From Awareness to Action: Reframing Mental Health Awareness for Healthcare Workers
“If everyone has a little bit of courage, then no one has to be a hero.” - David McBride
(quoted by Sarah McBride on Pod Save America, Episode 1008)
For more than 75 years, the United States has recognized Mental Health Awareness. The movement began in 1908 when author and mental health advocate Clifford Beers - who lived with bipolar disorder - began speaking out about the trauma he experienced during his own treatment. It wasn’t until 1949, following decades of advocacy from Mental Health America, that a formal observance was established and the National Institute for Mental Health was founded. The goals were clear: educate the public,reduce stigma, promote research and treatment, and celebrate recovery.
Since then, we have made great strides in understanding and treating mental health conditions. But for health professionals, accessing care - especially mental health support - is still fraught with risk.
Even after the Rehabilitation Act of 1973 prohibited pre-employment inquiries about mental health history for federal workers, many state licensing boards continued to include intrusive questions on medical, nursing and pharmacy license applications and renewals. Only recently, after the tragic death of emergency physician Dr. Lorna Breen during the early days of the COVID-19 pandemic and the advocacy of the foundation established in her name, have these barriers begun to fall. Removing these questions is a necessary first step toward reducing stigma and creating safe pathways to care.
However, the unacceptably high number of health professionals experiencing occupational distress is neither an awareness problem, nor an education problem. They are a problem of perspective.
In 1946, the WHO defined health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” It is time to look at occupational distress in healthcare through that lens.
Rethinking the Causes of Distress
Addressing occupational distress in healthcare requires a broader, more nuanced understanding of what’s driving the problem. We recommend three foundational shifts in perspective:
Mental health treatment alone isn’t enough. Diagnosing and treating mental illness is critical - but insufficient - if we want to support true well-being.
We must acknowledge non-diagnostic drivers of distress. Conditions like moral injury, burnout, and the erosion of professional values are not, and never should be classified as, mental health conditions and yet they contribute substantially to clinician suffering.
Work environments matter. The conditions under which care is delivered profoundly impact clinician well-being.
It’s Time to Go Upstream
Most well-meaning mental health interventions target individuals in crisis, offering what we might call “ICU-like” care. Just like in physical health, though, ICU care only reaches those already in acute distress. That’s why, after decades of these programs, distress remains widespread and persistent.
This challenge brings to mind the well-known parable attributed to Archbishop Desmond Tutu:Villagers tirelessly rescue people from a river, never questioning why so many are falling in (full-scale ICU mode, if you will). Eventually, someone leaves the rescuers at the riverbank, walking upstream to find the source of the problem.
In healthcare, the “rescue work” - heroism - is dramatic, visible, and emotionally compelling. But real progress requires a quieter, harder kind of courage: the willingness to investigate the systems that are failing, the environments that wound, and the structures that perpetuate them.
It means acknowledging that some workplaces designed to heal patients may be harming those who provide care.
Speaking up, Together.
Upstream solutions take time. They involve speaking hard truths to powerful institutions and doing it in ways that they can hear. But when we build safer, healthier, more reparative organizations, the ripple effects are transformative: less distress, improved retention, stronger recruitment, and an environment that is simultaneously thriving and sustainable for the workforce. Those environments celebrate humanness, so no one needs to be a hero.
We can create those environments if we speak up together.
We know you have the courage. Will you join the movement?
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