Mental health toll creates “shadow pandemic” for patients, doctors

Social isolation and feelings of instability over the past couple of years have only exacerbated mental health needs in the United States. And physicians are not immune to the pressures that the pandemic placed on people, experts said during a Behavior Health Integration (BHI) Overcoming Obstacles webinar.

During the "Shadow Pandemic: Mental Health Impacts of COVID-19 on Patients and the Care Team" webinar, physician experts shared their experiences before and throughout the pandemic, including how patient health needs have changed over time, the challenges that doctors are encountering, solutions to creatively address patient needs and what is next for patient care. They also stressed that physicians shouldn’t forget to acknowledge and address that they too have been affected by the mental health toll that the COVID-19 pandemic has taken on the nation.

“Our health care workers are really enduring a lot. They are part of the shadow pandemic,” AMA member Eileen Barrett, MD, MPH, an internal medicine hospitalist in New Mexico and an AMA-Satcher Health Leadership Institute Medical Justice in Advocacy fellow, said during the webinar. “Culturally in medicine it is often hard for us to take care of each other and also to take care of ourselves.”

Joining Dr. Barrett on the webinar were Stephen O’Connor, PhD, chief of the Suicide Prevention Research Program at the National Institute of Mental Health Division of Services and Intervention, and Sala S. Webb, MD, a child and adolescent psychiatrist and the chief medical officer for OhioRISE—a new health plan for Ohio youth with significant behavioral health needs.

During the webinar, Dr. Barrett shared five ways that health care leaders can help improve their colleagues’ well-being and mental health:

• Acknowledge it is a hard time.
• Thank people for the work they are doing in personal ways to help them feel connected.
• Show your own vulnerabilities and that things can be difficult at times.
• Share support resources that are available to physicians, including support groups and other avenues. Make sure you share what is available in multiple venues and have a low barrier of entry for people to access the help.
• Talk about things that are hard—and why they are hard—but also talk about the things that are positive. Share resources, tips and hacks for well-being as much as possible because not being in a crisis is different than thriving.

Additionally, Dr. Barrett mentioned another way to help physicians seek mental health care is to follow the lead of the AMA and others in organized medicine in the push to remove questions on licensing and credentialling applications that stigmatize mental health diagnoses or individuals seeking mental health care.

Read more about how physicians and health systems can cut the stigma on seeking help.

Integrating behavioral health care—an approach that allows a patient to receive mental health care within the primary care office, whether from a psychiatrist, other mental health professional or a combination via a team-based care approach—can help patients and physicians alike.

With shortages of psychiatrists, social workers and other mental health professionals that have only been amplified by the pandemic, BHI allows patients to more easily access the mental health care that they need. In turn, it helps physicians by:

• Meeting patients’ increased needs due to the pandemic and more completely caring for the whole patient,  boosting professional satisfaction.
• Decreasing administrative complexity for clinicians, making their professional life more enjoyable.
• Reducing feelings of hopelessness.
• Helping health care workers take care of one another.

The AMA established the BHI Collaborative with seven other leading medical associations to help empower physicians to create practices that are able to help treat the whole patient.

Resources include the Behavioral Health Integration Compendium, which provides health care organizations with a proven pathway for delivering integrated behavioral care and ensuring they have the most recent, actionable information at their disposal.