4 minute read
President’s Comments The Time to Discuss Mental Health is Now
Angela M. Mills, MD
The Time to Discuss Mental Health Is Now
For the month of October, SAEM hosted its largest campaign yet: #StopTheStigmaEM Month. This first-ever Stop the Stigma EM awareness campaign was focused on breaking down the barriers for mental health care in emergency medicine. Successful efforts included a robust use of social media, events including an in-person session at ACEP, and free “Zoom Gatherings” and activities to get folks engaged, sharing stories, and talking about the importance of our mental health. I want to extend a special thanks to our SAEM Wellness Committee, our All-EM Mental Health Collaborative, and all of our members, staff, and partners who helped take our initial Stop the Stigma EM idea to the next level.
Over the past few years as department chair, I have witnessed firsthand the struggles that physicians and other health care professionals have endured during the pandemic, coping with sadness and loss, the changes to our everyday lives, and being stretched in new ways both professionally and personally. Personally, and for our group, the tragic loss of our colleague and friend, Dr. Lorna Breen, to suicide was devastating. As one physician dies by suicide each day in the United States, it is critical that mental health services are available and easily accessible to the medical community.
Earlier this year, President Biden signed the Dr. Lorna Breen Health Care Provider Protection Act into law, allocating $135 million in federal grants over three years to mental health efforts in suicide prevention and well-being for health care workers. While the availability of mental health treatment is important, we know there is significant stigma in seeking care within the medical community. A poll of emergency physicians demonstrated that 45 percent are not comfortable accessing mental health care and over half reported being concerned for their job if they were to access mental health treatment.
While the effects of the pandemic have changed over time, ongoing challenges in our emergency departments remain with staffing, boarding and other issues affecting our ability to provide the excellent care we strive to deliver for our patients and the education for our learners. We know that burnout in emergency medicine was well documented prior to the pandemic. Stress and anxiety have only been exacerbated over the past few years with a recent survey demonstrating 60 percent of emergency physicians struggle with burn-out.
Following the loss of our colleague, our department instituted confidential “opt-out” peer support sessions with a psychiatrist or psychologist. These one-on-one sessions were free, without any documentation in the electronic health record, and appointments were scheduled with the choice to “opt-out” to make things as convenient as possible. We know that folks who may be most in need of mental health treatment are sometimes also challenged in scheduling an appointment. During the first year of our intervention in Spring 2020, 70 percent of our group took part in these one-on-one sessions. The following year 26 percent participated, and this past spring we had 12 percent of the group take part in these “opt-out” sessions. While the number of participants has decreased over time, I wonder if some of this may be attributed to more people engaging in ongoing mental health care with a few of our faculty having shared they meet with a mental health specialist regularly. With the goal of destigmatizing mental health care for all, I am grateful we have been able to continue the sessions for our group.
It is expected that we see our primary care provider yearly for a check-up and preventive care, just as we are expected to visit the dentist’s office every six months. Having an annual session to check in regarding our mental health should be no different. Our opt-out sessions assisted in breaking down the barriers to accessing mental health care, reducing stigma, and normalizing the discussion.
With the continued challenges facing emergency medicine and the recent signing of the Dr. Lorna Breen Act, the time is now to openly and regularly discuss mental health. While our SAEM #StopTheStigmaEM Month campaign was focused in the month of October, I implore all of us to continue these efforts, regularly checking in on ourselves as well as those around us. It will take all of us to dismantle the culture of stigma to ultimately improve well-being for emergency medicine as well as in our greater community.
ABOUT DR. MILLS: Angela M. Mills, MD, is the J. E. Beaumont professor and chair of the department of emergency medicine at Columbia University Vagelos College of Physicians & Surgeons and chief of emergency services for NewYork-Presbyterian –Columbia
