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Becker-Haimes EM, Schaechter T, Green KL, Bridges K, Jager-Hyman S. Mobile Crisis Services: A Clinician Survey of Current Suicide Prevention Practices and Barriers to Care Delivery. Community Ment Health J 2024; 60:562-571. [PMID: 37982974 DOI: 10.1007/s10597-023-01208-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 11/04/2023] [Indexed: 11/21/2023]
Abstract
Mobile crisis teams (MCTs) deploy clinicians to assist individuals in acute crisis in the community. Little is known about the extent to which these teams provide evidence-based practices (EBPs) for suicide prevention nor the barriers they face. We surveyed 120 MCT clinicians across the United States about their: (1) use of suicide risk screening and assessment tools; (2) strategies used to address suicide risk (both EBPs and non-EBPs); and (3) perceived barriers to high-quality MCT services. Nearly all clinicians reported use of validated suicide screening tools and generic "safety planning." However, a sizeable minority also reported use of non-EBPs. Open-ended responses suggested many client/family-, clinician-, and systems-level barriers to MCT use of EBPs for suicide prevention. We identified several targets for future implementation efforts, including the need for de-implementation strategies to reduce use of ineffective and potentially harmful practices, and unique aspects of MCTs that require tailored implementation supports.
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Affiliation(s)
- Emily M Becker-Haimes
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA.
- Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia, PA, USA.
| | - Temma Schaechter
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA
| | - Kelly L Green
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA
| | | | - Shari Jager-Hyman
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, 3rd floor, Philadelphia, PA, 19104, USA
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Dye ME, Runyan P, Scott TA, Dietrich MS, Hatch LD, France D, Alrifai MW. Small Patients but a Heavy Lift: Workload and Burnout of Advanced Practice Providers and Physicians in a Level IV Neonatal Intensive Care Unit. J Perinat Neonatal Nurs 2024; 38:192-200. [PMID: 38758274 PMCID: PMC11104510 DOI: 10.1097/jpn.0000000000000804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
OBJECTIVE This study explored the association between workload and the level of burnout reported by clinicians in our neonatal intensive care unit (NICU). A qualitative analysis was used to identify specific factors that contributed to workload and modulated clinician workload in the NICU. STUDY DESIGN We conducted a study utilizing postshift surveys to explore workload of 42 NICU advanced practice providers and physicians over a 6-month period. We used multinomial logistic regression models to determine associations between workload and burnout. We used a descriptive qualitative design with an inductive thematic analysis to analyze qualitative data. RESULTS Clinicians reported feelings of burnout on nearly half of their shifts (44%), and higher levels of workload during a shift were associated with report of a burnout symptom. Our study identified 7 themes related to workload in the NICU. Two themes focused on contributors to workload, 3 themes focused on modulators of workload, and the final 2 themes represented mixed experiences of clinicians' workload. CONCLUSION We found an association between burnout and increased workload. Clinicians in our study described common contributors to workload and actions to reduce workload. Decreasing workload and burnout along with improving clinician well-being requires a multifaceted approach on unit and systems levels.
