Do you know a mental health provider who’s always physically and emotionally tired? What about a colleague who is going through a significant life stressor such as a divorce and doesn’t pay enough attention to how this stressor impacts his or her functioning and work with patients?

How often do you stop and think about your own emotional well-being? What do you do about it?

"Please secure your oxygen mask before assisting others."

It’s important to recognize early warning signs of mental health problems, pay attention to self-care and seek help in a timely manner.

Practice what you preach

Pleasant activity scheduling, deep breathing, behavioral activation, regular exercise, and mindfulness practice: as a mental health provider, you have likely recommended this familiar list of coping strategies with a patient or two. But when was the last time you used these strategies yourself?

As providers, we spend a lot of time engrossed in the thoughts, emotions and behaviors of those we treat. This knowledge and awareness does not always extend to our own experiences. Over time, our own life stressors interact with our occupational stressors and may cause adverse outcomes. We must develop awareness of and cope with our own emotional, cognitive and behavioral health difficulties.

Provider self-care pitfalls

We would not expect an oncologist to be immune to breast cancer, but some of us, due to our expertise in diagnosing and treating mental health issues in others, may believe that we are resistant or immune to the effects of illnesses such as depression and anxiety. Or, we may recognize mental health symptoms in ourselves but believe that we must treat ourselves before seeking outside help. As one colleague stated, “I am a therapist. I shouldn’t need a therapist.”

Regardless of the circumstances, recognizing our own mental health issues is often difficult and painful, and may result in a cycle of avoidance. Just as our patients develop maladaptive thoughts, emotions and behaviors, we are susceptible too. Recognizing that we need help to cope with our own psychological difficulties may make us feel inadequate and less confident of our clinical skills.

Practical reminders, proven strategies

As you strive to overcome the internal and external stigma related to mental health treatments, it is essential to remember that:

• No one is immune from the damaging effects of stress
• Our mental health and physical health are inextricably connected
• The ability to effectively help others depends on our psychological well-being
• Success and longevity in our careers depend on psychological well-being
• Seeking help is a sign of strength and a positive step toward overall health

Our approach to our own psychological health is likely to improve if we implement strategies that are effective with patients. These tactics may include increasing awareness and recognition of a problem, reducing stigma, using assessment and screening tools, and using empirically based interventions.

Periodic self-assessment can help you recognize rising stress levels and identify areas of practice that have the greatest impact on well-being. Just as a female oncologist does a breast self-exam rather than relying solely on her knowledge of cancer, mental health providers can use objective tools and measures to check their emotional health.

The Primary Care Provider Acceptance and Action Questionnaire (PCP-AAQ) and Primary Care Provider Stress Checklist (PCP-SC) are designed for primary care clinicians but may be appropriate for mental health providers as well.¹ Various smartphone apps also have self-assessment tools, such as The National Center for Telehealth & Technology Provider Resilience app, which enables users to rate their professional quality of life (things like burnout and secondary traumatization levels) on a daily basis as well as track the time since their last vacation.²

It takes a village

Strong social support helps reduce the stress of working with difficult populations such as patients with personality disorders or those who we perceive are malingering.^3-4 Building a strong consultation and mentorship network can be as simple as seeking feedback: “Please talk to me if you see signs of burnout in my behavior, I’d like to catch it sooner rather than later.”

Open conversations with co-workers that come from a safe and caring place can help us feel supported during individual work with patients. Regular communication with other professionals reduces the anxiety of seeking help when we recognize signs of distress, fatigue or burnout in ourselves.

Supportive relationships in the workplace improve overall resilience for the entire team by improving the well-being of individual members and by modeling health-promoting and accepting behavior for others in the workplace.

As mental health providers, we must effectively recognize and seek help for our own needs so that we can successfully support those we serve.

References

1. Robinson, P.J., Gould, D.A., & Strosahl, K.S. (2010). Real behavior change in primary care: Improving patient outcomes and increasing job satisfaction. Oakland, CA: New Harbinger Publications, Inc.
2. National Center for Telehealth & Technology (T2). Provider Resilience: Provider Resilience apphttp://t2health.dcoe.mil/apps/provider-resilience
3. Ballenger-Browing, K.K., Schmitz, K.J., Rothaker, J.A., Hammer, P.S., Webb-Murphy, J.A., Johnson, D.C. (2011). Predictors of burnout among military mental health providers. Military Medicine, 176 (3), 253-260.
4. Garcia, H.A., McGreary, C.A., Finley, E.P., McGreary, D.D, Ketchum, N.S. & Peterson, A.L. (2016). The influence of trauma and patient characteristics on provider burnout in VA post-traumatic stress disorder specialty programmes.Psychology and Psychotherapy: Theory, Research and Practice, 89, 66-81.