming.
On April 9, Dr. Breen called her sister and said she couldn’t get out of her chair. In an eight-day period, she went from being a highly functioning physician to curling into a fetal position unable to move. The Feists immediately rallied friends and family to transport Dr. Breen home to Virginia and admitted her to the psychiatric unit at the University of Virginia hospital.
After spending less than two days in the hospital, Dr. Breen began talking with her family about losing her license to practice medicine and expressing fear that her career was over. Dumbfounded, her family tried to help Dr. Breen to focus on getting healthy. When she was discharged after 10 days, Dr. Breen returned home, and died by suicide on April 26, 2020.
Senator Kaine, as he describes in the podcast, was shocked that Dr. Breen was concerned about losing her job more than taking care of her own health—that seeking mental health treatment could affect licensure or professional certifications. She worried that if she stepped away to care for herself, she would appear to abandon her already overwhelmed colleagues. “And that's because of a society broadly, but particularly in the medical field, that doesn't make it easy for people to feel like they can seek help,” says Senator Kaine. “And I worry that frankly, those of us who aren't healthcare professionals make it worse when we say people are heroes. Heroes are often put on pedestals, and you can't live on a pedestal. I think healer is a better word than hero.”
Johnson & Johnson partners with the Lorna Breen Heroes’ Foundation to advance the legislation
Johnson & Johnson has been championing healthcare workers for more than 100 years, and is dedicated to improving outcomes for those suffering from mental illness.
In July 2020, Johnson & Johnson joined #FirstRespondersFirst, a partnership with Harvard T.H. Chan School of Public Health, Thrive Global, and the CAA Foundation, to ensure that frontline health workers are well-supported with resilience resources during the COVID-19 pandemic. In addition to over $1.3 million in grant funding from Johnson & Johnson Foundation, the Johnson & Johnson Center for Health Worker Innovation (the Center) brought together mental health and behavior science experts from Janssen R&D and the Johnson & Johnson Health and Wellness organizations to develop an evidence-based resource bank to help frontline health workers manage stress, introduce recovery into their routine, and know when to seek help.
To carry this work forward, #FirstRespondersFirst partnered with the Dr. Lorna Breen Heroes’ Foundation to launch ALL IN: Wellbeing First for Healthcare, a coalition of leading healthcare organizations committed to taking responsibility for workforce well-being with the goal of promoting a cultural transformation toward systemic accountability.
Johnson & Johnson’s Tommy Lobben leads the Center’s partnership with the ALL IN: WellBeing First for Healthcare Campaign and the Dr. Lorna Breen Heroes Foundation. Having learned about the legislative push in Dr. Breen’s name, Lobben connected Feist with the Johnson & Johnson Worldwide Government Affairs & Policy team. “I am immensely grateful to be in a position to bring the advocacy expertise of J&J’s collective Government Affairs & Policy organization to support such a meaningful piece of legislation,” says Lobben. “Self-care resources and a healthy work environment are vital to the well-being of the healthcare workforce. Solutions need to be available ahead of—not during—times of distress. Employers of health workers bear a responsibility to create an environment for their workforce to thrive and this legislation provides critically needed resources to support them as they care for those who care for us.”
Lobben approached Kelly Waters, Senior Manager, Federal Affairs, Johnson & Johnson. “When I met Corey and Jennifer and learned about Lorna’s story, I knew immediately that I wanted to help,” says Waters. “Our team had the unique ability to advance this critical legislation until it became a federal law. Over the past year I have been absolutely awestruck by the teamwork and commitment of our colleagues and our partners like the National Black Nurses Association and National Alliance on Mental Illness in bringing this issue to the top of our agendas.”
“Johnson & Johnson is humbled to stand with the Dr. Lorna Breen Heroes’ Foundation to honor Dr. Lorna Breen’s memory,” says Jane Adams, Vice President, US Federal Affairs and Canada, Johnson & Johnson. “Our purpose as an organization is to support public policy efforts to address unmet patient need and secure a healthier future. Dr. Breen’s legacy of helping to save lives inspired us to advance policy solutions to support the very heroes suffering in silence who save our lives each day. Supporting community partners is Our J&J Credo in action.”
Legislation like the Dr. Lorna Breen Health Care Provider Protection Act that brings people together in such a powerful way is also a very rare thing, adds Waters. “We were able to secure bipartisan Members of Congress to support the bill, and in some instances right after the initial conversation, which is extraordinarily rare. This legislation proves that a common goal of saving lives can transcend partisanship.”
What the law does
The bipartisan, bicameral bill is the first ever to support the mental health of the U.S. healthcare workforce at the federal level. It was funded in the first American Rescue Plan, and $103 million was allocated to 46 different institutions even before the law was enacted.
The legislation establishes grants for helping healthcare professionals and students manage mental health and substance use disorders. It requires the identification and dissemination of best practices for preventing burnout, stress and suicide among all healthcare professionals, including students and trainees. It creates a national education and awareness initiative to encourage healthcare providers to seek the help that they need and ensure that they're not burdened or punished if they do so. The bill also launches a comprehensive study on the mental health of healthcare professionals, including how the COVID-19 pandemic has affected them.
“This law is an essential step forward in what is a global and long-term effort to prioritize the well-being of health workers,” concludes Lauren Moore, Vice President, Global Community Impact, Johnson & Johnson. “Ensuring that health workers can freely seek mental health treatment and services without fear of professional repercussions must absolutely be a priority for all of us who believe thriving health workers are the heart of health systems around the world. Self-care is vital to the well-being of health workers, to the quality of care they can provide, and to our ability to attract and retain the healers upon whom health access and equity depend.”