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Affiliation(s)
- M. Eva Dye
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
| | - Patti Runyan
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
| | - Theresa A. Scott
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
| | - Mary S. Dietrich
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN
- School of Nursing, Vanderbilt University, Nashville, TN
| | - L Dupree Hatch
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
- Center for Child Health Policy, Vanderbilt University Medical Center, Nashville, TN
| | - Daniel France
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
- Center for Research and Innovation in Systems Safety, Vanderbilt University Medical Center, Nashville, TN
| | - Mhd Wael Alrifai
- Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
- Department of Pediatrics, Division of Neonatology, Vanderbilt University Medical Center, Nashville, TN
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
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Luce A, Turner G, Kennedy L, Bush-Evans RD. "Quite simply they don't communicate": a case study of a National Health Service response to staff suicide. MEDICAL HUMANITIES 2024; 50:116-124. [PMID: 38195242 DOI: 10.1136/medhum-2023-012722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 01/11/2024]
Abstract
Workplace suicide can have significant knock-on effects within an organisation, yet research has shown within the healthcare profession, not all staff receive suicide prevention training, and few employers take the time to reflect on the need to change workplace policies or practices following the death of a staff member to suicide. How staff suicide is communicated across an organisation and to family members is important. Effective crisis communication is critical for effective management for a timely and sensitive response to a staff suicide within an organisation. By doing so, workplaces can help to reduce the significant emotional trauma suicide can have on an employee, and support good mental health across its workforce. This study aimed to explore and understand the communication processes around staff suicide across a National Health Service (NHS) Trust and to provide recommendations based on these findings. Semi-structured interviews were conducted with 29 participants, each lasting approximately 90 min. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were followed. Thematic analysis was used to analyse the data, resulting in seven themes being identified based on communication. Findings indicated that the Trust had no clear communication strategy in place for tackling staff suicide. Each suicide was handled differently, training across staff roles was lacking and operational procedures were deemed insensitive. This paper aimed to provide insight into the communication strategies used in the aftermath of a staff suicide. These findings highlight the inconsistency of the communication, lack of clear policy and guidance and the negative impact this had on staff. Further research is needed across NHS Trusts nationwide to gain insight into the current communication strategies in place to develop a national approach to clear communication following the death of an NHS worker to suicide. Tweetable abstract: Effective communication is critical in the aftermath of an NHS staff suicide. By doing so, NHS Trusts can help to reduce the trauma suicide can have on an employee and support good mental health across its workforce @stann2.
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Affiliation(s)
- Ann Luce
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Georgia Turner
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Lauren Kennedy
- Department of Communication and Journalism, Bournemouth University, Poole, UK
| | - Reece D Bush-Evans
- Department of Communication and Journalism, Bournemouth University, Poole, UK
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García-Iglesias JJ, Gómez-Salgado J, Fernández-Carrasco FJ, Rodríguez-Díaz L, Vázquez-Lara JM, Prieto-Callejero B, Allande-Cussó R. Suicidal ideation and suicide attempts in healthcare professionals during the COVID-19 pandemic: A systematic review. Front Public Health 2022; 10:1043216. [PMID: 36561871 PMCID: PMC9767440 DOI: 10.3389/fpubh.2022.1043216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Background COVID-19 has caused a series of economic, social, personal, and occupational consequences that may affect the mental health of healthcare workers (HCWs), with the consequent risk of developing suicidal ideation and behaviors. Objectives The aim of this study was to identify the main risk factors that may predispose HCWs to suicidal ideation and suicide attempts during the COVID-19 pandemic. Methods A systematic review of studies published between January 2020 and August 2022 was conducted following the PRISMA guidelines in the following electronic databases: Pubmed, Scopus, Web of Science, CINAHL, and PsycINFO. Methodological quality was assessed using the critical appraisal tools for non-randomized studies of the Joanna Briggs Institute (JBI). The followed protocol is listed in the International Prospective Register of Systematic Reviews (PROSPERO) with code CRD42022340732. Results A total of 34 studies were included in this review. There are a number of underlying factors such as higher rates of depression, anxiety, pre-pandemic lifetime mental disorders or previous lifetime suicide attempt, living alone, having problems with alcohol and/or other drugs, etc. that favor the emergence of suicidal tendencies and ideation in times of COVID-19. Similarly, the pandemic may have precipitated a series of factors such as economic concerns, assessing one's working conditions as poor, having family members or friends infected, changes in services or functions, and feeling discriminated against or stigmatized by society. Other factors such as age, sex, or type of healthcare worker show differences between studies. Conclusion Organizations should ensure the adoption of strategies and programmes for early detection of suicides as well as increased attention to the mental health of professions with a high workload. Systematic review registration PROSPERO, identifier CRD42022340732.
