There are countless tragedies surrounding COVID-19, but a lesser-known tragedy is the impact this crisis is having on the mental health of our medical professionals.
The death by suicide of Dr. Lorna M. Breen, the medical director of the emergency department at New York – Presbyterian Allen Hospital, is heartbreaking. Her death highlights that the mental health needs of healthcare workers on the frontline of this crisis must be addressed.
Some sobering facts to consider:
- Physicians have higher rates of suicide, suicide risk, and symptoms of depression than the general population
- At the same time, physicians are less likely to seek mental health treatment.
- For male physicians, the suicide rate is 1.41 times higher than the general male population
- For female physicians, this risk is even higher, at 2.27 times greater than the general female population.
- Physicians are even more prone to the stigma surrounding mental health care
- For physicians, barriers to seeking counseling are:
- concerns about reputation
- concerns about confidentiality
- From 2004 to 2014, Healthcare Providers and Social Assistance workers have had the fifth highest number of suicides in Colorado (638 suicides within this 10 year time frame),
- health diagnosing and treating practitioners have by far the highest number of suicides within that group (317 suicides within this ten year time frame).
- Healthcare support and Office and Administrative Support workers have had the second and third highest number of suicides, respectively, within the Healthcare Provider group.
- Risk for suicide increases among physicians when mental health conditions go untreated
- Self-medicating, even with prescription medications, may temporarily reduce some symptoms of depression and anxiety, but the underlying issue remains untreated.
About 50% of my clients are healthcare professionals. I can assure you that those on the frontlines of this crisis are struggling. Yes, they are humbled that they can attempt to help, but they’re also feeling alone, isolated, helpless, powerless, and overwhelmed. This often shows up as being numb, detached, or burnt out. They have no time to grieve, little ability to reach out for support, are isolated from their families, and see no end in sight. It is so important that we all model good self-care and prioritize our mental health, and even more important for those on the frontlines.
The mental health toll on all of us is growing, and as it grows, I want to take this opportunity to emphasize the importance of reaching out for help, the warning signs of suicide, and resources for support.
The Importance of Reaching Out for Help for Medical Professionals
- Awareness of one’s own emotional reactions and distress when confronting others’ difficult and traumatic experiences is paramount. Pay attention to how you’re doing, and increase self-care and support as needed.
- Connect with others by talking with trusted colleagues or other trusted friends
- Maintain a balance between one’s professional and personal life, with a focus on self-care such as exercise, relaxation, and stress management
- Speak up if you’re down … it may be vulnerable to do so, but that same vulnerability leads to the healing you need.
- Know that depression is a problem that has a solution. When you have a sore throat, you go to the doctor who knows how to help. When you have a sore heart or an anxious brain, you go to a therapist who knows how to help.
- Resist withdrawing … it is common to withdraw when feeling depressed, and we know that connections are a powerful curative factor in depression
- Prioritize healthy coping strategies, such as adequate sleep, exercise, and confiding in friends
- Be aware of the stigma surrounding mental health and know that you alone have the ability to combat that stigma for yourself
- Cling to better self-care, including reaching out to a therapist for mental health care
- Seek professional help when symptoms of depression, anxiety or other mental health or substance use issues impact your daily personal or professional functioning
- Kindred Counseling, PLLC, is offering $50 telehealth sessions for healthcare workers during the COVID-19 pandemic.
How to Reach Out for Help
I realizing that telling someone to ask for help is easier said, than done. In the depths of depression, reaching out for help can feel like a monumental, scary, and impossible task. To take the guess work out of it, here are some things you could say:
- “This is hard for me to admit, but I want you to know I’m feeling depressed/anxious/suicidal.”
- “I know you can’t fix it and I don’t expect you to fix anything, but I am in a tough spot right now. Can you talk?”
- “I know we don’t talk much, but I’m going through a tough time and I feel like you’re someone I can trust. Would you be up for talking on the phone?”
- “I’m struggling with my mental health and what I’ve been trying isn’t helping. Would you mind chatting with me about a plan to help me feel better?”
- “I don’t feel safe by myself right now. Can you stay on the phone with me/facetime with me until I can calm down?”
- “I’m in a tough place but I’m not ready to talk about it. Can you help me distract myself?”
- “I am struggling with depression. I haven’t wanted to share this with anyone, but I know if you were in this spot I’d want you to share with me. Can we talk about it?”
- “I’m not okay.”
- “This is really hard. I’m tired of pretending to be okay and I feel like you’re someone I can trust. I am struggling with depression/anxiety/feeling suicidal.”
Risk factors are characteristics that make it more likely that someone will consider, attempt, or die by suicide. They can’t cause or predict a suicide attempt, but they’re important to be aware of.
- Mental disorders, particularly mood disorders, schizophrenia, anxiety disorders, and certain personality disorders
- Alcohol and other substance use disorders
- Impulsive and/or aggressive tendencies
- History of trauma or abuse
- Major physical illnesses
- Previous suicide attempt(s)
- Family history of suicide
- Job or financial loss
- Loss of relationship(s)
- Easy access to lethal means
- Local clusters of suicide
- Lack of social support and sense of isolation
- Stigma associated with asking for help
- Lack of healthcare, especially mental health and substance abuse treatment
- Cultural and religious beliefs, such as the belief that suicide is a noble resolution of a personal dilemma
- Exposure to others who have died by suicide (in real life or via the media and Internet)
Some warning signs may help you determine if a loved one is at risk for suicide, especially if the behavior is new, has increased, or seems related to a painful event, loss, or change. If you or someone you know exhibits any of these, seek help by calling the Lifeline.
- Talking about wanting to die or to kill themselves
- Looking for a way to kill themselves, like searching online or buying a gun
- Talking about feeling hopeless or having no reason to live
- Talking about feeling trapped or in unbearable pain
- Talking about being a burden to others
- Increasing the use of alcohol or drugs
- Acting anxious or agitated; behaving recklessly
- Sleeping too little or too much
- Withdrawing or isolating themselves
- Showing rage or talking about seeking revenge
- Extreme mood swings
Resources for Support
- A list of Colorado Community Mental Health Centers (CMHCs) can be found at: https://www.cbhc.org/. A list of Colorado Crisis Services Walk-In Centers can be found at: http://coloradocrisisservices.org/.
- The Healthcare Toolbox provides excellent and concise advice on physician self-care: https://healthcaretoolbox.org/self-care-for-providers.html
- National Suicide Prevention Lifeline: 1-844-493-TALK (8255) or text “TALK” to 38255. This number will connect you to a local certified crisis line.
- Visit www.coloradocrisisservices.org to identify your nearest walk-in location, access crisis chat features or download printable wallet cards.
- Visit the Zero Suicide initiative (http://zerosuicide.sprc.org) for information and resources related to suicide prevention.
- Visit https://suicidepreventionlifeline.org/ for 24/7, free and confidential support for people in distress, prevention and crisis resources
- How to talk to kids about suicide: https://www.mirecc.va.gov/visn19/talk2kids/e/
- If you are in another country, find a 24/7 hotline at www.iasp.info/resources/Crises_Centres.
May Dr. Lorna M. Breen rest in peace.