Welcome Topic Introduction · 47% of Canadians say work is the most stressful part of their life #1...
Transcript of Welcome Topic Introduction · 47% of Canadians say work is the most stressful part of their life #1...
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
[email protected] 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
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 [email protected].
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:[email protected]
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 [email protected]
Questions?