Content repurposed from VITAL WorkLife.
BY SIMON MITTAL, MD, MMM
May recognizes Mental Health Month across the United States. It’s a time to share information, stories, and resources about mental health. SafeHaven™ is dedicated to doing this work for physicians and other healthcare professionals by raising awareness about clinician well-being and burnout.
The first step in supporting healthcare professionals’ well-being and mental health is to recognize and understand the warning signs, and then take action.
Early Warning Signs Colleagues May Notice
Based on my experience as a healthcare executive and physician peer coach, I’ve found the best people to identify signs of distress at the earliest stages are a physician’s colleagues. Working with the same group of colleagues day in and day out offers more instances to notice changes in their behavior, and as a result more opportunities to follow-up and check-in with them. Signs may be as simple as:
- A chance remark. The physician may say something like ‘I feel pretty stressed’ or ‘I’m not getting much appreciation around here.’
- A change of attitude. The person might be less cooperative, less collegial, more withdrawn. They may have a shorter fuse than they used to have, and a greater tendency to show impatience or exasperation. This may take the form of an explosion or tirade, but it may also be far less intense.
- Failure to follow protocols. Another possible symptom of lowered morale or resentment.
- Team trouble. A team that was functioning reasonably well might start to struggle due to the negative behavior of one or more of its members.
- Scheduling changes. When a physician cuts back from seeing 20 people in a given time period to seeing 18 and is still making errors—or making more errors—it could be a sign that he or she is overwhelmed.
None of these early warning signs are direct pointers to specific conditions on the spectrum of concerns. It can also be easy to ignore or minimize them, especially with medical culture’s emphasis on stoicism, self-denial, and “sticking it out” no matter what. But addressing them early on can forestall exasperated issues later on.
As for the action to take, a casual approach that respects the physician by not making assumptions or invading his or her privacy is recommended. You may talk with your colleague one-on-one, ‘I’ve noticed that you don’t seem quite like yourself recently, and I just wondered if there might be something going on that I could help you with.’
The colleague may or may not reveal some significant concern or problem, but that’s an opportunity to be of real help if they do. Go beyond simply suggesting they take advantage of the mental health resources the organization offers, but take them to that help directly—by providing a pamphlet, a web address, the name of a peer coach, or another resource.
What Administrators Should Notice – And Know
Direct person-to-person help, where one physician takes responsibility for helping another with information and support, is an important expression of a “culture of care” in the organization—and building that culture is the responsibility of leadership. Additionally, building a culture of care is good for the business overall because it improves morale and retention while reducing negative issues commonly associated with bad or toxic cultures.
While administrators may not be able to notice the more subtle early signs of mental health issues in individuals, they can and should be aware of the pressures those who work for them experience. Here are a few stressors to be aware of:
- Schedule and workload: The stressors that have made working in healthcare particularly taxing even before the pandemic1 have become all too familiar:
- Productivity requirements that limit time with patients.
- Aging patient populations with complex conditions.
- The demands of EMRs, especially time-consuming data entry and coding.
- Pandemic worries: COVID-19 has severely impacted physicians and filled them with uncertainties of all kinds. Potential thoughts may include, ‘Sometimes I’m not sure I’m making a difference.’ And ‘Some days, I’m not sure if I can do this anymore’ Or, ‘I don’t know who’s been vaccinated and what kind of exposure I have. Am I bringing this disease home to my family?’
- Financial, legal, and domestic pressures: Physicians may be undergoing stressors that are “invisible” when they’re at work—dealing with malpractice suits or other legal problems; struggling with financial obligations or family or partnership crises.
- The burdens of change: One financial issue is compensation. How physicians get compensated is changing, and that creates stress. However, it’s not because of the money, but because of the change itself, and whether it’s being communicated and supported by the administration. Leaders should ask themselves, ‘Am I recognizing that, given everything physicians are dealing with changes, large or small, need to be handled with care and clarity?’
What Physicians May—or May Not—Notice about Themselves
Medical stoicism is one of the major roadblocks to physicians being able to notice early warning signs in their own feelings and actions. A lot of physicians feel they aren’t working hard enough. Physicians are not good at looking inward, and rarely seek help—the data bears this out. Concerns about confidentiality, access to help, and the general social stigma concerning mental health problems, intensified by medicine’s tough-it-out attitude, are major roadblocks. One physician’s experience was detailed during an interview with his wife following his suicide, in which he experienced many of these feelings prior to his death.
Given all of this, it may be difficult for a physician even to self-identify early symptoms of incipient burnout or other problems. They are often unaware of their symptoms and believe they don’t need help or can work through it themselves, which can lead to suicide ideation. Some of these symptoms can include:
- Increased alcohol consumption: or use of other chemical mood changers.
- Changes in sleep patterns: sleeping significantly less, or more, than normal.
- Changes in diet: eating significantly more or less.
- Trouble with relationships, especially outside of the work environment: Such as noticing if you’re yelling at your kids or your partner more often. Very often those closest to you will notice changes in your attitude and behavior sooner than you will. A good tip is to check in with your partner—how do they feel about what seems to be going on with you?
SafeHaven – Caring for Physicians, their Teams, and their Families
Everyone around a physician plays a key role in supporting them, but the resources available to these clinicians is extremely limited, and a lack of confidentiality prevents many physicians from seeking mental health support.
SafeHaven™ ensures clinicians can seek support for burnout, career fatigue, and mental health reasons without the fear of undue repercussions to their medical license.
This program offers physicians exclusive well-being benefits from VITAL WorkLife including:
- Counseling Sessions
- Peer Coaching
- Leadership Development
- 24/7 time of need helpline
- WorkLife “virtual” Concierge – to help with everyday errands and needs
- And more!
By ensuring confidentiality and offering exclusive well-being resources, SafeHaven is changing the landscape of physician mental health. Make your mental health a priority this Mental Health Month, enroll in SafeHaven today.