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Dr. Lorna Breen Heroes Foundation co-founder Corey Feist and physician advocate Kim Downey discuss their article, “Health workers deserve care too: How to protect their mental health.” They highlight the ongoing mental health crisis facing the health care workforce, where CDC data shows mental health is worse than in any other segment, yet only 38 percent of those in distress seek care. Kim shares personal anecdotes that reveal the immense pressure and stigma physicians face, while Corey outlines the systemic barriers that prevent healers from getting help. The conversation centers on the six crucial actions from their “Health Workers Have The Right, Too” initiative, providing a concrete roadmap for employers and policymakers. Corey and Kim argue for practical solutions like confidential peer support, the removal of invasive mental health questions on licensing applications, and accessible, affordable care that works for a 24/7 workforce. Their core message is clear: To ensure patient safety, we must first build a system that protects the well-being of our health care workers.

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome back both Kim Downey and Corey Feist. Kim is a physical therapist and physician advocate. Corey is the co-founder of the Dr. Lorna Breen Heroes Foundation. Together they co-wrote the KevinMD article, “Health workers deserve care, too: How to protect their mental health.” Kim and Corey, welcome to the show.

Kim Downey: Thanks, Kevin.

Kevin Pho: So Kim, how did you and Corey meet?

Kim Downey: Sure. So if there’s anyone who isn’t familiar with me in these spaces, it’s because one of my amazing doctors took his own life, and I felt a calling to support doctors. And one thing Corey might not know is my very first public presentation on these things was a KevinMD article, a tribute to my radiologists. My first podcast ever was, again, a tribute to my radiologists. So Kevin, without planning on it, has followed me in this journey since the very beginning.

A little over a year ago, I became a very proud ambassador for the Dr. Lorna Breen Heroes Foundation. I have my pen. And this past March, they co-sponsored the Health Care Worker Wellbeing Day. I went in person, and my doctor’s wife actually came with me. In the morning of the event, I approached Corey. I think you might have heard my name but didn’t really know me or my story. So I took a few minutes to tell him, and I offered to collaborate in any way I could to expand the message of the Dr. Lorna Breen Heroes Foundation. He graciously offered to take me up on that.

So I had him on my YouTube channel with Dr. Stephanie Simmons, the Chief Medical Officer for the Dr. Lorna Breen Heroes Foundation. And then I suggested that we collaborate on an article for May, which is Mental Health Awareness Month. Thank you for publishing our article, and that’s why we’re here today: to further spread these critical messages.

Kevin Pho: And Kim, it’s just so wonderful to see your growth from that first podcast. I’m glad that the KevinMD platform has played a very, very small role in your journey. And of course, now you have your own podcast and your book, congratulations on that. You’re such a prominent figure in this physician wellness space. I see you all over LinkedIn, so congratulations, Kim.

Kim Downey: Well, thank you very much. And in case Corey doesn’t know about our book, it’s called White Coats Courageous Hearts, and it’s a compilation with 15 physicians. Kevin wrote the beautiful endorsement on the back. So thank you, and Kevin, you’ve actually played a major part. So thank you very much.

Kevin Pho: So Corey, I was looking back, and we last spoke in the fall of 2021. For those who aren’t familiar with the Dr. Lorna Breen Heroes Foundation, just tell us a little bit about that, and then how have things gone over the last four years since we last spoke?

Corey Feist: Yeah, I will summarize the last four years as succinctly as I can. Again, it’s great to be back with you, and Kim is an amazing ambassador of our foundation. I came to this, if you will, in 2021 as the then-CEO of the University of Virginia Physicians Group, having spent over two decades embedded inside health care, first as an attorney and then as a health care leader. I was working with and dedicated to the clinicians at the University of Virginia Health System, trying to identify how we could make their day-to-day experience clinically better and how to remove as much administrative burden from their shoulders so they could focus on patient care.

In the spring of 2020, my sister-in-law, Dr. Lorna Breen, who was an emergency medicine physician and leader at NewYork-Presbyterian/Columbia University, took her life. She took her life after a very short mental health episode. She’d never had any mental health conditions, but taking care of COVID patients and having been very sick with COVID herself compromised her. She died on April 26th. On the 27th, the publicity around her death began over our family’s objection.

