By Gary Evans
For employee health professionals looking for more resources and tactics to prevent suicide in healthcare workers, the American Hospital Association (AHA) has posted a free, downloadable report that identifies three driving factors in self-harm ideation.1
Based on a literature review, a survey, focus groups, and interviews with healthcare workers, the AHA determined the primary drivers of suicidal behavior in healthcare work are:
• Stigma around discussing and seeking treatment for mental health.
This issue includes fears of losing medical licensure and hospital privileges, being perceived as “weak” or unable to perform the job, and the risk of judgment and lack of support from colleagues and administrators. Mitigation measures recommended by the AHA include:
- Improving awareness and understanding of the prevalence of behavioral health disorders;
- Creating a culture of transparency where all employees feel safe to discuss behavioral health;
- Eliminating credentialing questions and policies that stigmatize seeking treatment.
• Lack of access to mental health education, resources, and treatment.
Access issues include long wait times between referrals and appointments and inconvenient office hours. Out-of-pocket expenses for therapy could be a barrier for some. Employees also reported uncertainty about how to access free resources from employee assistance programs (EAP). Mitigation measures recommended by the AHA include:
- Providing employees with several options to pursue mental health services, including on-site, off-site, and virtually. Ensuring employees are aware of EAPs and other resources.
- Offering peer-to-peer support training and encouraging employees to engage in peer support programming.
• Job-related stress.
Healthcare workers have emotionally draining jobs that involve repeated exposure to death and workplace violence, the AHA noted. They might believe they are not supported enough by management, for example, with appropriate compensation. More subtle issues involve connection with colleagues or perceived fairness and mutual respect. Employees lack sufficient control over the resources they need and have little authority to make changes they feel would improve work efficiency.
Mitigation measures recommended by the AHA include:
- Improving psychological safety through nonpunitive debriefing after adverse events;
- Addressing immediate concerns, such as staffing shortages, burnout, and stress management;
- Committing to providing employees and medical staff with several options for behavioral health treatment and resources.
High-priority interventions in the AHA report include a baseline review of current resources for mental health and suicide prevention.
“Inventory the suicide prevention, behavioral health, and well-being tools already available at your organization,” the AHA recommended. “Identify what offerings are available at the individual level, the unit or department level, and at the organizational level. Quantify current program use, value, and success, where possible. This could be well-being or employee engagement survey data, specific program evaluations, or other existing data to provide clarity on what is needed to support the workforce.”
The AHA report and ongoing actions were made possible in part by a 2021 grant from the National Institute of Occupational Safety and Health, which charged the AHA to identify current and developing evidence-based tactics for reducing suicide risk in hospital personnel.
REFERENCE
- American Hospital Association. Suicide prevention: Evidence-informed interventions for the health care workforce. 2022.
For employee health professionals looking for more resources and tactics to prevent suicide in healthcare workers, the American Hospital Association has posted a free, downloadable report that identifies three driving factors in self-harm ideation.
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