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Affiliation(s)
- Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador,*Correspondence: Juan Gómez-Salgado
| | - Francisco Javier Fernández-Carrasco
- Department of Obstetrics, Punta de Europa Hospital, Algeciras, Spain,Nursing and Physiotherapy Department, Faculty of Nursing, University of Cádiz, Algeciras, Spain
| | | | | | | | - Regina Allande-Cussó
- Department of Nursing, Faculty of Nursing, Podiatry and Physiotherapy, University of Seville, Seville, Spain
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Zimmaro LA, Moss A, Reibel DK, Handorf EA, Reese JB, Fang CY. A Telephone-Adapted Mindfulness-Based Stress Reduction Program: Preliminary Effects among Healthcare Employees. Behav Sci (Basel) 2021; 11:139. [PMID: 34677232 PMCID: PMC8533574 DOI: 10.3390/bs11100139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 10/09/2021] [Accepted: 10/14/2021] [Indexed: 11/16/2022] Open
Abstract
Healthcare employees often experience high stress and may benefit from accessible psychosocial interventions. In this pilot study, we explored preliminary feasibility, acceptability, and psychological effects of a telephone-based adaption of mindfulness-based stress reduction (MBSR) for healthcare employees. Eleven participants (M age = 49.9; 27.3% ethnic/racial minority) were enrolled in an eight-session group-based MBSR program adapted for telephone delivery. Feasibility was assessed using rates of program attrition and session completion; acceptability was explored qualitatively via participants' responses to an open-ended item about their program experience. Participants also completed pre-and post-program assessments on psychosocial outcomes (distress (overall distress, depression, anxiety, somatization), mindfulness, and self-compassion). We characterized mean change scores, 95% confidence intervals, and effect sizes to explore preliminary program effects. With regard to preliminary feasibility, one participant dropped out prior to the intervention; of the remaining 10 participants, 90% completed at least half (≥4) of the sessions; 70% completed at least three-quarters (≥6 sessions). Feedback reflected positive experiences and included suggestions for program delivery. Participants reported reductions in distress post-program (M difference range = -5.0 to -9.4), showing medium to large effect sizes (d range = 0.68 to 1.11). Mindfulness scores increased from pre- to post-intervention (M difference range = 1.0 to 10.4), with small-to-medium effects (d range = 0.18 to 0.55). Almost all aspects of self-compassion remained stable over time, with the exception of common humanity, which increased post-program (M difference = 2.9, CI 95% 0.5 to 5.4, d = 0.91). Preliminary findings from our small pilot trial suggest that telephone-based adaptations of MBSR may be a useful mode of delivery for healthcare employees; however, larger studies are needed to provide further evidence of feasibility, acceptability, and program effects.
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Affiliation(s)
- Lauren A. Zimmaro
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (L.A.Z.); (E.A.H.); (J.B.R.)
| | - Aleeze Moss
- Myrna Brind Center for Mindfulness, Marcus Institute of Integrative Health—Jefferson Health, Department of Integrative Medicine and Nutritional Sciences, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA; (A.M.); (D.K.R.)
| | - Diane K. Reibel
- Myrna Brind Center for Mindfulness, Marcus Institute of Integrative Health—Jefferson Health, Department of Integrative Medicine and Nutritional Sciences, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA; (A.M.); (D.K.R.)
| | - Elizabeth A. Handorf
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (L.A.Z.); (E.A.H.); (J.B.R.)
| | - Jennifer B. Reese
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (L.A.Z.); (E.A.H.); (J.B.R.)
| | - Carolyn Y. Fang
- Cancer Prevention and Control Program, Fox Chase Cancer Center, Philadelphia, PA 19111, USA; (L.A.Z.); (E.A.H.); (J.B.R.)
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Telepsychiatry to Provide Mental Health Support to Healthcare Professionals during the COVID-19 Crisis: A Cross-Sectional Survey among 321 Healthcare Professionals in France. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910146. [PMID: 34639447 PMCID: PMC8508285 DOI: 10.3390/ijerph181910146] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/25/2021] [Accepted: 09/26/2021] [Indexed: 12/28/2022]
Abstract
Pandemics are difficult times for the mental health of healthcare professionals, who are more likely to present with PTSD-like symptoms. In the context of a highly contagious communicable disease, telemedicine is a useful alternative to usual care, and should be considered as a means to support healthcare professionals’ mental health. This is a multicenter (n = 19), cross-sectional study, based on a 27-item questionnaire, aiming to investigate the acceptability to healthcare workers of a telepsychiatry service as a means of providing mental health support during the COVID-19 pandemic. Between October and December 2020, 321 responses were received, showing that women, caregiving staff, and those directly involved in the care of COVID-19 patients are less favorable to the idea of receiving remote support. In our population, barriers were related to the clinical setting or ethics, and most of the respondents would not accept a drug prescription by telepsychiatry. Although telepsychiatry should be a part of the armamentarium of mental health management, it is not suitable as a stand-alone approach, and should be combined with conventional face-to-face consultations.
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