[Federal Register Volume 86, Number 184 (Monday, September 27, 2021)]
[Notices]
[Pages 53306-53308]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-20931]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[Docket No. CDC-2021-0106; NIOSH-344]


Interventions To Prevent Work-Related Stress and Support Health 
Worker Mental Health; Request for Information

AGENCY: Centers for Disease Control and Prevention, HHS.

ACTION: Request for information.

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SUMMARY: The National Institute for Occupational Safety and Health 
(NIOSH), within the Centers for Disease Control and Prevention (CDC), 
announces an opportunity for the public to provide information and 
comments on current evidence-based, workplace and occupational safety 
and health interventions to prevent work-associated stress, support 
stress reduction, and foster positive mental health and well-being 
among the nation's health workers. Information and comments are also 
requested on interventions under development and research in progress 
to support and promote the mental health and well-being of health 
workers. NIOSH is seeking information on related best practices, 
promising practices, or

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successful programs related to providing stress prevention and mental 
health services to health workers. Examples of such services include, 
but are not limited to, employee assistance programs, screenings, 
supervisor trainings, workplace policies, talk therapy, mindfulness, 
peer support, and mobile apps.

DATES: Comments must be received by November 26, 2021.

ADDRESSES: Comments may be submitted through either of the following 
two methods:
     Federal eRulemaking Portal: http://www.regulations.gov 
(follow the instructions for submitting comments), or
     By Mail: NIOSH Docket Office, Robert A. Taft Laboratories, 
MS C-34, 1090 Tusculum Avenue, Cincinnati, Ohio 45226-1998.
    Instructions: All written submissions received in response to this 
notice must include the agency name (Centers for Disease Control and 
Prevention, HHS) and docket number (CDC-2021-0106; NIOSH-344) for this 
action. All relevant comments, including any personal information 
provided, will be posted without change to http://www.regulations.gov.

FOR FURTHER INFORMATION CONTACT: Rachel Weiss, Program Analyst; 1090 
Tusculum Ave., MS: C-48, Cincinnati, OH 45226; telephone (855) 818-1629 
(this is a toll-free number); email [email protected].

SUPPLEMENTARY INFORMATION: The Centers for Disease Control and 
Prevention (CDC) is charged by the American Rescue Plan Act of 2021 
(Pub. L. 117-2, sec. 2704) with educating health workers and first 
responders on primary prevention of mental health conditions and 
substance use disorders and encouraging these professionals to identify 
and seek support for their own mental health or substance use concerns. 
Accordingly, CDC's National Institute for Occupational Safety and 
Health (NIOSH) announces an opportunity for the public to provide 
information and comments on evidence-based workplace and occupational 
safety and health interventions, policies, or other activities relevant 
to health care professionals and first responders, including those at 
the population, organizational, or individual levels. Information and 
comments are requested on related interventions under development and 
research in progress. NIOSH is also seeking information on related best 
practices, promising practices, or successful programs related to 
providing stress prevention and mental health services to health 
workers.
    Health workers include everyone who works in healthcare--for public 
and private providers, in clinical and community settings--such as 
first responders, admitting and ward clerks, laboratory technologists 
and technicians, nurses, physicians, environmental services workers, 
and food service staff in healthcare settings. Health workers face many 
demands at work, which may include difficult working conditions, long 
work hours, rotating and irregular shifts, exposure to human suffering 
and death, and increased risks for personal exposure to disease and 
harm.\1\ The COVID-19 pandemic has exacerbated these challenges and 
contributed to new and worsening mental health concerns, including 
burnout, compassion fatigue, depression, anxiety, substance use 
disorders, and suicidal ideation. These concerns, in turn, can affect 
workers' overall health, job performance, and patient care and 
safety.\2\
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    \1\ National Occupational Research Agenda (NORA) Healthcare and 
Social Assistance Council. National Occupational Research Agenda for 
Healthcare and Social Assistance (HCSA). February 2019. https://www.cdc.gov/nora/councils/hcsa/pdfs/National_Occpational_Agenda_for_HCSA_February_2019-508.pdf.
    \2\ National Academy of Medicine. Strategies to Support the 
Health and Well-Being of Clinicians during the COVID-19 Outbreak. 
https://nam.edu/initiatives/clinician-resilience-and-well-being/clinician-well-being-strategies-during-covid-19/.
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    Many lower-paid or part-time health workers--such as home health 
aides, orderlies, medical assistants, phlebotomists, and pharmacy 
aides--may have experienced barriers preventing access to health care 
services and information, including financial challenges, lack of 
health insurance coverage, or lack of adequate transportation. They can 
also face lack of recognition and civility (including threatened and 
actual workplace violence) for the important work they do. Even health 
workers who are not on the frontlines or at high risk of infection may 
still encounter work demands that cause poor mental health outcomes.\3\
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    \3\ See supra note 1.
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    Public health workers are also at increased risk for negative 
mental health consequences when responding to public health 
emergencies, such as the COVID-19 pandemic, where they must operate 
under high-stakes conditions for extended periods of time without 
relief.\4\
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    \4\ Bryant-Genevier J, Rao CY, Lopes-Cardozo B, et al. Symptoms 
of Depression, Anxiety, Post-Traumatic Stress Disorder, and Suicidal 
Ideation Among State, Tribal, Local, and Territorial Public Health 
Workers During the COVID-19 Pandemic -- United States, March-April 
2021. MMWR Morb Mortal Wkly Rep 2021;70:947-952.
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    NIOSH is interested in receiving comments and other relevant, 
evidence-based information from a variety of partners, including 
employers, labor unions, workers, researchers, treatment providers, and 
government agencies at all levels (Federal, State, Territorial, local, 
and Tribal). Information provided, including narrative evidence, data, 
or anecdotes, will support nation-wide efforts to raise awareness of 
mental health concerns, identify best practices to prevent and reduce 
work stress and related adverse mental health outcomes, identify 
workplace and community supports, and reduce stigma related to seeking 
and receiving care. NIOSH may use the information provided to 
assimilate the best available evidence; develop a repository of best 
practices, resources, and interventions; identify and adapt tools; 
improve data and surveillance; and develop trainings and resources to 
inform and support employer policy change. NIOSH will also generate 
awareness by conducting a national social marketing campaign to provide 
tools and resources to employers, normalize the conversation around 
mental health, and lower barriers for health workers seeking care for 
mental health.
    Commenters are not required to respond to the questions below and 
may respond to as many or few as desired. While all inputs are 
welcomed, comments addressing the following questions are especially 
helpful:

