Welcome

&

Topic Introduction

Psychological Health

Psychological Health and

Safety in Health Care

Marion Cooper, Executive Director, CMHA

Manitoba and Winnipeg

Ela Partyka, Manager, Workplace Mental

Health , CMHA Manitoba and Winnipeg

Impact of Pandemic on Healthcare

Workforce

• The coronavirus pandemic has placed extraordinary demands on

healthcare leaders.

• The humanitarian toll taken by COVID-19 creates fear among the

population, health services employees and other stakeholders.

• The potential scale of the outbreak and its sheer unpredictability make it

challenging for leaders to respond.

• This “landscape scale” crisis is an unexpected event of enormous scale

and overwhelming speed, resulting in a high degree of uncertainty that

gives rise to disorientation, a feeling of lost control, and strong emotional

disturbance

Psychological Distress & COVID

It’s no surprise to us that one of the lessons learned during SARS and studied in the literature about Pandemic and Mental Health was the following:

“ It was found that among quarantined persons there was a high prevalence of psychological distress, including symptoms of depression and posttraumatic stress disorder (PTSD).” Even if we can halt the physical spread of the virus using quarantine and

social distancing, we will still have to contend with its mental health effects in the long-term.”

Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004). SARS control and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Disease, 10(7), 1206-1212.

Choosing to see the impact

47%

47% of Canadians say work is the

most stressful part of their life

#1 Cause

Mental illness is the #1 cause of

workplace disability claims,

accounting for 30% of all claims

$25,000

Average cost of a short term

disability claim related to mental

illness is $25,000

2.5% Annually

Bottom line: Mental illness is

costing our economy - and your

business - 2.5% annually

Cause for concern

Choosing

to see the

impact

PHS Benefits

Choosing to do business

differently

Psychosocial risk factors

From <https://www.ccohs.ca/oshanswers/psychosocial/mentalhealth_risk.html

Critical Outcomes

Take

Action

Creating Psychological Safety

The simple takeaways…… Empathy and understanding Be clear about team priorities Communicate consistently Role model healthy behaviors Speak human to human Respond to signs of poor mental health

Connect Now/Sharing

Circles/Diffusing

Support for health-care

workers during a pandemic

Frank Cantafio, M.S.W., R.S.W.

Manitoba Blue Cross

Manager, Employee Assistance Program

CONTACT US Directly: 204.786.8880

Toll free: 1.800.590.5553

TTY: 204.775.0586

mb.bluecross.ca/member/eap

18

Where do we come in?

Counselling Services

Work-Life Services

Addictions Management Program

Psychiatric Consultation

My Good Health

WORK-LIFE FOCUS

WELLNESS FOCUS

Personal wellness Services My Good Health

Caregiver Support

Workshops

Healthy employees

Acute conditions

Chronic conditions

Tends to have the

greatest benefit for: • Population

Cost load

• Employee

population

10%

25%

65%

11%

37% 52%

Attridge, M. and Nyce, S. Watson Wyatt Consulting (2006)

ORGANIZATIONAL HEALTH

Organizational Assistance Conflict Resolution Trauma & Critical Incident Response

Employee Wellness Workshops Management Consultation

CLINICAL FOCUS

Comprehensiveness

Extensive scope of services

and delivery methods

Counsellor and client

matching process

Multidisciplinary team and

diverse designations

Holistic treatment philosophy

Diversity

High level of expertise

and service

Clinically managed

intake

Extensive provider

network and

infrastructure

Superior counsellor

credentials

Accessibility

Access to support 24/7,

365 days per year

Appointments available

within 72 hours

Providers in and northern

communities

Alternate channels, including

video, text-based and

telephonic options

Professionalism

Multicultural and culturally

diverse counselling

Services provided in 150

languages

Aboriginal Awareness

Program and Indigenous

community connections

LGBTQ supports

What are our values?

v

What we are doing

during the pandemic?

CONNECT NOW

SHARING CIRCLES

ORGANIZATIONAL

ASSISTANCE

A Sharing Circle is a tool that provides a safe environment for participants to speak about what they are thinking, experiencing and feeling.

Support for critical workplace events, transitional debriefings and consultation resources for leaders.

Connect Now is our

clinical, personal and

immediate support line

where members can call

to connect instantly with a

professional counsellor

from our Employee

Assistance Program

(EAP).

