Pandemics are known to cause panic disorder, anxiety, depression, sleep disturbances, and posttraumatic stress. Depression can lead to suicide if not treated, yet is a treatable disease. We have seen nurses die by suicide during this pandemic in Italy.
Past experience suggests that health care workers exposed to the stress of the pandemic will need help long after the pandemic is under control.
I am serving as co-chair of the Strength Through Resilience task force of the American Nurses Association, whose focus was originally to collate resources to reduce suicide among nurses. We quickly shifted gears when the pandemic hit to collate resources to optimize resiliency and mental health among nurses in relation to the projected impact of the pandemic. Curiously, these resources are virtually identical. The ANA has posted initial resources as part of their Healthy Nurse, Healthy Nation campaign and is and building more resources as quickly as possible.
Nurses already at higher suicide risk.
The added stress of the pandemic is particularly problematic because of evidence that emerged before the pandemic that nurses were at higher risk of suicide than the general public. If leaders at health care organizations have not already started proactively screening staff for depression and suicide risk, it would be important to do so now. Immediately. Offering screening is seen as an act of caring in leadership. Staff appreciate the fact that leaders care about their mental health.
A risk-screening program for health care workers.
We predict that without proactive efforts at preserving mental health and identifying and referring those who are suffering into treatment, the suicide rate among health care workers will increase. We can’t just sit and wait to look at the numbers in a year or two. There is something every organization can do right now. A tested model of risk screening for doctors, nurses, and other health care workers is available that is inexpensive, simple, and ready for replication. The screening program works through encrypted email to maintain anonymity of the person being screened and referred for treatment. Contact the American Foundation for Suicide Prevention (email@example.com) for more information on how to start a program.
Anticipating that an increased number of workers will screen as high risk now and in the aftermath of the pandemic, at the University of California San Diego we have increased the number of therapists available for our staff. The department of psychiatry has also launched a hotline for people under stress or with excessive anxiety, uncontrolled fear, depression, or other mental health issues.
We have also launched a systemwide peer-support program, training doctors, nurses, and other health care workers how to support each other through anxious times and how to detect colleagues who might need more help than a friend can offer. The program is modeled after the successful 2nd victim prevention program created by Susan Scott at the University of Missouri. After initial training, we have been meeting weekly to discuss techniques of addressing and supporting colleagues in need.
In addition to testing and peer support, building resiliency skills through cognitive-based therapy techniques has been shown to decrease suicide risk among nurses.
Now more than ever it is important that we let go of the ‘buck up and take it’ mentality and look out for ourselves with self-care and each other with compassion.
Judy E. Davidson, DNP, RN, MCCM, FAAN, nurse scientist, UC San Diego Health Sciences and UC San Diego School of Medicine, Department of Psychiatry, and associate editor, Journal of Nursing Management