The mental health of Americans is the worst it's been in the last two decades, and the demand for mental healthcare is at an all-time high. As psychiatrists and frontline workers in this mental health crisis, we have a tremendous collective responsibility. But the physical toll and emotional nature of our work has left many of us struggling with pandemic-era burnout.
In order to help others and reduce the stigma around mental illness, we need to lead by example by being more open about our own challenges and help ourselves first.
Also, I would be remiss if I didn't address the practical steps that can be taken by employers, whether that's a hospital or private practice, to support mental health workers by cutting back on time spent on tasks outside of helping patients like administrative work.
Physicians die by suicide at twice the rate of any other profession, with roughly one doctor dying every day. The lack of time for self care and the stigma around seeking help — deepened by the even longer hours and isolation of the pandemic — paints a bleak picture for the wellness of healthcare workers.
Burnout is the reason I left my last job in a psychiatric ER at a city hospital. Even after 80, 90, sometimes 100-hour weeks, I felt like there wasn't enough time to accomplish the job I was hired to do. We were understaffed and overworked, with too many patients and not enough resources. Every day, I was putting out fires, doing tedious administrative work, and cutting through red tape to make sure patients were taken care of.
Compounded by the emotional nature of my work, my cup was empty. As a psychiatrist focused on children and adolescents, I bore witness to the worst parts of peoples' lives and often dealt with abuse. While I approach my work through the lens of a physician, I'm human, and it's impossible to completely detach from the job. Being able to help others is a privilege, but I knew that in order to effectively do that, I had to prioritize my own needs.
Thankfully the concept of therapy is becoming less taboo. When I was kid, therapy wasn't a thing people did and if they did, they never talked about it. You were more likely to hear about someone seeing their parole officer than their psychiatrist. Today, mental health is seen as an important part of our health, self care, and personal and professional stability. Especially as we end a taxing year with almost a third of the US workforce nearing burnout, companies are focusing on the mental health of their employees and studying its impact on productivity.
But this gets complicated for a psychiatrist. I'll be the first to admit that we're not well-conditioned to process the truths we spend our lives helping our patients accept. It's difficult to fit into that patient role and be on the receiving end of therapy.
In the United States, there's an average of 30 psychiatrists for every 100,000 people and for psychiatrists, there aren't many degrees of separation from a therapist and someone else in your life, possibly another patient. You're typically seeing another colleague that you might run into later at a work obligation.
Like many who face burnout, I reached my own crossroads and asked myself if I wanted to do this for the rest of my life or if there was another purpose this job was serving in my life. While I can't lighten the emotional load for my peers, I took it upon myself to co-found Talkiatry, a mental health service built with providers' needs in mind, to address other issues contributing to psychiatrist burnout.
A positive development from this year is the widespread use of telepsychiatry which allows for greater scheduling flexibility. When you think about odd hours required to staff in-person psychiatric ERs around the clock, it can be logistically difficult for these workers to seek their own help.
"Back office" advancements like streamlining electronic medical records and automating administrative tasks can free up significant amounts of time for mental health workers. Quartet Health, Mindstrong, American Well, and eClinicalWorks are a few other examples of companies that are improving processes for us so we can dedicate more time to our patients and our personal wellness.
2020 has forced us to take stock of our own lives and to confront difficult truths. Frontline workers have been celebrated, but we need to talk more about the emotional battles we're fighting daily and the supportive environment we need in order to best help others.
As Americans face the worst mental health crisis in two decades, the psychiatrists tasked with helping them are also burning out
Mental health professionals are facing a heavy burden during the pandemic. They need to prioritize self care and employers need to offer support.
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