24/7 Mental Health Support
I am grateful that senior human resources and physician leadership at Nemours Children’s Hospital, where I work, listened when I brought these concerns forward. Our hospital now contracts with a dedicated psychologist who has treated physicians for more than 30 years. Last summer, when we welcomed the first class of pediatric residents, we implemented a Resident and Faculty Wellbeing Program. The absolute most impactful aspect of our program was the creation of a 24/7 immediate access mental crisis line for all residents and faculty. The psychologist rotates being on call with a team of three additional psychologists. When physicians call this line for acute crisis, the calls are answered live or within 30 minutes. There is immediate de-escalation counseling provided on call, followed by a session the next day. After the acute de-escalation, the psychologist identifies for the caller a mental health counselor from our EAP list who is also “in network” for our insurance plan. The psychologist has vetted a list of mental health counselors and has confirmed that the counselors on the list have availability and experience treating physicians and healthcare providers.
Explore This IssueApril 2020
Last summer, our program also had our psychologist meet with every chief and chair, senior physician leader, and incoming resident, one on one, for an hour. The goal was to establish baseline assessments of their mental health. Physician leaders will be expected to do this program once, but residents will do it every year. The psychologist also provides monthly sessions with the entire class of residents.
Residents and faculty have activated our immediate crisis access line over a dozen times. Sometimes chiefs or chairs contact me, and we activate the line for the physician in need who refuses to call for help or isn’t able to. This dedicated resource for acute mental health crisis and direct facilitation for ongoing mental health support is critical to ensure that no physicians are at risk for suicide.
I intentionally designed our Resident and Faculty Wellbeing Program to focus on addressing mental and physical health. We encourage participants to use an app, Engaged Performance Advantage, that has been customized for our medical staff, including all advanced practitioners. Every day, the app updates with a short read: something inspirational, practical tips to manage well-being, or a hot topic in healthcare or self-care. One day per week, the app sends a three-question survey that assesses sleep, emotional health, and well-being. For physical health, last year, every surgeon, as well as every chief, chair, and senior leader, attended an energy management training at the Johnson & Johnson Human Performance Institute. This was a great investment by the hospital. Attendees shared positive feedback and felt it was valuable, but the reality is that as soon as everyone returned back to our daily grind and stress, many admitted to not developing the new routines they had planned in order to increase individual well-being. We’ll continue to try initiatives to keep well-being at the forefront of conversations and daily experience.
In addition, in April 2019, Nemours hosted the “Do No Harm” documentary by Robyn Simon on physician suicide. I moderated a panel with two psychologists, an ED faculty whose husband had committed suicide in December of 2018, and the PD for our new peds residency program. It was hugely attended and created permission for all to discuss mental health needs for physicians and providers.
To create a culture of wellness, it’s imperative that we are brave and honest. We need to speak out and call attention to our own sentinel events as well as those sentinel events that affect our colleagues. We must design algorithms to quickly appropriate mental health counseling during sentinel events and not just focus on risk management. My next endeavor is to get our hospital to implement the notable Schwartz Rounds program for second victims. This program gives healthcare providers a regularly scheduled time to openly talk about the social and emotional stress that comes with their work. As long as each of us come together and help ourselves and one another, we will be better able to heal ourselves while healing others. We will always be able to get up again the next day, and experience life and humanity at its fullest.