So we were thrust into a national spotlight that we didn’t want, and yet we couldn’t ignore it because we began to hear from thousands and thousands of health workers around the country about their mental health challenges and how they are penalized by the culture and practices within health care just for taking care of themselves. And so we began the Dr. Lorna Breen Heroes Foundation in the summer of 2020, really focused on responding to the feedback that we had heard as a family.

Some of that feedback was from the clinicians I had dedicated my professional career to at the University of Virginia, who would say things like, “If you look at my CV, there’s a break and it says a fellowship, but really I needed inpatient hospitalization, and I couldn’t risk telling anybody that because it would hurt my career.” So our foundation began in earnest in the summer of 2020. Since that time, we’ve been on your podcast, Kevin, but we are really focusing on three main areas. From an overarching perspective, our foundation is focused on protecting health workers’ mental health and wellbeing by transforming the health care industry at the root because what we found is that, by and large, these are preventable issues caused and driven heavily by the day-to-day workplace of health care workers.

So we’ve been attacking this problem by advancing collaboration, getting those different silos in health care working together collectively on the workforce as a whole—not just focusing on the doctors or the nurses or the pharmacists, but working on this together, because there’s so much we can do together. One of the ways we do that is we’ve got an ambassador program with over 300 ambassadors like Kim who’ve raised their hand to us to say, “How can I get involved in this movement?”

We’ve also accelerated solutions. We know that there’s been a lot of talk over the last two decades, frankly, as this issue around the wellbeing of workers and burnout has begun to percolate. Things like taking the traditional triple aim of a hospital—focused on patient quality, patient access, and affordable care—and adding the quadruple aim, which is the impact of the work on the workforce. Why hasn’t this been widely adopted when practices have been talking about it for years? So we’ve been accelerating those kinds of solutions, and we’ve also been working to eliminate the penalties that health workers uniquely carry in the U.S. for just taking care of themselves.

One of the things that Kim and I have talked about and published in your article is this new campaign we created called All In for Mental Health, which identifies six ways that organizations and policymakers need to embrace and change to support the mental health and wellbeing of health workers. Patients have the right to seek mental health care: Health workers do too. They just don’t always know it. So that’s been a large part of our work.

I’ll just end by saying, and we’ve become most known for this since I was on your podcast last: we were also in the Oval Office with the President of the United States as he signed the Dr. Lorna Breen Health Care Provider Protection Act into law. This was the first-ever federal law that creates programs to support the mental health and wellbeing of health workers. It infused over a hundred million dollars into the health care industry to help create programs to support the workforce. We’re actually working with Congress right now to extend those programs for five more years since they’ve all expired. So we’ve been attacking this from a systems perspective, both embedded inside health care and also looking at those external policy drivers that influence and impact the day-to-day experience of health workers—again, all under the umbrella of supporting and protecting the mental health and wellbeing of our workforce by transforming the industry.

Kevin Pho: So Corey, of course, I want to talk about this new campaign and the six ways we could address the mental health care of the health workforce. But Kim, I want to get back to you. Obviously, you are an ambassador for the Dr. Lorna Breen Heroes Foundation. Tell us about that experience and some of the stories you can share with us about being an ambassador.

Kim Downey: Sure. So I had heard of the organization, but I didn’t know how to become an ambassador. And I believe they accept people maybe quarterly, because I remember one day last spring, some of my favorite doctor friends, I think they had all shared that they were ambassadors for the Dr. Lorna Breen Heroes Foundation. And I was like, “Oh, wow. I wonder if I could be an ambassador.” Because obviously, the mission is so close to my heart. So I went on the site, found the form, which is easy to do, and I filled it out and got the acceptance that I was an ambassador.

There are quarterly meetings, and I love being on the call. It’s doctors, other health care professionals, and patients. It’s so meaningful to see so many people who care about these issues and are taking steps on what we can all do next. So that’s very empowering, to feel like instead of just talking about it, there’s actually something you can do. And I’m so very impressed with what the organization has been able to do in a relatively short period of time.

