Is mental health a priority at your healthcare facility?
Recent research shows a clear correlation between mental wellness and job performance among healthcare providers; mental health must be a priority moving forward. What can hospital leaders and managers do to promote optimal mental health among the workforce?
The hospital is an especially unique work environment.
For an employee at, say, a marketing firm, crushing that big client presentation might seem like a matter of life or death. But a doctor or nurse can actually say they face legitimate life-or-death situations on a regular basis. Spending long work hours in such a pressure-packed atmosphere can put a serious strain on one’s mental state. And in this type of environment, just one mental lapse can result in the loss of much more than a big client.
Consider the link that recent research found between employee wellness and job performance in the healthcare setting.
In a 2018 report published in the Journal of Occupational and Environmental Medicine, researchers studied 1,790 nurses. More than half of those respondents reported subpar physical and mental health. These same nurses were found to be 26 percent to 71 percent more likely to make medical errors than their healthier counterparts. Roughly half of the nurses reporting mental health concerns also indicated they had made a medical error in the past five years.
Another recent study finds a distressing number of physicians in less than optimal mental health. Medscape’s National Physician Burnout, Depression and Suicide Report 2019 report found 44 percent of more than 15,000 physicians saying they were “burned out.” Another 11 percent described themselves as colloquially depressed (feeling “down, blue or sad,” according to the study’s authors).
Researchers asked these healthcare providers how professional burnout has affected their lives. The responses were eye-opening. One anesthesiologist, for example, noted that “I’m drinking more and have become less active.” A family physician offered a blunt assessment of how mental health issues can manifest themselves on the job.
“I’m having medical problems as a result; having recurrent miscarriages.”
These stories and statistics illustrate the importance of recognizing mental health’s role in employee well-being. They’re also a potent reminder that employee wellness initiatives must address mental health along with the physical, financial and other factors that go into overall well-being.
Creating a culture of wellness
There was a time when employee wellness programs focused almost exclusively on physical health. The average company’s wellness initiative might have included discounts on gym memberships, or maybe a tobacco cessation program or the occasional weight-loss competition. And that was about it. Physical health is certainly important. But employers should be expanding their definition of wellness to encompass financial fitness, social well-being, happiness at home and much more, including mental health. Healthcare providers’ employee wellness offerings should reflect as much, says Yolanda Graham, MD, senior vice president chief clinical/chief medical officer at Devereux Advanced Behavioral Health.
“At any organization … there are several strategies that leadership can implement to ensure that mental health is a priority in a company’s wellness programs and overall culture,” says Graham, noting that Devereux offers a host of programs and initiatives focused on overall employee well-being.
In addition to an employee assistance program and mental health-focused wellness events such as mindful meditation and yoga classes, Devereux’s Leadership Resiliency training program is designed to help managers and supervisors build their own resilience so they can in turn boost their employees’ resilience. In addition, Devereux’s Supervisory Excellence training provides information on various behavioral health-related challenges that healthcare employees typically face, and encourages employees to seek help with addressing mental health concerns.
All new Devereux employees also complete the Adult Resiliency Survey within their first 30 days of hire, and have the opportunity to meet with Devereux’s people operations team, and receive a copy of “Building Your Bounce,” a resource intended to teach caregivers and providers how to care for themselves and enhance their resiliency skills. Putting such programs and services in place sends employees a powerful and much-needed message about mental health, says Greg Hammer, MD, a professor of anesthesiology, perioperative and pain medicine (pediatric) and pediatrics (critical care) at Stanford University Medical Center.
“It is extremely important that healthcare providers know their employers care about their mental health,” says Hammer, author of Gain Without Pain: The Happiness Handbook for Health Care Professionals.
There are other actions that your facility’s leadership can take to show that mental health is an organizational priority and an integral part of its culture, adds Hammer. For example, employee health insurance options should include affordable access to mental health professionals, he says, noting that confidential, on-site psychotherapy should be available to employees as well. Department chairs and other leaders within the facility have a responsibility to create a culture of wellness, continues Hammer. Fostering this type of culture requires recognizing the connection between physical and mental well-being, and subsequently providing services that address the factors that affect both, such as sleep, hygiene, exercise, and nutrition.
“Without attention to these pillars of self-care,” says Hammer, “mental health will suffer.”
