Mental health has long been a priority for Johnson & Johnson. As a company, we believe that mental health impacts the physical, social and economic health and well-being of individuals and societies alike. At the Johnson & Johnson Center for Health Worker Innovation, our focus on strengthening health systems to make ‘healthcare for all’ a reality begins with supporting the resilience and well-being of frontline health workers who provide that care.
Health worker burnout was reaching a crisis point even before COVID-19, being especially worse in low-resource settings, adversely impacting patient care and increasing medical errors. The frighteningly high suicide rates among nurses has only been made worse by the enormous strain of caring for patients during COVID-19. The heavy toll of the pandemic is now resulting in US health workers leaving the profession in numbers that are not sustainable, when globally we have an estimated 18 million frontline health worker shortage. In a survey of health workers conducted by Mental Health America with support from the Johnson & Johnson Foundation, 75% of respondents reported exhaustion and burnout, 45% of nurse respondents said they were not getting enough emotional support, and more than half of those surveyed were questioning their career path.
Tackling this issue has to begin with addressing the stigma among health workers to reach out for mental health support when they need it. Our health workers are heroes—but that does not make them any less human. Health workers should not be expected to suffer in silence and be stigmatized for getting the care they need to get through difficult periods in their personal and professional lives. The tragic death of Dr. Lorna Breen by suicide early in the pandemic received much media attention last year, and sadly was one of many. It has been encouraging to see many in the profession respond to these tragedies by opening up about their own mental health struggles and providing better support services to health workers, but it is critical to not allow these moments to fade from memory.
Early exposure to resilience-building skills and self-care
As we look ahead to a post-pandemic future, at the Center we are collaborating with partners and experts in the field and within Johnson & Johnson to continue to elevate the importance of health worker resilience and well-being. Our goal is to bring to life specific and focused interventions and resources directly to health workers as well as to convene like-minded advocates to invest in efforts to strengthen the supporting culture and environments health workers operate in.
These resources include the free Nurse Resilience course launched by Osmosis and #FirstRespondersFirst with support from Johnson & Johnson Foundation, that aims at giving nurses early—ideally pre-service—exposure to foundational, resilience building skills and basic self-care principles including Mindfulness-Based Stress Reduction techniques. The Foundation has also partnered with the National Alliance on Mental Illness (NAMI) on the Frontline Wellness initiative that seeks to promote contextual, high-quality offerings for health workers, including peer support groups, mental health hotlines and referral services through local NAMI affiliates. The goal is to help prevent burnout from becoming a problem in the first place. The realities and learnings over the past year has made it clear that offering resilience tools in the midst of the storm can sometimes fail to meet health workers where they are.
Creating a healthy work culture, beginning at the top
The past year has also shown us that the wide range of thoughtful, individual resilience building opportunities for health workers we have been working on with our partners need to be complemented by an evolution in the health system structure and culture. While individual resilience is important, the evolution we need to see happen in this space ultimately depends on a culture shift of prioritizing clinician well-being and structural transformation within organizations to drive change. To that end, the Johnson & Johnson Foundation is supporting the ALL IN Campaign with #FirstRespondersFirst and the Dr. Lorna Breen Heroes' Foundation to convene major professional associations and employers of health workers to further a collective vision of ‘Well-Being First in Healthcare’ by bringing together science, practical steps and storytelling to highlight gaps in research, lift up best practices, and share ideas and resources.
The culture shift needs to happen across all levels, starting with the top of the house. Health system leaders through their leadership styles have the ability to create a healthy work culture for teams across their organizations. We have been pushing to integrate well-being and resilience into the course content of nurse leadership programs we support, such as the Wharton Nursing Leader Program and the Sigma Nurse Leadership Academy. Last April, during the thick of the COVID-19 crisis in the US, we partnered with the American Organization for Nursing Leadership to develop Leading Through Crisis: A resource compendium for nurse leaders—offering nurse leaders and their teams a deep well of resources to support them in taking care of themselves and each other.
COVID-19 has brought a spotlight on health worker resilience and well-being like never before. Through our Resilience Collaborative, we intend to build on this momentum and explore opportunities with current and new partners over the coming years to integrate resilience and well-being into formal health worker training programs as well as to help promote workplace environments where health workers can thrive.
At the end of the day, clinician well-being is not just about well-being on an individual level—all patients and the community at large will be better served if those who have chosen the vital role of caring for others feel valued and protected, and can sustain the sense of purpose and meaning in their work.