Mental Health

Let’s Talk About Mental Health

Written by Nancy Sokoler Steiner

Anyone reading this publication knows that while working in health care can be extremely gratifying, it can also be extremely stressful. The demanding pace, high stakes and emotional intensity all contribute to fatigue and burnout. And that was before the pandemic. Feelings of helplessness and fear in the face of the new and mysterious virus brought a whole new level of stress to the physicians and staff of Torrance Memorial Medical Center and their peers worldwide.

Now, COVID-19 has reached more manageable levels, but the impact it has had on health care workers persists. In the American Medical Association’s 2022 National Burnout Benchmarking report, 52% of respondents said they were experiencing a great deal of stress. In May, United States Surgeon General Vivek Murthy, MD, issued a new Surgeon General’s Advisory highlighting the urgent need to address the health worker burnout crisis across the country. “While the worst is over, people are stressed, they’re overworked and feeling anxious,” says Morris (Moe) Gelbart, PhD, Torrance Memorial’s director of behavioral health. “At this point, many of us are getting numb.”

He notes that in addition to all the stresses associated with caregiving, isolation and lack of connection have contributed to mental health challenges among physicians and staff. “Because of COVID-19 protocols, we’re having fewer in-person meetings, gatherings in the lunchroom or opportunities to socialize in the lounge,” he says. “That takes a toll.”

Caring for the Caregivers

The announcement on flights about oxygen masks is a good analogy for health care providers, says Frederick Dennis, MD, the medical director of Torrance Memorial IPA. “Put on your own oxygen mask first. You’re not going to be able to care for someone else if you don’t take care of yourself.”

To be productive, one needs renewal periods, he says, suggesting blocking out time on the calendar for the short- and long-term stress-reduction strategies he describes. For immediate relief, he suggests visualization, which entails closing one’s eyes and thinking of a peaceful, tranquil setting such as the beach or rainforest and engaging each of the senses in that setting—smelling the trees, hearing the birds sing and feeling the sun on one’s face. “Within one to two minutes, that can lower blood pressure, heart rate and breathing rate, as well as stop the release of stress chemicals,” he says.

Similarly, “one breath” entails breathing all the way out, then breathing in slowly using all the senses—noticing the feeling of the chair, the ambient sounds, the objects within sight, etc. “This gets you out of your mind and focused on the external instead,” says Dr. Dennis. “It stops the monkey chatter [in your head] by focusing on sensory input.” Apps such as Calm or Headspace can help with meditation and visualization.

Intermediate and longer-term measures include familiar ones such as regular exercise, a healthy diet and getting sufficient sleep. Dr. Dennis notes there are many online sources addressing these topics and is happy to direct readers to specific ones. He also suggests having a pet if possible. “Animals are centering and make you live in the present,” he says.

The mind can play a large role in increasing—or decreasing—stress. “If you change how you think, you can change how you feel,” says Dr. Gelbart. “Thinking can be incorrect, distorted and false. Most of us think in black-and-white terms.”

People often catastrophize and engage in “what if” thinking, he says. When that happens, “Stop, take a breath and change ‘what if’ to ‘what is’—what is going on in your life at the moment? That changes the focus to what you can do.”

Try to maintain perspective, he suggests. “If you see the glass half empty, you’re going to feel negative. If you can see it as half full, you’ll feel better. The beauty is, the water in the glass doesn’t have to change.”

The Great Revise – Life Reassessment

The Great Resignation refers to the record number of Americans who quit their jobs since the beginning of the pandemic—more than 40 million in 2021 alone. Dr. Dennis believes this is part of a larger phenomenon that he calls The Great Revise. People are reassessing all aspects of their lives, ranging from where they want to live to what kind of work they wish to do, and whether they want to strengthen or end relationships.

“People are looking at every aspect of their lives and often deciding they can do better or have nothing to lose,” he says. He advises hospital personnel to look at their preferences and desires to see how they can best align those with their lives.

Perhaps someone who’s become an empty nester might want to trade her house in Torrance for a condo near the beach. Or a nurse who feels he has learned all he can after working several years in med-surg might want to challenge himself by switching to the ICU. “It’s an incredible opportunity to take stock,” says Dr. Dennis.

Resources

Torrance Memorial Medical Center offers a variety of resources for employees. They include the EAP (Employee Assistance Program)—free and confidential counseling sessions with outside licensed therapists. In recognition of the stress so many are feeling, Torrance Memorial raised the number of visits each member of a family may receive from five sessions to 10.

SOS (Support Our Staff) provides peer counseling to employees who have experienced an adverse event in the workplace. The individual is matched with a Torrance Memorial counterpart who has dealt with a similar experience.

Workplace violence has become a growing concern given the disturbing incidences reported in the news. The medical center has a Workplace Violence Team in place, which holds exercises within the hospital and with the local police department. “The hospital is aware of what’s going on. We are as prepared as we can be, and we continue to work on this issue with the experts,” says Dr. Gelbart.

Torrance Memorial’s Health and Wellness Committee, led by vice president of nursing Shanna Hall, designs programs to promote physical and mental well-being and just plain fun. Activities include pop-up ice cream socials and an All-Star Game Spirit Day. In November, the committee invited staff, physicians and volunteers to celebrate Kindness is Contagious month. The event promoted gratitude and the importance of being kind to oneself, one another and the community. Special activities included staff appreciation welcome days, live music in the cafes, pet visitations, photo booths, newsletters and snack carts.

The committee has also instituted a monthly lecture series featuring outside experts. Last year focused on burnout and stress, while this year emphasizes positive psychology. Lectures are open to all hospital staff and are made available online afterward.

A Reminder For Those Who Are Struggling

Dr. Gelbart offers three suggestions for those who are struggling. First, talk to a trusted family member, friend or colleague rather than keeping feelings inside. “It doesn’t have to be a professional; just someone who won’t judge or tell you what to do. That can often be enough.”

Second, “Know that life is not perfect. There are times you won’t feel so good. That’s OK. Things will change.”

Third, if feelings begin impacting daily life, seek assistance from a professional. “We have good health care coverage that allows you to access professional help.”

“We want employees to know there are lots of avenues for help,” says Dr. Gelbart. “You don’t have to suffer on your own. Don’t judge yourself for how you feel. Accept your feelings and be willing to accept help. We’ll offer as many resources as we can.” •