“It’s OK to not be OK.”
That’s the message the Indiana University School of Medicine Department of Mental Health Services aims to convey through its Well Beings podcast and an anti-stigma video series launching this month.
“Unfortunately, it’s true that compared to age and education-matched peers, physicians and physicians-in-training experience higher rates of anxiety, burnout, depression and even suicidal thinking,” said Samia Hasan, MD, director of Mental Health Services at IU School of Medicine, speaking on a recent podcast titled “Physician, Health Thyself.”
Reasons for this disparity include personality traits like being ambitious, hardworking and perfectionistic, and the demands of the medical profession — long hours, patient suffering and potentially serious repercussions for mistakes. All of this can lead to feelings of inadequacy, Hasan said.
The Department of Mental Health Services (DMHS) offers resources for all members of the IU School of Medicine community and services specific to learners — including students, residents and fellows — across the state.
Well Beings episodes can be found on Spotify and are easily digestible for busy professionals and learners, each running about 10 minutes. On a recent episode, Psychologist Andrew Brown, PhD, defines Seasonal Affective Disorder and offers strategies for coping with depression brought on by the lack of sunshine, cold temperatures and gray skies of winter.
Other recent podcasts offer tips for managing election distress, helping a colleague who has suicidal ideation and understanding personal triggers.
For the anti-stigma videos, six IU School of Medicine faculty share their stories of mental health struggles and highlight the value of seeking professional care. These videos will be released on the DMHS website in the coming months.
“My hope is this project will spark important conversations that create a much-needed paradigm shift in medicine from judgment and reactivity to acceptance and proactivity,” said Kyra Reed, MD, a physician wellness advocate who recorded her story for the project. “We should be giving ourselves and our colleagues the same advice and recommendations that we provide our patients.”
Stamping out stigma
Here’s some good news: mental health stigma and professional barriers to seeking mental health services are decreasing. More than half of IU School of Medicine’s 2023 graduates and 41% of residents and fellows used mental health services provided by the school at some point during their training. Those numbers continue to rise each year.
Still, many physicians readily recommend mental health care to their patients but are hesitant to seek services themselves for fear of appearing incompetent to practice medicine. IU Health has taken meaningful steps to alleviate those fears. In 2020, the Academic Health Center in Indianapolis and several other IU Health hospitals throughout the state changed the language in questions used for credentialing so that mental health conditions are not treated differently than physical health conditions.
A $10,000 grant from Healthcare Initiatives allowed DMHS to produce the anti-stigma videos with a goal to help medical trainees understand that many of the physicians they look up to have also struggled and benefitted from good mental health care.
“I had rarely, if ever, heard anyone in my profession share a story of navigating their own mental health crisis, and I wanted others to not be ashamed or to feel so alone,” said Reed, an assistant professor of clinical emergency medicine and pediatrics. She has worked with DMHS to build opt-out counseling sessions, wellness dashboards and peer support programs into the Emergency Medicine Residency.
In her video, Reed shares her journey through postpartum depression and anxiety, culminating in suicidal ideation “with a specific plan that I very nearly successfully carried out.”
“As an emergency medicine physician, particularly a pediatric EM physician, I am constantly exposed to death and the unimaginable experiences human beings endure — this is called second victim syndrome,” Reed said. “I discuss how, during training, I proudly built walls and armor in my brain to cope, but upon returning to work postpartum, I could no longer retain this wall.”
She sought help only after inquiring how it might impact her employment. After experiencing healing and what Reed calls “a second chance at life,” she is determined to confront the medical culture and systems issues which create barriers for physicians who know they should get mental health care.
“We lose one physician every day to suicide,” Reed said. “To me, this is staggering and unacceptable, and our responsibility to address.”
As part of the video series, Laura Vater, MD, MPH, assistant professor of clinical medicine, also shares her story of suicidal ideation. When she was a senior medical resident, she found herself “utterly depleted” after working excessively long hospital shifts.