Questions for Workplaces With Interventions and Services in Place

    1. Please tell us about your experience with the development of any 
preventive interventions currently in place in your workplace to help 
health workers avoid work-related stress and maintain or improve their 
mental health and well-being. Describe the intervention's origins and 
basis, its target population, evaluation or outcome measures, 
challenges and successes, as well as any other information you think is 
noteworthy.
    2. Please tell us about your experience with the development of any 
diagnostic and/or therapeutic services offered in your workplace by the 
employer or union to health workers who are experiencing stress or 
difficulties with their mental health and well-being. Describe the 
services' origins and bases, their target population, evaluation or 
outcome measures, challenges and successes, as well as any other 
information you think is noteworthy.

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    3. For both preventive interventions and diagnostic/treatment 
services in your workplace, please describe how widely the services are 
used, how stigma associated with seeking mental health care is 
addressed, and how health workers are encouraged to participate. In 
your experience, how does the workplace benefit from implementing 
interventions or offering services to health workers to prevent/reduce 
work-related stress, to decrease stigma related to seeking and 
receiving care, and to improve the mental health and well-being of 
health workers?
    4. Please describe any programs you are aware of that help 
employers to fund or otherwise develop interventions or services to 
support health worker mental health and well-being.

Questions About Workplaces

    5. Please tell us about your experience with any workplace policies 
designed to protect workers from stress and adverse mental health 
outcomes and to address these issues. Describe the part(s) of your 
organization involved in work-associated stress prevention efforts.

Questions About Health Workers' Communication Preferences

    6. Please tell us about your workplace's most effective methods of 
informing health workers about available interventions, services, and 
workplace practices and policies, including but not limited to: 
Notification channels, trusted messengers (e.g., upper management, 
front line supervisor, union representatives), and efforts to reach 
workers who are underserved by mental health/behavioral health 
resources.
    7. In your experience, do workers seek mental health and well-being 
information outside the workplace and, if so, where (e.g., community-
based, faith-based)? Do health workers generally find sources of 
information outside the workplace more trustworthy and credible than 
employer-based programs? If so, what is the basis for this 
understanding and what efforts have you undertaken to address such 
concerns?
    In addition to the specific questions above, NIOSH would also like 
to hear from researchers currently conducting research on stress, 
burnout, and other mental health and well-being concerns among a broad 
range of health workers.

John J. Howard,
Administrator, World Trade Center Health Program and Director, National 
Institute for Occupational Safety and Health, Centers for Disease 
Control and Prevention, Department of Health and Human Services.
[FR Doc. 2021-20931 Filed 9-24-21; 8:45 am]
BILLING CODE 4163-18-P