It may be tempting to say, “Good riddance!” to 2020, but the reality is, many of 2020’s stressors will carry over into 2021. As we head into a new year, the COVID-19 pandemic continues to impact everyone’s daily lives. So too do the issues of systemic racism and political polarization.
Medical students, resident physicians and fellows inherently have high demands on their time and energy as they are continually learning in a field that is constantly evolving. For many, the added challenges brought by COVID-19—often compounded by other environmental and relational stressors—have compelled them to reach out for help.
This is a good thing, said Samia Hasan, MD, assistant professor of clinical psychiatry and director of Mental Health Services at Indiana University School of Medicine.
“Support from the dean’s office has led to a rapid expansion of mental health resources for IU School of Medicine trainees,” she said. “Across the IU School of Medicine system, there has been growing recognition and support for the use of mental health services by not only trainees, but faculty and staff as well.”
Stigmas about seeking mental health support are lessening, Hasan added.
“Mental health issues are incredibly common and are not related to strength or weakness,” she said. “Addressing mental health concerns helps people become more effective in their lives. It’s also important to recognize that the cost of not treating mental health concerns is likely to be much higher than any cost associated with seeking treatment. Untreated anxiety, depression or other mental health difficulties can impact functioning and cause very significant distress that can impact career performance and personal relationships.”
Several IU Health hospitals recently took a meaningful step in lessening the stigma for physicians and other health care workers who might be concerned about the implications of seeking mental health services. The Academic Health Center in Indianapolis and other hospitals agreed to change language in the questions used for credentialing so that mental health conditions are not treated differently than physical health conditions.
This could alleviate fears that a mental health diagnosis might cause someone to lose their job, said Jennifer Hartwell, MD, associate dean and chief wellness officer at IU School of Medicine. “This is a really big step for our health care community,” she said. “It eliminates the insinuation that mental health should be called out separately from physical health diagnoses. It’s important for breaking down barriers to getting help.”
In light of the extra stressors brought on by COVID-19, Hasan and licensed mental health counselor Stacie Pozdol, MS, answered some questions about Mental Health Services. They encourage anyone who could use some extra support to reach out.
What are the most common reasons someone comes to Mental Health Services seeking help?
Anxiety and requests for stress management are prevalent concerns. Low mood and depressive symptoms are also commonly reported. Trainees frequently experience adjustment-related issues—they may be trying to manage a number of life changes such as moving to a new city, starting medical school or a new program, working with new people, making new social connections, and adapting to significant and different school or work demands. Additionally, many learners come in for help with academic struggles; they may be looking for support with organization and focus, working through test anxiety, or learning how to better manage academic work demands. Trainees may also seek counseling in order to think through major life decisions. We offer a variety of services, including both individual and group counseling, as well as psychiatric evaluation and medication management.
How has the COVID-19 pandemic compounded the typical demands students, residents and fellows have on their time and energy?
From study groups to socializing, everything is different, and in some ways more difficult this year. Students are having to self-pace watching video lectures rather than attending in-person classes, some students are having limited exposure to patients because PPE may be limited, major exams have been postponed due to COVID, and interviews are happening virtually rather than in person. Two big stressors that learners frequently mention are the feeling of isolation that this year has brought on, as well as anxiety about how the changes from COVID will impact their learning process.
With learning being more virtual and many get-to-know-you events being canceled or moved online, it can be difficult to find a sense of community. Additionally, COVID has made it hard for people to use many of their typical coping strategies—going out with friends, going to concerts, going to the gym—all of these are more difficult now. Learners are trying to go through a process that is already demanding and stressful with fewer coping strategies available to them than ever before.
As we enter a new year, with the pandemic still very much a daily factor in our lives, how can people maintain a healthy mental outlook?
This pandemic is definitely a marathon rather than a sprint! It’s important to take good care of yourself: getting sleep, eating a healthy diet and exercising. Taking care of your body helps provide you with the physical strength to handle stressors. Having a routine can also be a huge help. With many people working or studying from home, it’s harder to separate family time from work time, or study time from free time. Making sure your day has clear divisions and a consistent routine can help you find the mental strength to get through these next few months.
Finally, it’s essential to have good coping strategies to ensure you have emotional strength as we round out a full year of life with COVID. Be sure to identify strategies that help you feel better, whether that’s social time (done safely—virtually or socially distanced), leisure activities (such as art, cooking or playing with your pets) or relaxation strategies (such as yoga and mindfulness). It’s incredibly important to build these components into your daily routine so you can stay strong physically, mentally and emotionally.
What lessons has 2020 taught us that might help us going forward into a new year?
It’s important to recognize that a lot of work and learning was accomplished this year. As much as we all want to believe 2020 was cursed and 2021 will be better, the reality is nothing will magically change on January 1, so it’s important to have realistic expectations. You may find that a few months into 2021, it still feels an awful lot like 2020. When things have been hard, like they have this year, it can be incredibly helpful to try to find the silver linings. Remember, no year is all good or all bad. 2020 had its rough spots, and so will 2021, but there’s always something good if you look for it.
How can we grow our resiliency and adaptability to make it through these difficult times?
Fortunately, resiliency and adaptability are not “all or nothing” traits. Adaptability and resiliency are skills, and just like any other skill, certain people will have a natural proclivity for them. Just as some people may be natural athletes or natural artists, some people are naturally better able to adapt and bounce back after struggles. If resiliency and adaptability aren’t your natural strengths, the good news is that you can learn strategies to help you improve in those areas. Managing your expectations for yourself is particularly important. Being resilient doesn’t necessarily mean that you’ll accomplish everything you set out to do; it can mean being flexible and responsive to the changes around you. If being adaptable is a challenge, reaching out to a mental health professional can be very helpful for developing useful tools and strategies to build your resiliency.
What other tips do you have for those who are struggling with mental health during this unprecedented time?
It’s really important to remember that you absolutely are not alone in your struggle. Right now, everyone’s baseline stress level is elevated due to multiple months of living with COVID. Because your baseline is elevated, you’re likely to notice things that didn’t bother you in the past are more upsetting for you now; it’s harder to handle the “small things.” Give yourself permission to have a harder time—don’t pressure yourself to do more than you can, and don’t guilt yourself for having hard days. Make sure you’re taking care of yourself, and reach out to your support people. If things start to feel overwhelming or seriously distressing, you should absolutely reach out to a mental health professional. IU School of Medicine has many resources available to learners, faculty and staff.
Resources for Learners:
The Department of Mental Health Services at IU School of Medicine is available to provide mental health and personal counseling services to all students, residents and fellows. There are two ways to access services:
- Contact the Department of Mental Health Services by calling the non-emergency number during normal business hours at 317-278-2383, or via the DMHS secure online portal to inquire about an appointment.
- In an emergency, call 317-278-HELP (4357) 24 hours a day, seven days a week. A licensed mental health specialist will provide an assessment and help direct you to appropriate treatment options based on the situation. You may also call on behalf of a trainee if you are a family member, friend or colleague concerned about their well-being. You may call anonymously if desired.
Resources for IU School of Medicine team members and families:
- Behavioral Health Virtual Hub (317-963-2200) provides 24/7 triage and access to a variety of resources through the Department of Psychiatry and the IU Employee Assistance Program (EAP).
- IU Employee Assistance Program provides 24/7 access to licensed mental health counselors 365 days a year. Visit SupportLinc or call 888-881-(LINC) 5462.