“I saw this pattern of really scary thoughts that came when I was exhausted,” Vater said. “I didn’t know at the time that sleep deprivation is a risk factor for suicide.”
Vater has successfully advocated to end most 28-hour shifts and to institute opt-out counseling for all internal medicine residents, meaning they automatically have a mental health counselor assigned to them — and an established relationship in advance of any potential mental health crisis.
Other faculty physicians involved in the project are Chemen Neal, MD; Gabriel Bosslet, MD; Emily Walvoord, MD; and Brian McFerron, MD — each sharing their own story addressing issues including racism, substance abuse, obsessive compulsive disorder and depression.
Mental health resources for the wellness journey
The bottom line for all DMHS outreach efforts — from podcasts to anti-stigma videos — is the normalization of mental health care. It should be no different than getting regular physical checkups or going to the doctor when an acute physical problem arises, said Stacie Pozdol, MS, LMHC, a mental health clinician and program manager with DMHS.
“Having a mental health struggle doesn’t mean you’re incapable of succeeding in medicine,” she said. “It’s both OK, and completely normal, to seek out support during difficult times.”
Fully anonymous screenings are available on the DMHS website for overall mental health, well-being, anxiety, depression and post-traumatic stress disorder. Each takes just five minutes to complete and can help individuals determine if they could benefit from mental health services.
IU School of Medicine recently launched a Wellness website that serves as a hub of all mental health and wellness resources for everyone in the IU School of Medicine community, including resources specific to faculty, staff, residents and fellows, medical students, graduate students, postdoctoral fellows and students in health professions programs.
“It is significantly easier to manage something when it is initially a concern rather than when it is a full-blown mental health crisis,” Pozdol said. “You can get strategies and tools to manage it before it becomes all-consuming and overwhelming.”
The Department of Mental Health Services is located at Gatch Hall, Suite 600, and can be reached by phone at 317-278-2383. DMHS offers:
- Free, confidential treatment for all IU School of Medicine trainees statewide
- Providers with specialized knowledge of the needs of learners
- Counseling and psychiatric sessions, including urgent visits for all IU School of Medicine trainees
- In-person and telehealth availability. Services may be scheduled via the online portal.
Resources for everyone:
- Reference materials on a range of mental health topics
- Mental Health Screenings to determine if you or a loved one should connect with a behavioral health professional
- Well Beings Podcast and DMHS Blog
Resources for Trainees:
- Mental Health Services: Unsure of which type of therapy best meets your needs? See a chart describing issues addressed by targeted therapy, urgent visits and psychotherapy.
- Resource Finder: Compare all services available to IU School of Medicine trainees, including resources specific to regional campuses.
- 24-hour Crisis Line: 317-278-HELP (4357); Calls can be anonymous and are answered by trained mental health professionals. Reports of calls are routed to the IU School of Medicine Mental Health Services team. Anyone can call on behalf of a trainee.
- TimelyCare: Free scheduled and immediate telehealth visits (up to nine session, with additional sessions available) with online counselors and access to digital resources; evening and week availability.
- IU Indianapolis Campus Health: Healthcare and medical visits, including psychiatric services
- Thriving Campus: Find a provider in this curated database of community providers, filtered by state and selected preferences.
- LiveHealth Online: Telehealth visits with counselors, psychologists and psychiatrists for anyone with an IU insurance plan, including trainees, faculty and staff.
Faculty and staff resources:
- IU Employee Assistance Program SupportLinc: 1-888-881-LINC (5462)
- IU Health Employee Assistance Program: 317-962-8001 (for dually employed faculty)
- VITAL WorkLife: Resources for restoring well-being and work-life balance, including concierge services (for dually employed faculty); 888-316-6616
Public resources (outside of IU):
- Physician Support Line: (888) 409-0141
- 988 Lifeline: 988 is the new three-digit number for the suicide prevention hotline.
- The Trevor Project: (866) 488-7386; suicide and crisis prevention for LGBTQ+ young people
- Suicide Prevention Crisis Text Line: Text HOME to 741741
