Every day, hospitals treat patients whose maladies include mental disorders in addition to medical illness. But hospital leaders also need to address mental health from their perspective as employers, H&HN Editorial Director Mary Grayson argues. Running Time: 3:29.
Community hospital executives and employees don't need a reminder of how huge mental health care problems loom in our delivery system. All that's required is to spend some time in an emergency department to witness the real life — and death — manifestations of mental health disorders.
Researchers and analysts tally up the official societal misery: One in four Americans experiences a mental illness or substance abuse disorder each year. Nearly half of all Americans will develop a mental illness during their lifetimes, and 27 percent will suffer from a substance abuse disorder.
Compounding the problem is the fact that mental health and medical conditions are risk factors for each other and the presence of one can complicate — to say the least — the treatment of the other. A Robert Wood Johnson Foundation study found that 29 percent of adults with medical conditions also have mental health conditions, and 68 percent of adults with mental health conditions also have medical conditions. The overall complicated — and frequently fatal — dynamic of how physical and mental disorders intertwine is even more challenging from a treatment standpoint, but I think we all get the basic picture.
And, of course, this wouldn't be our health care "system" if all of this didn't occur simultaneously with a precipitous decline in the number of psychiatric hospitals and units.
What we may not want to be reminded of is that there is no magic dome protecting us from the storm. Remember that one-in-four statistic? That "one" could be a colleague, a spouse, a son or a daughter, or you. Statistics have names and faces.
We talk and think about mental health care as a larger societal problem and a delivery system quagmire. But, as employers, we don't talk or think about it as our problem beyond obvious safety and liability concerns. A recent survey of employee health found that hospital employees were not as healthy as the general workforce and more likely to have serious medical conditions and mental illness.
But an odd mix of silence, flip talk and stereotyping surrounds and isolates people with psychological disorders and the loved ones who care for them. For all the significant scientific breakthroughs in treatment, there is an even higher, very real wall of stigma, probably dating to when man discovered fire.
Working in health care is stressful and it takes a daily toll. Without a structured program of help, nurses unknowingly may slip into a condition known as compassion fatigue, a combination of burnout and secondary traumatic stress from witnessing the suffering of others, becoming indifferent and irritable, showing poor judgment, and permanently losing their "ability to nurture."
Physicians are even more likely to be affected by stress and trauma. Even if they acknowledge the problem, that wall of stigma is higher for a physician to climb, and research shows they will not voluntarily reach out for help.
Remember what the wise man said: If we take care of our employees, all else will follow.
Well, that includes their mental health.
Let me know what you think. You can reach me at mgrayson@healthforum.com