COVID-19

CONTACT US Directly: 204.786.8880

Toll free: 1.800.590.5553

TTY: 204.775.0586

mb.bluecross.ca/member/eap

MD Care and Student Mental

Health Services

MDCARE – COVID-19

PHYSICIAN SUPPORTS

Dr. Sara Rusen

Assistant Professor of Psychiatry

University of Manitoba

Medical Director, MDCare

Consulting Psychiatrist, Shared Care Mental

Health Program, WRHA

WHAT IS MDCare?

CONFIDENTIAL comprehensive clinic - full range of Adult and C/A Psychiatric services and

Adult Psychological services

Multidisciplinary team: Psychiatry, Psychology, Psychiatric Nursing, Marriage and Family Therapy

Assessment and treatment of individuals, couples, and families

Current caseload – 250 patients

Provincial Physician Health Program (PHP) member

Supported by Department of Psychiatry, University of Manitoba; Doctors Manitoba; WRHA

ELIGIBILITY

All licensed practicing Physicians in MB, spouse or common-law partner, dependent children

(18 yrs and under)

SELF REFERRAL – MDCare confidential voicemail – 204-480-1310; call back in 1-2 business days

MDCare – COVID-19

RESPONSE:

early in pandemic – marked decrease in call volume (national); subsequent increase to above average followed by return to average (local)

PHYSICIAN CHALLENGES:

fears of becoming infected and infecting loved ones need for alternate living arrangements/childcare lack of PPE loss of income need to self-isolate fears of overburdening colleagues, inadequate staff resources, strain on local area

and system excessive work hours cumulative emotional and physical toll inadequate patient care – “staying home”, delays, cancellations; worry re: coping

with backlog moral and ethical concerns

THERAPY THEMES: fear, anxiety, uncertainty, anger, guilt, helplessness, blurring of boundaries,

loneliness, grief

MDCare - COVID -19

INITIATIVES: RAPID ACCESS TO VIRTUAL CARE including phone and video conferencing -Peer support – individual -Diagnostic assessment and treatment – individual, couples and family WEBINARS led by MDCare psychologist, Dr. Andrea Piotrowski, moderated by Dr. Sara

Rusen - COPING IN A CRISIS: WHAT WORKS? - Focus on front line health care providers with specific information for physicians - May 13, 6:30-8:00pm and May 21, 12noon-1:30pm; register through Docs MB GROUP SUPPORT – under development FUTURE PLANNING: ANTICIPATION of increased need for support in later stages of pandemic – as seen in

other countries PREPARATION – increased staff availability; brief supportive therapy; additional

initiatives

RESOURCES FOR PHYSICIANS AND

FAMILIES – COVID-19

LOCAL: MDCare

(204) – 480-1310; self referral via confidential voicemail; call back in 1-2 business days

Physicians at Risk (PAR) (204) – 237-8320

Physician and Family Support Program (204) – 1-844-436-2762

Doctors Manitoba Webinar Series – Virtual Care and Pandemic Updates (204) - 985-5888, https://www.doctorsmanitoba.ca

NATIONAL: Canadian Medical Association (CMA) https://www.cma.ca JOULE, COVID – 19 LEARNING SERIES Canadian Psychiatric Association (CPA) https://www.cpa-apc.org Women Physicians Drop-in Space, Tuesdays 8pm, email

sabinanagpal@gmail.com for Zoom link Centre for Addictions and Mental Health (CAMH) https://www.camh.ca

Student Services

Dr. Tanya Sala

Medical Director of Student Mental Health

Services at Faculty of Health Sciences

Student Services at Bannatyne Campus

A unit of the University of Manitoba

Student Affairs Office

Administratively separate and

distinct from all academic programs

Services are private, confidential,

and free

Exist solely to meet the needs of

learners in RFHS

S211 Medical Services Building 204-272-3190

Bcstudentservices@umanitoba.ca

Student Services is a ‘One-Stop-Shop’

Intake assessment and triage

Crisis intervention and case management

Counselling

Mental health assessment and follow-up

Learning skills development

Accessibility advising

Advocacy

Career planning

Spiritual care

Financial aid

Other services, as needed

Stepped Care

Lori Ulrich, RN, BN, MHS

Director, Crisis Response Services

Shared Health, MH and Addictions

Sandi Mitchell R.N B.N.

