The news spread quickly when Dr. Lorna Breene, medical director of the emergency department at NewYork-Presbyterian Allen Hospital, died by suicide last month.
Dr. Breene’s father said she’d described an “onslaught of patients who were dying before they could even be taken out of ambulances,” according to the New York Times.
“She tried to do her job, and it killed her,” he said.
Though suicide is complex and cannot be reduced to a single factor or cause, Dr. Breene’s death was perhaps the nation’s first reckoning with the emotional and psychological distress facing healthcare workers.
A recent analysis of social media data conducted by the artificial intelligence analytics firm Qntfy suggested that healthcare professionals’ wellbeing is decreasing more than members of the general population. Qntfy used machine learning and natural language processing to detect signals of depression, anxiety and suicide risk
Dr. Loice Swisher, an emergency room physician in Philadelphia and member of the American Association of Suicidology, said the death of Dr. Breene, whom she didn’t know personally, prompted her to reach out to a group of fellow physicians to offer support.
“When you can’t handle [the pressure], it feels like such a failure that you’d almost rather die than see disappointment in people’s eyes,” says Dr. Swisher. “It becomes such a story we tell ourselves that’s not true, but when you’re in that crisis, the stories you tell yourself separate you from others.”
Hard-charging healthcare providers might think that asking for emotional or mental health support would make them look weak and unreliable, or would confirm their own deeply held fears about being an imposter in medicine. Dr. Swisher says they may view reaching out as confirmation that they don’t belong. That’s why it’s critical for their friends and family to check on them and reiterate their support during this difficult time.
Healthcare professionals also tend to excel at compartmentalizing, which is a valuable skill in the operating room. It can also leave them overwhelmed once the stressors they’ve been blocking out — relationship troubles, financial strain, anxiety — rush back to the surface.
Dr. Swisher, who has been treating COVID-19 patients and has experienced suicidal thinking in the past, says she manages her mental and emotional wellbeing partly by sharing what she’s going through with colleagues she trusts. She outlined additional coping strategies and tips in a recent blog post for the Council of Residency Directors in Emergency Medicine.
She shared the following resources with Mashable:
Kristen Neff, an associate professor in the department of educational psychology at the University of Texas at Austin, hosts this website with information and exercises about self-compassion. Dr. Swisher believes that connection and self-compassion are what ultimately stand in the way of a health care worker and a suicide attempt.
“When you get to the very last stage … there are two things: connection to other people, a sense of purpose and calling in the world, and the ability to turn off the judgment and have compassion for yourself as human being,” she says.
Dr. Swisher uses this free journaling app to record her gratitude, an exercise that’s been shown to improve mood and outlook.
This app was developed by the Department of Veterans Affairs as a tool to help prevent suicide. Users can store photos, sound bites, and videos of loved ones, as well as music, games, and helpline numbers. Dr. Swisher says she uses the app to “recenter” herself after handling a particularly difficult case.
Dr. Swisher says it’s important for healthcare workers to grapple with shame, a powerful but rarely discussed emotion in medicine. Providers might experience shame when they feel responsible for an error, learning struggle, or personal failure, according the the initiative The Shame Conversation. The project is an effort to address shame in healthcare by starting and sustaining conversations about the emotion amongst providers. People can watch a short film on the subject and use it for self-reflection or as a starting point for a conversation with others.
Project Parachute provides pro-bono teletherapy (phone or video) sessions to health professionals on the frontline, including paramedics, hospital and urgent care staff, nurses, and doctors.
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This help line staffed by volunteer psychiatrists offers free and confidential peer support to physicians in the U.S. The line is available daily by calling 1 (888) 409-0141 from 8 a.m. to 3 a.m. EST.
The website Metanoia began long ago as a clearinghouse for information about online therapy. While it’s no longer updated, Dr. Swisher’s go-to page for self-help is the site’s long post about what to do if you’re feeling suicidal. The post walks readers through steps to help them put distance between them and their suicidal feelings, and to get help.
This 24/7 help line provides free crisis counseling for frontline workers. They can text FRONTLINE to 741741 in the U.S. (Support is also available for residents of Canada, Ireland, and the U.K.).
Here are some additional resources for healthcare workers on the frontline of the pandemic:
The Pandemic Crisis Services Coalition, a group of international mental health organizations, created a database of free crisis services searchable by state, county, contact method, support type, topics, and categories. The database contains contact information for hundreds of helplines and community centers in the U.S., whose volunteers and staff are trained to connect callers with local mental health providers and resources.
The American Medical Association compiled tips and strategies to help healthcare providers address their own mental health needs during the coronavirus pandemic.
The meditation app Headspace is offering free access to Headspace Plus for healthcare professionals in the U.S. through the end of 2020.
Healthcare workers can get free access to the meditation app 10 Percent Happier.
If you want to talk to someone or are experiencing emotional distress, you can contact the Disaster Distress Helpline by calling 1-800-985-5990 or texting TalkWithUs to 66746. The helpline, which is operated by the Substance Abuse and Mental Health Services Administration, specializes in helping people who are experiencing emotional distress related to any natural or human-caused disaster.