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Staying sane in Psychology
Transcript of Staying sane in Psychology
77% of counties had shortage of prescribers with half their needs unmet
2 out of 3 primary care physicians reported that they could not obtain mental health services for some of their patients
Medical students are reluctant to chose psychiatry as a specialty What challenges does the literature address? Burnout: A prolonged response to chronic emotional and interpersonal stressors on the job, defined by the 3 dimensions of: Coping strategies Trauma training is associated with reduced compassion fatigue and burnout
One study showed that colleagues are the most utilized resource in coping with stress
Physicians noted that lack of time was the most significant barrier to accessing help with negative events.
In a study of medical students the use of faculty, peers, and family support were noted to be positive coping strategies. Additionally, the use of mental health services were stated to be helpful among students. Lastly, extracurricular activities were another source of stress management. Psychiatrists are more vulnerable to vicarious trauma, compassion fatigue, and job burnout and have the highest rate of suicidal tendencies among male physicians
Physicians who are satisfied with their careers are more likely to provide better health care and have patients who are more satisfied
Older psychiatrists report a higher level of career satisfaction Survey Results: Self
reported stress Story Time 1) emotional exhaustion
3) personal accomplishment Effect on job performance:
1) Negative effect on colleagues
2) Poor job performance
3) Absenteeism Physical Health
Exhaustion component associated with known stress-related effects:
Accelerated aging and premature death
Alzheimer’s, HA, DM, obesity, heart disease
Precipitates depression and anxiety Burnout and health:
22-75% burn out among physicians
18-30% screened for depression were positive.
In one medical school student survey 60% reported some depressive symptoms, burnout responses near 55%. Physician
burnout is huge! Sources of
distress for physicians Lack of sleep
Lack of control and support from colleagues
Interruptions at work
Emotional pressure assoc with demanding patients
Problems with personal relationships
with depression, substance
abuse, suicide Finnish study shows physicians take sick leave more seldom than others and self-medicate
80% of Norwegian doctors prescribed medications (non-narcotic except for 10%) for themselves, and 80% reported that they work during illness for which they would ‘sick-list’ their patients Physician use of
primary health care
and self care Compassion
Compassion fatigue is defined as “the formal caregiver’s reduced capacity of, or interest in, being empathic or ‘‘bearing the suffering of clients.”
Compassion fatigue can occur after just one traumatic incident and is highest in psychiatrists and social workers compared with other
non-medical staff. Having a negative event
within 12 months increases the risk of CF, whereas multiple negative personal events increases the risk for burnout
Personal traumatic history, long work hours, and increased number of traumatic
patients are additional
risk factors Risk factors: Colorado Physician Health Program
CPHP is a nonprofit based in Denver but services are offered statewide
CPHP provides ‘peer assistance services’ for licensed physicians and physician assistants of Colorado.
CPHP also serves Resident and Medical Students
Confidentiality is guaranteed Think for a moment of a story,
Then share with a neighbor
Sticky Notes! Coping mechanisms (family/friends big winners)
Exercise/De-stress – run, bike, yoga, wine/beer
Sleep – varied, but dream content changed ‘CPHP assists its clients with medical and/or psychiatric conditions (e.g. Alzheimer’s disease, HIV infection, depression or substance abuse) as well as psychosocial conditions (e.g. family problems or stress related to work or professional liability difficulties)’
‘CPHP provides diagnostic evaluation, treatment referral as well as treatment monitoring and support services.’
CPHP stresses early interventions to help prevent problem from affecting career BEHAVIORAL INDICATORS OF A POSSIBLE HEALTH PROBLEM IN MEDICAL PROFESSIONALS Family
Withdrawal from family activities
Children neglected, abused or in trouble
Mood swings, arguments or violent outbursts
Sexual problems; impotence, extramarital affairs
Medicinal use of alcohol or drugs
Spouse in therapy or taking psychoactive medication
Geographical separation or divorce by spouse Employment
Frequent job changes or relocations
Unusual medical history
Indefinite, vague or inappropriate references
Working in positions inappropriate for qualifications
Resistance to preemployment physical or family interview Physical
Deterioration in personal hygiene
Deterioration in clothing and dressing habits
Numerous prescriptions and OTC drug use
Frequent ER visits or hospitalizations
Multiple somatic complaints
Excessive tiredness or insomnia
Memory problems, difficulty concentrating Office
Hostile, suspicious or unreasonable behavior to staff or patients
Excessive ordering of drug supplies
Excessive prescribing practices
Complaints from patients and staff
Unexplained absences from the office
Spasmodic work pace, or decreasing work load and tolerance
Taking sexual advantage of patients or coworkers
Procrastination or neglect of details
Avoidance of fellow workers
Errors in judgment 899 Logan St., Suite 410
Denver, CO 80203
http://www.cphp.org Contact Info A little advice References Baider, L (11/2001). "Reality and fugues in physicians facing death: confrontation, coping, and adaptation at the bedside". Critical reviews in oncology/hematology(1040-8428), 40 (2), p. 97.
Chang, Elaine (5/01/2012). "Survey of the prevalence of burnout, stress, depression, and the use of supports by medical students at one school."Academic psychiatry (1042-9670), 36 (3), p. 177.
DeMello, J. P., and S. P. Deshpande. "Career Satisfaction of Psychiatrists." Psychiatric Services 62.9 (2011): 1013-018. Print.
Hu, Yue-Yung (03/2012). "Physicians' needs in coping with emotional stressors: the case for peer support". Archives of surgery (Chicago. 1960) (0004-0010), 147(3), p. 212.
Maslach, C, Schaufeli WB, and Leiter MP. “Job burnout.” (2001) Annual Review of Psychology, 52:397-422.
Rossi, Alberto (8/27/2012) "Burnout, compassion fatigue, and compassion satisfaction among staff in community-based mental health services". Psychiatry research (0165-1781)
Thomas KC; Ellis AR; Konrad TR et al.: County-level estimates of mental health professional shortage in the United States. Psychiatric Services 60:1323–1328, 2009 Questions?