The sad thing is that there are intrusive questions on some licenses. For me, as a physical therapist, I just have to say if I was convicted of a felony in the last year. But I believe New York had already removed those intrusive questions, and Lorna didn’t know that. And that just kills me to know. So that’s such an important mission, and they have a map on their site that is constantly updated with the states where they’ve been able to remove the intrusive questions. To know that I’m involved in an organization that’s making a true impact where you can see the difference just fills my heart.

Kevin Pho: So Kim, tell us about those quarterly calls you have with all the different stakeholders when it comes to clinician wellness. What’s discussed during a call? Take us behind the scenes on some of the issues that come up when you all get together.

Kim Downey: Well, sometimes if there’s something they want you to promote with your senators, like when a bill is up for reauthorization, they tell you step-by-step what to do and how to do it, and then how you can share it with your audiences. And the wonderful thing is they make it so easy for anyone that within 60 seconds you can click on that button and send out the messages you want. And if you want to add a little blurb, you can. So just knowing how to do that, and that you’re not alone, and it doesn’t have to feel scary.

Sometimes doctors and other people choose to share their stories because they know it’s a safe and vulnerable place. There have been times where they’ll just share very personal stories. So to be in that space again, where you can talk about anything related to this and know it’s a safe space and everyone has the same mission, is powerful.

Kevin Pho: So, Corey, you mentioned earlier that there’s a campaign specifically addressing the mental wellness of our clinician workforce. Six ways to help. So talk more about that.

Corey Feist: Let me take you back to 2021, actually, when you and I last talked. One of our ways, as I said, that we’re breaking down the silos in health care is to get organizations working together across those silos. We’ve done that through a coalition we built called All In: Wellbeing First for Healthcare, because we want the wellbeing of the workforce to come before all the other things we ask them to do. In the Wellbeing First for Healthcare Coalition, we now have over 35 national associations and professional organizations spanning physicians, hospitals, nurses, et cetera. OK. We spent over a year with that coalition identifying the ways that health workers are currently penalized, intentionally or otherwise, by the systems when it comes to just taking care of their own mental health and wellbeing. That All In coalition then developed All In for Mental Health, which identified six discrete actions.

So what are those? The first, and the throughline for many of these is concern about confidentiality. The very first one is accessible and affordable mental health care, particularly during the times of day that health workers need it, which is generally not nine-to-five. It’s also generally not care they want to have from the institution where they work because they are concerned about confidentiality. So that’s number one.

Number two is confidential access to a professional support program, or physician’s health program as they’re called in some cases. These programs exist, but many people don’t know about them. It’s all about preserving confidentiality so that the workforce can get taken care of, reenter the workplace, and continue to care for patients.

The third one is what Kim was just alluding to: equal privacy in getting mental health care. This was Lorna’s biggest concern. “Is my license at risk? Are my hospital credentials at risk? Because I’m going to have to fill out a form every couple of years that says, ‘Have you been treated for mental health?’ And I’m worried if I answer yes that I’m going to be penalized.” That specific action we call our Champions Challenge, where we have a toolkit for organizations and individuals to make these changes within their organizations or on licensing boards. That one program, as I sit here today, is currently benefiting 1.5 million health workers in the U.S. because their licensing board or their hospital has made these changes.

The fourth one is confidential peer support. We hear from health workers across the country who say, “I don’t actually need formal mental health treatment, but I want to talk to somebody who’s walked a day in my shoes. I need to make sure that I can do that confidentially because I’m probably going to talk about things I don’t want other people to hear about.” In some cases, Kevin, that peer support is not necessarily given the confidential protections you would expect. If you talk to a formal mental health counselor, it’s protected. But if you’re talking to a trained peer supporter in my institution, somebody might later ask them what you talked about, and unless there’s that formality around it, they might have to disclose it.

The fifth one is something that, for me as a non-clinician, was surprising. Health care professionals are not always trained and educated on mental health care, and certainly, health care leaders in different organizations don’t always understand what their workforce needs. So, education and training on mental health and wellbeing.

