RP 101 Mental Health – April 2020



Session Readings

 

As we are laser-focused on our protecting our physical health in the war path of the corona virus pandemic, our mental health is also in the spotlight.  Social distancing, general worry, and pervasive uncertainty about the near future have created more opportunity for us to be attentive to and care for our mental health. This topic ends up being timely, for multiple reasons.

When we are not in a national crisis and hearing regular acknowledgements of the toll this crisis takes on one’s mental wellness, we have a history, as a country, of not talking about mental illness in the same way we talk about physical ailments.  As a result of this, people who suffer from mental illness may deny their symptoms, hide any signs of illness, and avoid seeking treatment.   Not seeking care can be life-threatening — and not only because of an increased risk of suicide associated with many mental health conditions. Mental illness is associated with increased risk of stroke, coronary artery disease, and dementia. Co-existing mental illness can also increase mortality in people with cancer, diabetes, or chronic kidney disease and in those following myocardial infarction or coronary artery bypass surgery.

No person is completely immune to mental illness.  This includes us: providers. It should come as no surprise that there are clearly documented increases in the rates of suicide in health care professionals, including dentists, veterinarians, physicians(1).  Yet what some may not recognize is that the same characteristics which allow us, as providers, to be successful in our careers — compassion, drive, commitment – may also be interwoven with or make us vulnerable to anxiety or excess worry and depression. The burden of being a clinician struggling with mental health may feel insurmountable —  it may lead to feared or actualized threats to one’s job and professional identity. 

We add to these layers the fact that we are military personnel. War, deployments, frequent moves and many other factors all take a toll on the average military member and can pose significant threats to mental health. The military has actively worked to destigmatize mental health treatment at all levels of leadership, and yet many individual members may still perceive this stigma and continue to avoid seeking help.

As we acknowledge the stress of the current state of the world, we are talking about how mental illness manifests, how we recognize it in our colleagues, and how we work to manage our mental health. In this session, we explore some of the bias around mental health, ask you to consider the ways in which this might manifest for you and in your future practice, and reflect on ways to manage that.

FOR GSN STUDENTS ONLY:  Please see your GPS class site (week 14) on Sakai for link to the video

OBJECTIVES:

By the end of RP 101: Mental Health, you (the learner) will be able to:

  1. Thoughtfully examine your own reaction to and biases about mental illness and people who suffer with mental health conditions.
  2. Identify and explore the sources of your reactions.
  3. Identify the positive and negative implications of your reactions for patient care in the future.
  4. Consider what you’ve learned about yourself in this reflection and in this time of national crisis.
  5. Bring a question for discussion and explore, in a small group setting, the kinds of attitudes and behaviors that put health professionals at risk for mental health struggles, and consider how we might mitigate that experience.

ASSIGNMENT:

Reaction: As stimulated by the speakers on the video and supplemental resources, identify at least one reaction to the narratives and at least one other to either the panelist or the supplemental resources.

Sources/Your Story: Explore the sources of these thoughts, feelings, and reactions, through your own narrative. As always, include specifics and be written in the first person. Your sources might include one or more of the following:

  • Your experience to date with mental health conditions – maybe as experienced by yourself personally, in your family, or by your friends.
  • Your perceptions of how mental health conditions are viewed in the military and medical communities
  • Your perceptions of how various your cultural contexts may influence the recognition, acceptance and treatment of mental health conditions.

Implications: Keeping in mind what your reactions and the sources of those reactions reveal about your perspective on mental illness, analyze both the positive and negative implications of this perspective for how you might care for patients in the future.

Review: Consider what you’ve learned about your own mental wellness during this time of national crisis, how you’ve been coping, and how your response influences how you think about mental illness going forward.

Make sure to also include:  What question would you want to bring to the group discussion to further explore?

 

 

OTHER HELPFUL LINKS RE: COVID:

https://www.psychiatry.org/news-room/apa-blogs/apa-blog/2020/03/covid-19-mental-health-impacts-resources-for-psychiatrists

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext#seccestitle150

https://www.apna.org/i4a/pages/index.cfm?pageid=6685

Washington-PostMental Health and Coronavirus
Topics:
NPRWhen Doctors Struggle with Suicide, their profession often fails them (3 min) Doctors commit suicide at twice the rate of the general population. Significant stigma surrounds the issue of mental health care for mental health professionals, but something has to change; the cost of their deaths is far far too high.
Topics: / / / Keywords: /
Active duty more likely to seek out MH care than veterans A stigma shift? The messaging and the access may be changing the habits of current and future generations of military personnel, but there is still a gap in how veterans seek out MH care.
Topics: / Keywords: / / / /
TEDxWe train soldiers for war; let's train them to come home too. (10min) TedTalk -- Before soldiers are sent into combat, they're trained on how to function in an immensely dangerous environment. But they also need training on how to return from the battlefield to civilian life, says psychologist Hector Garcia. Applying the same principles used to prepare soldiers for war, Garcia is helping veterans suffering from PTSD get their lives back.
Topics: / / / / Keywords: / / /
Stress, burnout and coping mechanisms in Nurse Anesthetists An increasing number of nurse anesthesia programs are identifying stress, burnout and poor coping mechanisms in their students, but the system has not been set up to address it well. This is a look at the scope of the problem.
Topics: Keywords: / / /
NPRKids and Coronavirus: a comic and quick listen (3min)
Topics:
Topics:
nejm_logo1aSuicide - Rewriting My Story A resident shares his story of depression and suicidal ideation.
Topics:
bbUnlocking Us: Comparative Suffering, the 50/50 Myth, and Settling the Ball (24min) We have collectively hit weary. This is especially true for the brave folks on the front lines of this pandemic and for the people who love and support them. And, it’s also true for all of us. In this episode, Brene Brown talks about strategies for falling apart, staying connected + kind, and giving ourselves permission to feel hard things.
Topics: / / / / Keywords:
Session originally created by: Francesca Cimino | Uniformed Services University | Curriculum Director, Reflective Practice | Family Medicine