Addressing mental health issues among healthcare workers

The same people who offer help often need it the most. That’s according to a study published last year that showed doctors make great sacrifices to save lives, often at the expense of their own health.

This study, published by researchers at Stanford Medicine in Mayo Clinic Proceedingsfound that one in 15 American physicians reported having had suicidal thoughts within a year, a rate that exceeds that of other American professions.

Physician burnout is a national epidemic that has reached an all-time high during the pandemic. I recently turned to Tait Shanafelt, MD, Jeanie and Stew Ritchie Professor of Hematology and physician wellness expert, to discuss this crisis and understand how health systems and healthcare professionals can change the landscape. wellness to support healthcare workers.

In a recent study you found that doctors with suicidal thoughts were less likely to seek help. How can colleagues and family members help doctors and other healthcare professionals get the help they need?

When doctors are in trouble, they often invest all their energy in their work to provide the best care for their patients. As a result, family members and those in their personal lives are the ones who most often see their struggles.

If family members of physicians begin to see that their partner or loved one is not themselves, they should ask how they are doing and encourage them to consider speaking to a confidential or anonymous support resource.

Better yet, systematize these types of records. For example, on the first Saturday of each month, a friend or family member might ask three questions: How do you feel about your workload? How are you handling all the demands on your time right now? And how are you feeling emotionally, at home and at work, right now?

As colleagues, we know that when physicians experience work-related distress, it’s often their peers they want to talk to the most. And yet doctors have professional standards that imply that they are expected to always have it all together. This can be an obstacle for a struggling doctor who wants to engage in genuine conversation with colleagues.

Hospitals and healthcare systems should support regular forums and physician connection groups where physicians consult with each other. Having such a pre-existing community removes the burden of people in distress from finding or creating such a forum when difficulties arise.

All physicians and healthcare professionals should also strive to foster a professional culture that encourages vulnerability with colleagues, help-seeking, and mutual support.

How is Stanford Medicine providing better support for healthcare professionals in distress?

We have a peer support program for physicians experiencing distress as a result of medical error, adverse patient outcome, or other personal or professional challenges. We also have the Stanford Medicine WellConnect program led by my colleague Mickey Trockel, MD, professor of psychiatry and behavioral sciences. WellConnect is a program that provides free 24-hour access to licensed professionals who specialize in assisting physicians and others and can help them overcome emotional and mental health challenges related to the profession. They offer access by phone, video or in person, 365 days a year. They provide confidential care that is not recorded in the person’s medical record.

If not, how can we make progress on this issue? What questions have not yet been asked or answered?

Since professional distress is so common among physicians, we need to think about what we can do upstream to address issues in practice and prevent distress in the first place.

It starts with recalibrating unrealistic workloads, addressing ineffective and suboptimal work approaches, and improving aspects of organizational and work culture that contribute to distress. For example, we know that the number of messages received in a doctor’s inbox is strongly correlated with burnout.

National data also shows that in the first month of the pandemic, the volume of these messages increased by 50% as patients transitioned to telehealth. He didn’t come back down. We need to develop care delivery models that allow us to continue to provide telehealth-based care without taxing physicians’ personal time.

Further, in many cases, the physician compensation structure in the United States is a productivity-based compensation system that incentivizes overwork. So a newly trained doctor who has a lot of student debt is incentivized to work 60, 70, 80 hours a week in order to be able to repay his loans. It is unsustainable and contributes to burnout. We’ve shown that this ultimately leads to lower productivity, lower patient satisfaction, and unsustainable turnover rates for organizations.

Finally, healthcare organizations sometimes create cultures that expect perfection rather than a commitment to excellence, growth, and learning. The solution is not to teach doctors and healthcare professionals better personal resilience. It’s about changing expectations of perfection and solving workload issues and inefficiencies that make the workday overwhelming.

Get help for yourself or others

Editor’s note: As the wellness landscape for healthcare workers and physicians continues to evolve, we’ve compiled a collection of resources, videos, and insightful stories from Stanford Medicine experts. The videos, hosted by the Stanford Center for Health Education team and Shashank Joshi, MD, professor of psychiatry and behavioral sciences, explore how to help someone who is grieving, what to say to a friend who is thinking about suicide and strategies adaptation for educators and students. . The stories below take an honest look at distress, grief, and other mental health topics among doctors.

Mental health hygiene can improve mood and reduce stress

In this article, Hui Qi Tong, PhD, Clinical Associate Professor of Psychiatry and Behavioral Sciences who directs the Mindfulness program at the Stanford Center for Integrative Medicine, discusses how we can generate our own peace of mind. She calls it “mental health hygiene” and includes daily mindfulness practices, which can reduce stress levels and improve mood.

How the grief of one million COVID-19 deaths in the United States hurts us all

Stanford Medicine psychiatrist David Spiegel, MD, explains how the United States as a community is suffering from widespread and prolonged grief, and what we can do about it. Spiegel talks about community grief, the impact it has individually and in the community, how we can care for ourselves and others, and what we can do to resume our normal activities – especially as we grapple with the realization that COVID-19 will not disappear entirely.

How COVID-19 has harmed the mental health of healthcare workers

Sarah Hagerty, Ph.D., clinical psychologist and postdoctoral fellow at Stanford Medicine, explains how the mental health of healthcare workers has been impacted by the pandemic. Hagerty discusses the mental state of healthcare workers and how the industry can help them move forward.

Attitude to mistakes – and lack of self-care – hurt doctors’ well-being

A survey by psychiatrist Mickey Trockel, MD, PhD, shows that there is nothing inherent in being a doctor that leads to burnout. The problems are long hours and the shame of mistakes. The study found that physicians who view mistakes as an opportunity to learn and who don’t overwork are less likely to burn out than their non-physician peers.

Stanford experts talk about COVID mental health transitions in 2021

The next phase of the global pandemic will bring new mental health challenges. Stanford Medicine experts Debra Kaysen, PhD, professor of psychiatry and behavioral sciences, and Victor Carrion, MD, director of the Stanford Medicine Early Life Stress and Resilience Program, offer tips for building resilience and managing chronic stress.

Resources for mental health support

For Stanford Medicine employees, extensive mental health and wellness resources are available through the programs listed below (employee IDs may be required):

Additional resources for healthcare workers in need of mental health support are available below:

People in crisis can also receive help from the Santa Clara County Suicide and Crisis Hotline at 855-278-4204. Help is available from anywhere in the United States via Crisis Text Line (HOME text at 741741) or the National Suicide Prevention Lifeline at 800-273-8255. All three services are free, confidential and available 24 hours a day, seven days a week.

Top photos images by Marina Zlochin, clockwise from top left,, boyloso, Jukan Tateisi and fernandohiminaicela

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