Regional Manager, WRHA Organization &

Staff Development

Health Care Worker Psychological Health

and Wellness: Stepped Care Approach

Objectives

Describe how the Stepped Care Model is used to

identify organizations, agencies and resources

available to provide psychological support to Health

Care Workers during COVID-19.

Highlight innovative examples of Active Offerings of

psychological support available during COVID-19.

Psychological Support

Working Groups – Awareness/Communication

– Evidence Based

– Coordination and Innovation

• Conduct an environment scan to quickly identify provincial

support options, organizational capacity and innovation.

• Document supports using a stepped care approach.

– Active Offerings

• Consider the types of questions/issues front line staff may

have.

• Identify innovative support options assertively offered.

• Consider a variety of methods of offering support (virtual etc).

**Acknowledgment of working group members.

Stepped Care Model Adapted from the Virgo Report, 2018. Improving Access and Coordination of Mental

Health and Addiction Services: A Provincial Strategy for all Manitobans.

Health Promotion/Prevention

High Intensity/Complexity (Highly Integrated Treatment/Support)

Moderate Intensity (Focused Services/Interventions)

Low Intensity (Early identification /Interventions

Seve

rity

an

d C

om

ple

xity

Low number of people

High number of people

Stepped Care Model

• Prevention and Promotion

– Promotion of wellness, support for health needs

– Education, information

• Low Intensity

– Early Intervention, service navigation, self-management

resources, brief interventions, targeted prevention

• Moderate Intensity

– Specialized consultation, assessment and treatment, structured

brief intervention.

• High Intensity

– Crisis response and support, psychiatric treatment and support

COVID-19 Psychological Safety and Health: Support

Organizations, Agencies, Services

Name of

Organization, Agency,

Service

Description of Support Service National

Provincial

Regional

Target

Groups

Support issue Delivery

Options

Contact / Web Link

Health Promotion &

Prevention

Clinical Health

Psychology

Presentation on maintaining Psychological

Health during COVID-19.

P Medical staff

and their

department

teams

Grand Rounds

Webinar

Q&A session

Dr. Maxine Holmqvist mholmqvist@hsc.mb.ca.

Association of Regulated Nurses of MB

“Wellness Matters” – is a self-care program for nurses, featuring supports and services r/t the pandemic response. The program offers “Talk Tuesdays”, which is a one hour live virtual forum provided weekly with different featured topics

Provincial Nurses Specific topic discussed weekly – first session focused on infection prevention and control

Virtual forum https://arnm.ca 204-992-1520

or email:info@arnm.ca

Low Intensity

Public Health Agency of

Canada - Wellness

Together Canada

Tools and resources to support mental health wellness impacted by COVID19. Wellness self-assessment and tracking. Self-guided courses, apps, and other resources. Group coaching and community of support. Counselling by text or phone

N Canadians Stress Management,

Wellness Tools &

Resources

On line https://ca.portal.gs/

Morneau Shepell -

AbilitiCBT

Online Cognitive Behavioral Therapy delivered by a therapist through a digital platform accessible from a smartphone or tablet. It virtually pairs individual with a professional therapist that supports you through your program.

P Manitoban’s 16 years and over

Anxiety related to

COVID-19

Online https://www.gov.mb.ca/covid19/bewe

ll/virtualtherapy.html

COVID-19 Psychological Safety and Health:

Support Organizations, Agencies, Services

Health Promotion and Prevention

Clinical Health Psychology

Presentation on Maintaining Psychological Health during COVID-19.

Association of Regulated Nurses of MB

“Wellness Matters” – a self- care program for nurses, featuring supports and

services r/t COVID-19.

“Talk Tuesdays” – weekly one hour virtual forum with variety of topics

Canadian Centre on Substance Use and Addictions

Managing Stress, Anxiety And Substance Use During Covid-19: A Resource

For Canadian Healthcare Providers

• https://www.ccsa.ca/managing-stress-anxiety-and-substance-use-during-

covid-19-resource-healthcare-providers-infographic

COVID-19 Psychological Safety and Health:

Support Organizations, Agencies, Services

Low Need/Intensity

a. Morneau Shepell- AbilitiCBT • CBT delivered through a digital platform accessible from a smartphone or tablet.

• Virtually pairs individuals with a professional therapist that provides support through the

program.

