Category: Job Stress

COVID-19 front line workers vulnerable to mental health problems

COVID Stress Takes a Toll on Mental Health with Health Care Worker

The daily toll of COVID-19, as measured by new cases and the growing number of deaths, overlooks a shadowy set of casualties: the rising risk of mental health problems among health care professionals working on the front lines of the pandemic. A new study, led by University of Utah Health scientists, suggests more than half of doctors, nurses, and emergency responders involved in COVID-19 care could be at risk for one or more mental health problems, including acute traumatic stress, depression, anxiety, problematic alcohol use, and insomnia. The researchers found that the risk of these mental health conditions was comparable to rates observed during natural disasters, such as 9/11 and Hurricane Katrina.

"What health care workers are experiencing is akin to domestic combat," says Andrew J. Smith, Ph.D., director of the U of U Health Occupational Trauma Program at the Huntsman Mental Health Institute and the study's corresponding author. "Although the majority of health care professionals and emergency responders aren't necessarily going to develop PTSD, they are working under severe duress, day after day, with a lot of unknowns. Some will be susceptible to a host of stress-related mental health consequences. By studying both resilient and pathological trajectories, we can build a scaffold for constructing evidence-based interventions for both individuals and public health systems."

The study appears in the Journal of Psychiatric Research. In addition to U of U Health scientists, contributors include researchers from the University of Arkansas for Medical Sciences; University of Colorado, Colorado Springs; Central Arkansas VA Health Care System; Salt Lake City VA Healthcare System; and the National Institute for Human Resilience. The researchers surveyed 571 health care workers, including 473 emergency responders (firefighters, police, EMTs) and 98 hospital staff (doctors, nurses), in the Mountain West between April 1 and May 7, 2020. Overall, 56% of the respondents screened positive for at least one mental health disorder. The prevalence for each specific disorder ranged from 15% to 30% of the respondents, with problematic alcohol use, insomnia, and depression topping the list.

"Front line providers are exhausted, not only from the impact of the pandemic itself, but also in terms of coping day to day," says Charles C. Benight, Ph.D., co-author of the study and a professor of psychology at the University of Colorado, Colorado Springs. "They're trying to make sure that their families are safe [and] they're frustrated over not having the pandemic under control. Those things create the sort of burnout, trauma, and stress that lead to the mental health challenges we're seeing among these caregivers."

In particular, the scientists found that health care workers who were exposed to the virus or who were at greater risk of infection because they were immunocompromised had a significantly increased risk of acute traumatic stress, anxiety, and depression. The researchers suggest that identifying these individuals and offering them alternative roles could reduce anxiety, fear, and the sense of helplessness associated with becoming infected.

Alcohol abuse was another area of concern. About 36% of health care workers reported risky alcohol usage. In comparison, estimates suggest that less than 21% of physicians and 23% of emergency responders abuse alcohol in typical circumstances. Caregivers who provided direct patient care or who were in supervisory positions were at greatest risk, according to the researchers. They say offering these workers preventative education and alcohol abuse treatment is vital. Surprisingly, health care workers in this study felt less anxious as they treated more COVID-19 cases.

"As these health care professionals heard about cases elsewhere before COVID-19 was detected in their communities, their anxiety levels likely rose in anticipation of having to confront the disease," Smith says. "But when the disease started trickling in where they were, perhaps it grounded them back to their mission and purpose. They saw the need and they were in there fighting and working hard to make a difference with their knowledge and skills, even at risk to themselves."

Among the study's limitations are its small sample size. It was also conducted early in the pandemic in a region that wasn't as affected by the disease as other areas with higher infection and death rates. Moving forward, the researchers are in the final stages of a similar but larger study conducted in late 2020 that they hope will build on these findings. "This pandemic, as horrific as it is, offers us the opportunity to better understand the extraordinary mental stress and strains that health care providers are dealing with right now," Smith says. "With that understanding, perhaps we can develop ways to mitigate these problems and help health care workers and emergency responders better cope with these sorts of challenges in the future."

Read this article on Science Daily: Dr. Smith, Hannah M. Wright, Tiffany M. Love, and Scott A. Langenecker of University of Utah Health contributed to this study. The study, "Pandemic-related mental health risk among front line personnel," was published in the Journal of Psychiatric Research.


Teletherapy – Online Video Counseling Services

Short-term sessions, single sessions or ongoing support

Contact Dr. Holland to learn more and to schedule an appointment or call 707-479-2946.