Spotting the signs
Such offerings don’t do much good if employees don’t take advantage of them, of course. Unfortunately, a certain stigma still exists around mental health, and employees who are struggling might be reluctant to open up about their mental wellness challenges. The aforementioned Medscape report, for instance, found 64 percent of physicians experiencing burnout or depression saying they have not sought professional help to cope with these issues in the past, and have no plans to do so in the future.
So, how can your facility’s employees better monitor their own mental health? And, how can managers and co-workers learn to spot the signs of mental distress, and help ensure they and their colleagues feel comfortable seeking out the mental health resources they need? When should the organization and/or co-workers intervene, and what’s the best way to do so? These questions don’t have easy answers. But whatever approach you take, early intervention is key.
“Unfortunately, most employers wait until the problem is evident and interfering with work performance to intervene,” says Graham. “This is often too late.”
Co-workers and colleagues often notice early signs that an employee is distressed—changes in demeanor and/or physical appearance, increased absenteeism or tardiness, changes in work habits: outbursts or mood swings, for instance.
“But [co-workers] hesitate to get involved, feeling the most supportive thing to do is to not address it,” says Graham. “Not true.”
Graham suggests encouraging supervisors to acknowledge the stress that comes with being healthcare providers, and to ask their reports if they’re managing their health and taking good care of themselves.
“[This] is a very non-intrusive approach,” she says. “Normalizing mental well-being as a priority also can change the culture of an organization and destigmatize the use of resources focused on brain health.”
Communication can be a simple first step toward this goal, such as posters and other visuals around the facility that talk about mental health, sending email blasts with messages supporting mental health or focusing on mental wellness in employee newsletters, says Graham.
“The mind-body connection has been proven,” she says. “Encouraging mindfulness and making mindfulness resources and apps available can be an efficient way to assist employees in being ‘present in the moment’ while doing their jobs.”
For employees in care-providing positions, just doing their jobs often puts them in a precarious situation, says Graham.
“They are asked to be fully available for others while facing their own life challenges,” she says. “Stressors such as the need to work long hours, assisting aging parents and managing childcare and finances create physical and physiological challenges that can impact productivity and mental health.”
Indeed, the brain releases hormones during periods of stress, adds Graham. The result is an activation of the nervous system that leads to tension, irritability, sleep problems, headaches, muscle pains and a reduced ability to fight infections, for example.
It stands to reason that grappling with such issues while on the job can affect an employee’s judgment, productivity, and engagement level—with potentially grave consequences for all concerned parties, says Graham.
“For the employee and the employer, there are real costs associated with failure to proactively address employee well-being, both of which impact the customer receiving care.”
A Business Case for Better Mental Health
The logic is pretty easy to follow. Healthcare providers who work at a facility that prioritizes their mental well-being are mentally healthier. Mentally healthier employees are more engaged and productive on the job. Employees who are more engaged and productive on the job provide better patient care. Providing better patient care ultimately boosts the facility’s bottom line. The prevalence of mental health issues among physicians and other healthcare providers is well-documented. Hospital and clinic administrative leadership need to be familiar with this type of data, says Greg Hammer, MD, professor of anesthesiology, perioperative and pain medicine (pediatric), and pediatrics (critical care) at Stanford University Medical Center.
“These are important quality indicators, and are linked to increased costs and decreased revenue,” says Hammer, MD, author of Gain Without Pain: The Happiness Handbook for Health Care Professionals.
Leaders in the healthcare community have indeed become increasingly aware of this connection, says Hammer, noting his desire for this recognition to translate to an even closer focus on healthcare providers’ mental health and its impact on patient care.
“Let’s hope this awareness leads to significant changes in the paradigm of healthcare delivery.”
- Melynk B, Orsolini L, et al. A National Study Links Nurses’ Physical and Mental Health to Medical Errors and Perceived Worksite Wellness. Journal of Occupational and Environmental Medicine. Feb 2018, Vol. 60, Issue 2, p. 126 – 131. [https://journals.lww.com/joem/Abstract/2018/02000/A_National_Study_Links_Nurses__Physical_and_Mental.3.aspx]
- Medscape, National Physician Burnout, Depression & Suicide Report 2019. Accessed 2/25/2020 [https://www.medscape.com/slideshow/2019-lifestyle-burnout-depression-6011056]