Supervisor Joseph Simitian
SAN JOSE – To address health care workers’ growing mental health burden, a burden exacerbated by the COVID-19 pandemic, the Santa Clara County Board of Supervisors is calling for the formation of a County program to support more than 9,000 employees at the Santa Clara Valley Medical Center (VMC).

“We depend on health care professionals for the health and safety of our community, especially during times of crisis. But it’s important to recognize the really significant mental health challenges facing these very same employees even before the pandemic,” said County Supervisor Joe Simitian, who proposed the effort. Simitian cited challenges such as increased workloads, nursing shortages, increased workplace violence, and burnout. “The pandemic has been challenging for all of us, but we know there’s a disproportionate burden borne by our health care workers.”

The proposal, brought forward by Simitian and Board colleague Cindy Chavez, addresses the pandemic’s unprecedented impact on the mental health of medical professionals, documented in a host of research studies. The International Journal of Environmental Research and Public Health cited heavy workloads, lack of social support, and stigma against seeking care as factors that contributed to poor mental health and workplace stress for health care workers. Most impacted, according to the study, were those working in psychiatric and intensive care. And a 2021 study published in the Journal of the American Medical Association Psychiatry found that nurses were twice as likely to die by suicide compared to the national average.

“Many nurses face situations where they experience emotions at a higher, faster intensity level than most people going about their workday, and so they must be able to process their emotions and not bottle them up,” said Chavez. “Working through sometimes painful emotions is often necessary and very helpful. We need to make our workplace receptive to this approach.”

Jennifer Hughes, Vice President of the Registered Nurses Professional Association, noted that nurses have had a hard time accessing their Employee Assistance Program (EAP) and even their own health care providers for mental health support.

“Unfortunately, nurses are not immune to the negative effects of working in a stressful environment, sometimes even going so far as to develop negative coping mechanisms,” Hughes said. “With suicide rates among nurses on the rise, it is essential that the County assists them in accessing mental health support services, so they can continue to care for the health of the community.”

A survey by Mental Health America revealed that the pandemic has caused increased anxiety, depression, and loneliness, along with other mental health conditions among health care workers. According to the survey, 86% of health care workers experienced anxiety, 76% experienced exhaustion, and 75% were overwhelmed. A majority of health care workers said they experienced burnout, while 41% experienced loneliness and 40% experienced financial stress. For health care workers with children, the survey found that about one-third said they lacked quality time with their children.

Ironically, describing health care workers as “heroes” appears to have been counterproductive to morale, and may have even held some health care workers back from seeking help. A survey conducted by Mental Health America found that only 15% reported seeing a therapist and just 5% were in a support group.

Not surprisingly, poor mental health among health professionals tends to have a ripple effect on patients. A study by the International Journal of Environmental Research and Public Health found that health care workers suffering from mental health challenges resulted in the delivery of poor quality of care, reduced satisfaction, and higher infections among patients. And Frontiers in Public Health found that burnout doubled the risk of medical error.

Poor mental health among health professionals also comes at an economic cost. A study in the International Journal of Environmental Research and Public Health found that poor mental health among this workforce led to staffing shortages and turnover, including workers leaving the workforce entirely, resulting in significant financial cost. According to the Kaiser Family Foundation, almost one-third of health care workers are considering leaving the profession. Locally, Valley Medical Center, like many Bay Area health care organizations, struggled with hiring and retention even before the pandemic; pandemic burnout may very well make it worse.

“We need to provide support for our employees – it’s the right thing to do for them, and it’s the smart thing to do to protect the quality and long-term sustainability of our County’s health care system,” said Simitian. “My hope is that this program serves as a model for improving the health and wellness of employees throughout the County.”

The Board unanimously directed County Administration to return to the Board on August 16 with a plan for implementing a mental health and wellness program for Valley Medical Center employees.

County Administration is also being asked to identify potential state and federal funding sources for such a program, targeting a fall 2022 implementation date. Simitian noted, “Frankly, this is a problem virtually every health care organization is facing—be they public, private, or nonprofit. The smart and compassionate organizations are facing up to the problem head-on, and confronting it.”