Before she died in April 2020, one of the last academic articles Lorna Breen co-authored focused on the “alarming prevalence” of burnout among emergency-department clinicians, and what was to be done about it.

But if Breen, an emergency-department physician at NewYork-Presbyterian Allen Hospital, was ever experiencing burnout herself, she didn’t show it, her family says. She had no history of mental illness, no bouts of anxiety or depression, and that was what made what happened to Breen feel so implausible after the pandemic hit, said her sister, Jennifer Feist.

Weeks into the pandemic, Breen fell ill with covid-19. After she recovered, she promptly returned to work at the hospital.

Twenty-four days later, she died by suicide in Charlottesville, where her family lives and where she is from — feeling overwhelmed by the onslaught of dying covid-19 patients.

On Wednesday, Feist and her husband joined Sen. Tim Kaine (D-Va.) and two Northern Virginia doctors outside the U.S. Capitol to call on the House of Representatives to pass legislation in Breen’s honor — intended to finally do something about the largely silent crisis of physician burnout and mental health strain in America.

The Dr. Lorna Breen Health Care Provider Protection Act, which Kaine sponsored and which unanimously passed the Senate last month, would provide grant funding for suicide-prevention and peer-support mental health-care programs at health-care facilities; establish national education and awareness initiatives to encourage health-care workers to seek help for mental health or substance-use issues; and require a study of the problem among health-care workers and how the pandemic has affected their well-being.

Kaine noted that some provisions were funded by the American Rescue Plan and will take effect but that the House needs to pass the full bill to formally authorize all programs and the study in the bill, and to provide more direction on how the money should be spent. The ARP provisions also did not honor Breen.

“We need the House of Representatives and the Energy and Commerce Committee to act on this legislation,” said Corey Feist, Breen’s brother-in-law, who along with his wife, Jennifer, founded the Dr. Lorna Breen Heroes Foundation. “We need to demonstrate to our healers that this is our recognition of their care for us, and we need to care right back for them.”

Feist and the doctors at Wednesday’s news conference were quick to stress that this problem long predates the pandemic, though the pandemic has badly exacerbated it. Studies have shown that doctors die by suicide at a higher rate than the general population — but health-care workers can be hesitant to seek mental health help out of fear that it could reflect badly on their ability to do their jobs or even affect their medical license.

Lucas Collazo, a cardiac surgeon the Inova Health system, said that when he graduated from medical school in 1989, “self-care was considered selfish, and talking about well-being was a sign of weakness — you didn’t talk about it.” He would never have imagined then, he said, that 32 years later there would be a National Physician Suicide Awareness Day — which falls on Friday.

“It perpetuated, it propagated, a culture of suffering in silence,” Collazo said, “and because of that, we failed Dr. Breen and countless physicians.”

Now, more than a year and a half into the pandemic, the burnout is growing more evident among staff at Inova Health and at hospitals across the country, as nurses and other health-care practitioners are leaving their jobs, Collazo and his colleague Riva Kamat, said in an interview. Contributing to the fatigue is that just when things seem to be improving, another surge or another mutation of the virus emerges, and hospital beds fill up again.

Coronavirus hospitalizations have gone up drastically in the Washington region in recent weeks, with some hospitals in Maryland and Virginia even choosing to delay elective surgeries to free up beds.

In Virginia, hospitalizations for covid-19 have nearly doubled over the past month, up to a seven-day average of 2,048 hospitalizations as of Wednesday from 1,013 a month ago. Collazo and Kamat, a pediatrician, described bed space atInova Fairfax as “limited,” and the Fairfax campus as “overwhelmed,” with the recent influx of Afghan evacuees plus more pediatric patients with respiratory infections having adding to the strain.

“People have such covid fatigue right now, and they are waiting for the end of this pandemic but there’s so much uncertainty as to, when are these multiple surges going to end? And how and when are we actually going to get a break?” Kamat said.

Breen began treating covid-19 patients in the emergency room in New York at a time when few treatment options for the disease were available, when hospitals were overflowing with patients and makeshift morgues were being set up in trailers.

“Like so many of our healers at the beginning of the pandemic,” Jennifer Feist said, “she had no idea what was going on.”

She suffered what Feist said they considered a “catastrophic mental health injury” because of what she experienced on the front lines — a “documented occupational hazard,” Feist said, that she and her husband became determined to do something about.

They created the foundation to raise awareness about physician burnout, and began hearing from hundreds of people with their own stories to tell, Jennifer Feist said.

And they started working with Kaine to take Breen’s story to Congress, and put federal funding behind their mission.

“They have taken the unimaginable grief of losing a loved one, a devoted sister and friend and physician, and taken up as a cause a very important thing,” Kaine said of the Feists, “and that is making sure our health-care professionals know they can come forward to ask for mental health assistance without facing any negative consequences. . . . Making sure that when we say healers are our heroes, we really treat them like that.”

This story has been updated to provide more detail on the additional steps needed for the full passage of the Dr. Lorna Breen Health Care Provider Protection Act.

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). You can also text a crisis counselor by messaging the Crisis Text Line at 741741. For doctors struggling with burnout and mental health, volunteer psychiatrists are offering free peer support at the Physician Support Line at 888-409-0141, seven days a week from 8 a.m. to 1 a.m. Eastern time.