And then finally, as I alluded to before, when health workers have to come back into the workplace once they’ve been treated, we need to have supportive pathways for reentry so that they can seamlessly reintegrate in a supportive way and not be worried about the cultural stigma around getting mental health treatment and the scarlet letter they might have to wear. So those are the six ways. Again, it’s all under this concept that patients have the right to mental health care, and health workers do too. These are six different ways that organizations can demonstrate that they are walking that talk with their workforce.

Kevin Pho: And Corey, what are some tangible, actionable ways health care organizations can begin to implement some of the things you’re talking about?

Corey Feist: I’ll go back to the one where we’ve had the most traction, which is our equal privacy in mental health care. The very first thing they need to do is take a look at their peer reference forms and their credentialing applications because those are the primary places organizations have been perpetuating this stigma for years. When we talk to health workers, Kevin, the first thing they’re concerned about when getting mental health treatment is the impact on their job. The second thing they’re worried about is the impact on their license. So the very first thing organizations need to do is join the 600-plus other hospitals in the U.S. who’ve gotten our badge. We now have over 10 percent of the hospitals in the country that have done this work in the last 24 months. That’s huge progress. Huge. But that means we have 90 percent left to go, and we would love for everybody to do that.

That’s the first one. Then I would direct everyone to this website, which is allinformentalhealth.org, and look at the different actions we have listed on the website for how your organization can actually do that. Do you have a peer support program? Have you made sure that it’s confidential? Does your organization educate the workforce on mental health training so that health care leaders, in particular, can recognize the signs and symptoms of when a worker is having a mental health challenge and know how to have that conversation in a supportive way?

Those are just a few examples, Kevin, but they’re all practical. As Kim, our great ambassador, knows, we’re trying to put out these practical, common-sense tools to start changing the landscape for the workforce. What we hear is when organizations and leaders do this, it can completely change things.

I’ll pick on one for a second, in a positive way. One organization in the Midwest trained its frontline nurse leaders in suicide prevention. Those nurse leaders didn’t necessarily have formal training to recognize the signs and symptoms of when an employee or a patient was exhibiting suicidality. In the case I’m referring to, the frontline nurse leaders were educated. One of them identified suicidal ideation in one of her nurses on the unit and intervened in the moment. She didn’t wait around; she intervened in the moment because she had been trained. That nurse is here today. They’re taking care of patients. But that nurse did express to her leader that she had intended to divert medicine that day at the end of her shift and take her life that night. That is so powerful, right? And it’s simple. A lot of this stuff just takes intentionality, using the practical, common-sense solutions that we’re putting out in our All In for Mental Health campaign.

Kevin Pho: We’re talking to Kim Downey and Corey Feist. Kim is a physician advocate and physical therapist. Corey is the co-founder of the Dr. Lorna Breen Heroes Foundation. They wrote the KevinMD article, “Health workers deserve care, too: How to protect their mental health.” Now I’m going to end by asking each of you to share some take-home messages with the KevinMD audience. Kim, why don’t we start with you?

Kim Downey: Sure. I thought I would end with the last paragraph of our article, in case anyone hasn’t read it. We conclude with why it matters, and it’s simple: A healthy workforce is essential for safe, compassionate patient care. The current mental health crisis among health workers is contributing to unprecedented burnout rates, staff shortages, and declining patient care. By implementing these six actions that Corey just talked about, we can create an environment where health workers feel safe, supported, and empowered to seek the help they need to be at their best, both for themselves and for their patients. Together we can change the culture of health care. We can eliminate the stigma, break down the barriers, and build a system that respects the mental health of those who care for us.

Kevin Pho: And Corey, we’ll end with you.

Corey Feist: Join our movement to support the mental health and wellbeing of health workers at allinformentalhealth.org. We believe that just as patients deserve and have the right to mental health care, so too do our health care workers. Join the movement today. Reach out with any questions you have. Support the mental health and wellbeing of all of our health workers so we can have a thriving health care delivery system in the U.S.

Kevin Pho: Kim and Corey, thank you so much for sharing your perspective and insight, and thanks again for coming back on the show.

Kim Downey: Thanks for having us, Kevin.

Corey Feist: Thanks, Kevin.