• 16 years of age and older

• Anxiety related to COVID-19

b. Public Health Agency of Canada – Wellness Together Canada • Tools and resources to support mental health and wellness during COVID-19

• Wellness self-assessment and tracking, self guided courses, apps and other resources

• Group coaching and a community of support

c. CMHA Bounce Back a. Coaching program for those experiencing low mood, stress, worry, anxiety, depression

COVID-19 Psychological Safety and Health:

Support Organizations, Agencies, Services

(con’t)

Moderate Need/Intensity

a. MD Care

b. Student MH Services

High Need/Intensity

a. Crisis Lines / Manitoba Suicide Prevention and Support Line

b. Crisis Response Services

c. RAAM Clinics

Active Offerings

HIGHLIGHTS:“ACTIVE OFFERINGS”

Stress Management/Self-Care - Pocket Card

Critical Incident Stress Support Training

Maintaining Psychological Health During COVID-

19 - for Medical Staff

Leadership Support – “Engagement Through

Crisis”

(3.5

x2)x

1.5

Due to COVID-19, people working in health care and essential services are experiencing prolonged stress exposure. Being aware of how we are caring for our Mind, Body, and Spirit can help minimize the impact on our well-being.

Prolonged Stress Exposure- COVID 19

(3.5

x2)x

1.5

Practicing Self-Care: • Validate your reactions: Understand stressful

thoughts and feelings are a normal reaction to an abnormal event. Be curious, rather than judgmental.

• Draw on positive coping skills that you have used in the past and add new ones when possible.

• Build support networks: Share experiences with others and stay connected.

• Take care of your basic needs: Are you eating well? Have you taken a break? Are you keeping hydrated? Are you sleeping?

• Practice compassion for yourself and others: Each of us reacts differently to stressful events. Be sensitive to how team members are reacting.

• Monitor your perceptions and influences. We can foster anxiety or comfort, we need to monitor how we behave and interact.

• Be creative: write, draw, paint, sing, play.

• Use humour and savor joyful moments.

• Breathe mindfully.

• Engage in comfort activities you enjoy.

• Connect with supports:

EAP - 204-786-8880 or 1-800-590-5553

MD Care 204-480-1310 (MD’s & families only)

Students contact your University Health Services

Site CISM Team (where available)

The A-B-C’s for Self-Care

AWARENESS

Of self and the situation

CONNECTION

With yourself, others, and a

greater meaning

BALANCE

Of mind, body, and

spirit

Mindful Breathing Cycle

The A-B-C’s In Practice: • Pause – focus on the task at hand,

be aware before you act • Use credible information sources • Practice meditation and

mindfulness • Ensure you take breaks • Go for a walk • Appreciate your colleagues’ unique

knowledge, skills and abilities – work together

• Make your relationships count • Have each other’s back • Share positive stories • Express gratitude • Assume others have positive

intention • Encourage kindness • Appreciate we are all under stress • Remember we are all in this

together

“Between stimulus and response there is a space. In that space is our power to chose our response. In

our response lies our growth and our freedom”. Viktor Frankel

Critical Incident Stress Support

Training for COVID-19

1-day course to build capacity within the system for

health care providers to: 1. Recognize stress response symptoms in themselves and

colleagues

2. Engage in psychological first -aid supporting peers and colleagues

affected by the pressures and impact of COVID-19

3. Provide education on effective ways to manage a prolonged stress

exposure

4. Assist in connecting others with more intensive mental health

resources when needed

1. Initial offering May 4, 2020- 53 participants

2. 14 participants attended in a train-the-trainer capacity and

will begin rolling out similar training across RHAs, sites, and

programs

MAINTAINING PSYCHOLOGICAL HEALTH DURING

COVID-19 Initiative by Clinical Health Psychology (CHP),

Max Rady College of Medicine/Shared Health

This is an Interactive virtual session for medical staff and their departments and teams, led by clinical psychologists

1. Tailored to the unique circumstances and challenges of the department and medical staff

2. Flexibly delivered as Grand Rounds, Webinar or Q & A session, during day or evening

Session Objectives:

a. Identify common reactions of healthcare providers to the COVID-19 pandemic

b. Learn and utilize evidence-based strategies to manage stress and enhance wellbeing and resilience

c. Discuss other areas of interest identified by participants prior to or during the session

CHP Contact: Dr. Maxine Holmqvist mholmqvist@hsc.mb.ca

Questions?