Video Conference Therapy During Difficult Times

Distance therapy helps to address the stay-at-home trend during flu outbreak

Distance therapy helps to address the stay-at-home trend during flu outbreak

Dr. Holland has offered phone and video conferencing therapy options for patients for some time, and with the rising concerns surrounding the coronavirus, these types of therapy sessions are more relevant than ever.

“Distance therapy using the phone or an online video conferencing system such as FaceTime has long been a good option for my clients who have access issues due to lack of transportation, health or time constraints. And, some clients simply find it more appealing to hold a session outside of an office environment.” Dr. Holland explains. “Now, with the widespread concern over the coronavirus, online therapy is a great way to stay connected with my clients, and a terrific option for new clients that don’t want to put off getting the help they need.” Therapy sessions are one-on-one and individually tailored to the client’s needs.

What is required for online conferencing? New clients will need to go through a screening process that begins with a free 15-minute phone consultation with Dr. Holland. Once the screening process is complete, clients simply need to have access to a reliable computer with a webcam, a smartphone or a tablet equipped with camera and mic. After the appointment is confirmed, Dr. Holland will send a link to the video conference that is used to access the therapist’s private online office room.

Additional Information

As with any new therapy system, it’s a good idea to research and understand the benefits and limits of this form of technology before signing up for a session. It is important to have access to a computer or mobile device with a webcam, a good microphone as well as up-to-date antivirus software and a personal firewall. Clients will also need access to a private space where they will not be overheard. It's also good to create a space that is free from distractions that could interrupt the session such as phone calls, emails, other people or pets in the area.

Please bear in mind that this program is not meant to replace crisis services or hospitalization. New clients who are a good fit for this program are typically eager to get help, they are stable, and they are open to receiving information and guidance for symptom relief.

Please start by booking a free 15-minute phone consultation with Dr. Holland.

 

 

Report finds burnout prevalent in health care community

Addressing clinician burnout will require a deliberate and substantive health care system redesign

Clinician burnout is affecting between one-third and one-half of all of U.S. nurses and physicians, and 45 to 60% of medical students and residents, according to a National Academy of Medicine (NAM) report.
Vanderbilt University Medical Center is among 32 institutions and foundations that sponsored the 296-page report, "Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being," which investigates the causes of widespread clinician burnout and offers solutions to address the problem at its source.

"There's an all too direct connection between clinician burnout and health care safety and quality. While clinician burnout isn't a new problem, its worsening prevalence and impact are due to system factors inherent in the modern health care system," said Matthew Weinger, MD, professor of Anesthesiology and Norman Ty Smith Chair in Patient Safety and Medical Simulation at VUMC, and a member of the NAM authoring committee for the new report.

"The Committee came to realize that addressing clinician burnout will require a deliberate and substantive health care system redesign with a focus on those activities that deliver the most value to patients while enabling and empowering clinicians to deliver high-quality care," he said.

The report discusses key issues that need to be addressed:

  • Clinician burnout needs to be tackled early in professional development and special stressors in the learning environment need to be recognized. Leaders in health care and health professions education have a responsibility to foster, monitor and continuously improve work and learning environments.
  • While some health care technologies appear to contribute to clinician burnout (poorly designed electronic health record systems, for example), there is real potential for well-designed and implemented technologies to help reduce burnout.
  • Federal and state governments, other payors and regulators and the health care industry itself have important roles to play in preventing clinician burnout. Increasing administrative burdens and distracting clinicians from the care of their patients can directly affect burnout.
  • Medical societies, state licensing boards, specialty certification boards, medical education and health care organizations all need to take concrete steps to reduce the stigma for clinicians seeking help for psychological distress and make assistance more easily available.

The report concludes with goals and recommendations centered on creating more positive work and learning environments, reducing administrative burden, enabling technology solutions, providing more support to clinicians and learners, and investing in research to address clinician burnout.


Story Source: Materials provided by Science Daily ---> Note: Content may be edited for style and length. Vanderbilt University Medical Center. "Consensus report shows burnout prevalent in health care community." ScienceDaily. ScienceDaily, 23 October 2019. www.sciencedaily.com/releases/2019/10/191023172121.htm.


Dr. Jenny Holland"On the job burnout reduces productivity and saps energy, causing feelings of being helpless, hopeless, cynical and resentful. The negative effects of burnout will eventually spill over into every area of life—including home, work and social life. Burnout can also cause long-term physical changes and increased vulnerability to illnesses like colds and flu. Because of its many consequences, it’s important to work through feelings of burnout with a counselor."

