Tackling healthcare worker burnout, stress and anxiety: a fireside chat with Cigna's behavioral strategy director

Burnout, systemic stress and anxiety have gained a permanent foothold in the lives of many healthcare workers. Finding ways to neutralize and reverse their effects is a growing priority for organizations.

During a June Becker's Hospital Review webinar sponsored by Cigna, two of Cigna's leaders — Allison Hofmann, national vice president, health systems division, and Jason Youngblood, director, Behavioral Center of Excellence — discussed why preventing and addressing employee mental health issues is of vital importance and what steps organizations can take to successfully do so.

Four key takeaways were:

1. The COVID-19 pandemic augmented burnout and spurred a wave of behavioral health issues. In the aftermath of the most acute phases of the pandemic, eating and substance use disorders, untreated depression and other behavioral and mental conditions spiked. The impact of such conditions can be so severe that some turn into impediments to daily living, yet as Mr. Youngblood shared, as many as 60 percent of people who experience symptoms never get care. For those who do, he said, it takes on average 10 years from the onset of symptoms until the time they get treatment.

"Behavioral issues may never go to pre-COVID levels, they're here to stay, so the window of opportunity to focus on [how we deal with] behavioral health is open now," Mr. Youngblood said. To underscore the need for action, he noted that clinical depression tends to particularly affect women between the ages of 25 and 44, meaning that roughly one out of every eight women can expect to develop depression during her lifetime. Ms. Hofmann observed that as of 2021, approximately 75 percent of the U.S. healthcare workforce is female. 

2. To address mental health issues, it is paramount to reduce the stigma surrounding them. Stigma around mental health is still very present in society, including the way such conditions are talked about in the media. To tackle stigma, Mr. Youngblood said it is important to talk openly about mental health and be self-aware about common words and expressions that frame mental or behavioral health pejoratively (e.g., "nuthouse," "crazy"). From an organizational perspective, it is vital to provide adequate education and awareness training.

3. Employee assistance programs (EAPs) can incorporate elements that support mental health and resilience. Beyond education and awareness training, healthcare organizations should strive to provide conditions that enable optimal mental health for employees. Those conditions include healthy food choices; water fountains and hydration campaigns; quiet rooms where frontline staff can catch some sleep; an onsite fitness center, walking path or discounts to local gyms; and capable people managers along with activities that facilitate social connections among colleagues. "Study after study shows that teams who are better connected tend to have better performance and outcomes," Mr. Youngblood said.

4. Rethinking and repositioning EAPs as a tool for managers can further promote employee well-being. EAPs date back to the 1950s and are due for an upgrade to the purpose and meaning attached to them. While at many organizations such programs are barely utilized by employees, there is an opportunity to refashion them into an active support tool for frontline managers, who are often the first to notice changes in employees' conduct or performance. That way if a manager has a concern, they have a designated channel through which to consult with HR about how the issue should be handled. "We see that organizations that treat their EAP as a tool for managers tend to double the utilization of that benefit," Mr. Youngblood said. 

Healthcare entities should also strive to do a better job promoting existing behavioral health benefits, similar to how they encourage employees to make use of wellness visits and screenings. Lastly, Mr. Youngblood recommended that organizations provide mental health first-aid trainings that enable employees to recognize mental or behavioral health-related stress and know how to respond in an emergency.

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