Dr. Holland works with professionals suffering from burnout by connecting the dots between symptoms and the root of the problem. She will help you to creatively work with your situation to help you discover new meaning in your work and offer ways you can stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others.

Contact Dr. Holland to get help with these problems today.

Poor sleep and job stress even more toxic than predicted

Employers should provide stress management and sleep treatment in the workplace

Stressed at work and trouble sleeping? It's more serious than you think

Work stress and impaired sleep are linked to a threefold higher risk of cardiovascular death in employees with hypertension. Study author Professor Karl-Heinz Ladwig said: "Sleep should be a time for recreation, unwinding, and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic."

One-third of the working population has hypertension (high blood pressure). Previous research has shown that psychosocial factors have a stronger detrimental effect on individuals with per-existing cardiovascular risks than on healthy people. This was the first study to examine the combined effects of work stress and impaired sleep on death from cardiovascular disease in hypertensive workers. The study included 1,959 hypertensive workers aged 25-65, without cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease. People with work stress alone had a 1.6-fold higher risk while those with only poor sleep had a 1.8-times higher risk.

In the study, work stress was defined as jobs with high demand and low control -- for example when an employer wants results but denies authority to make decisions. "If you have high demands but also high control, in other words you can make decisions, this may even be positive for health," said Professor Ladwig. "But being entrapped in a pressured situation that you have no power to change is harmful." Impaired sleep was defined as difficulties falling asleep and/or maintaining sleep. "Maintaining sleep is the most common problem in people with stressful jobs," said Professor Ladwig. "They wake up at 4 o'clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues."

"These are insidious problems," noted Professor Ladwig. "The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave." The findings are a red flag for doctors to ask patients with high blood pressure about sleep and job strain, said Professor Ladwig. "Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases risk of the other. Physical activity, eating healthily and relaxation strategies are important, as well as blood pressure lowering medication if appropriate."

Employers should provide stress management and sleep treatment in the workplace, he added, especially for staff with chronic conditions like hypertension.

Components of group stress management sessions:

  • Start with 5 to 10 minutes of relaxation.
  • Education about healthy lifestyle.
  • Help with smoking cessation, physical exercise, weight loss.
  • Techniques to cope with stress and anxiety at home and work.
  • How to monitor progress with stress management.
  • Improving social relationships and social support.

Sleep treatment can include:

    • Stimulus control therapy: training to associate the bed/bedroom with sleep and set a consistent sleep-wake schedule.
    • Relaxation training: progressive muscle relaxation, and reducing intrusive thoughts at bedtime that interfere with sleep.
    • Sleep restriction therapy: curtailing the period in bed to the time spent asleep, thereby inducing mild sleep deprivation, then lengthening sleep time.
    • Paradoxical intention therapy: remaining passively awake and avoiding any effort (i.e. intention) to fall asleep, thereby eliminating anxiety.

Story Source: Materials provided by Science Daily. Note: Content may be edited for style and length. European Society of Cardiology. "Stressed at work and trouble sleeping? It's more serious than you think." ScienceDaily. ScienceDaily. www.sciencedaily.com/releases/2019/04/190428143520.htm.


Every job situation will come with varying degrees of stress and frustration that ebb and flow. Burnout, however, is more than that. It is an all-encompassing feeling that you are being pulled in every direction at once and that no matter what you do, you are unable to make progress or move forward. If chronic burnout is left untreated, it can lead to issues with physical and mental health.

Dr. Holland understands that successful people are not immune to symptoms like depression, anxiety, and addiction. Yet, many successful people are often hesitant to seek treatment because of their high-profile statuses and stressful career responsibilities. For this reason, Dr. Holland takes great pride in offering a private environment that caters to the needs of these individuals, providing them with a therapeutic atmosphere that offers a sanctuary where they can step away from the stresses of their everyday lives.

A good first step for healthcare providers and other professionals suffering from burnout and exhaustion is to acknowledge those feeling and to talk about it with a trusted counselor. Dr. Holland works with professionals suffering from burnout by connecting the dots between symptoms and the root of the problem. She will help you to creatively work with your situation to discover new meaning in your work and discover ways to stay healthy. Dr. Holland will help you learn how to help yourself so you can continue to do the work you love of helping others.

Contact Dr. Holland to get help with these problems today.