Prioritizing the Mental Health of Providers Across the Country

Lorenz-Fisher: Hello everyone. I'm Susan Lorenz Fisher, vice president of corporate responsibility and sustainability at AmerisourceBergen, as well as the program officer of the AmerisourceBergen Foundation.

Mental health is certainly something that impacts all of us, particularly over the last year and a half of the COVID-19 pandemic. For pharmacists and other health care workers, their heroism on the frontlines has made them particularly susceptible to burnout, fatigue and other mental health challenges.

We're going to spend a little bit of time diving into this topic further and discuss ways to support the mental health of providers across the country.

I'm really proud to be joined by Erin Briggs, senior pharmacy advisor at Americares, one of the AmerisourceBergen Foundation's long time nonprofit partners. Erin, would you mind giving a quick intro?

Briggs: Of course, Susan. Thank you. I'm Erin Briggs. I'm the senior pharmacy advisor at Americares. I started my pharmacy career in 1999 at an independent pharmacy, and then I spent the last 15 years working at 2 different chain pharmacies in Virginia and New York. I also worked as a per diem floater pharmacist in the New York area during the pandemic, so I do have experience with the types of challenges that pharmacists have faced over the last year and a half.

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Now, Americares is a health-focused relief and development organization, and we save lives and improve the health of people affected by poverty and disaster. Americares reaches about 90 countries on average annually, including the United States. And we provide health programs, medicine, medical supplies, and emergency aid.

And Americares also has significant experience in delivering a range of mental health programs as well, and psychosocial support interventions, and also behavioral health programs in both domestic and international settings. So, we've provided health centers and health workers with other resources, including training workshops during COVID-19 in response to exhaustion and burnout that health workers were experiencing. We actually were able to provide mental health training for over 23,000 participants. And that is an ongoing program.

Lorenz-Fisher: Erin, thanks so much for that introduction. And it's great to learn a little bit more about Americares as well. And from my role as program officer of the AmerisourceBergen Foundation, I've definitely had the pleasure of getting to learn about Americares over the past couple of years through our partnership and really enjoyed getting to participate in the virtual airlift benefit over the weekend.

So, we're going to talk a little bit more about burnout amid COVID-19. I'd love to hear from you what you think some of the causes of burnout might be, and then we can dive into some tips on how to prevent that from happening.

Briggs: Yeah, absolutely. So as a pharmacist working in a pharmacy, there's going to be a couple different sources of stress and burnout. So, big picture burnout, stress is going to is considered systemic burnout. So, this is the politics of the job. And this could involve a trickle-down effect of systems and policies that are not particularly healthy.

For instance, early in the pandemic, and unfortunately, even now, what we're experiencing is a lot of new information. Different resources like [the] CDC, FDA, [and the] World Health Organization (WHO), tried to understand the pandemic as evolved. And early on in the pandemic, institutions were actually slow to mandate COVID-19 protocols, whether that was the government or even corporations.

So, protocols were slow to be developed, and then also to take effect. So essentially, what was happening was, the necessary precautions were very slow to be rolled out. Then on top of that, you have the personal protection equipment (PPE) shortages. This creates an enormous amount of stress for pharmacists and their staff who are trying to stay safe while working.

Then you have team burnout. Whether that's internal conflict with your colleagues or the technicians that you're working with, just trying to get along with people during a really stressful situation like a pandemic, this can be really challenging and create a lot of stress and burnout.

Now also being understaffed—so, I worked alone quite a bit during the pandemic because we just didn't have enough technicians to work. So, unfortunately, being overworked and understaffed is pretty common in pharmacies.

And then thirdly, you might have burnout from your patients. Pharmacists are patient's most trusted and reliable resources for medical information, and we are also the most accessible because you can walk right up to us at a pharmacy counter. And early in the pandemic, and still now, new information is constantly coming out, so it's extremely stressful to stay updated with all this information so that you can continue to be a reliable resource for your patient.

Not only that, but early on in the pandemic, we had to adapt pharmacies to maintain protocols, whether that was rearranging the layout of your pharmacies so you could stay safe, or providing additional services like curbside pickup or delivery. This was extremely stressful; just trying to adapt to all the changes that were going on.

And then you have the patients that might be disrespecting or disregarding the COVID-19 protocols that the pharmacy has implemented. So of course, that was causing quite a bit of stress.

And then, probably most importantly, the fear of your patients getting sick or dying. Not only do you have to worry about your family, friends, your neighbors, your community, but then your patients as well. I had the unfortunate incident a couple of times of calling my patients to remind them to pick up their prescriptions to find out that they had actually passed away, so I can imagine that causes quite a bit of stress.

Lorenz-Fisher: Thanks for that really valuable perspective, Erin. It really just underscores that independent pharmacists have definitely gone above and beyond for their communities, they're really feeling the impact of the pressure of keeping their patients healthy and their businesses running at the same time.

Let's move into preventing and mitigating burnout. It would really be great, Erin, if you could talk us through some of the ways that we can help prevent burnout and what pharmacists can do to prioritize their mental health.

Briggs: There are some strategies. So first, understanding your symptoms is really important.

Keep in mind that stress and burnout can be psychological, behavioral, or social. For instance, maybe you find yourself having difficulty sleeping, or you have chronic fatigue, or you're just getting angry more easily, you're having numbness or feelings of isolation or withdrawal. These can all be symptoms of stress and burnout, so understand and recognize those.

Additionally, you can identify the reasons for burnout. Keep in mind, burnout is actually typically work related. Recognizing what is causing the burnout can help you reflect on how to reduce the stress that's being caused.

I wanted to define burnout for you. It is a state of physical or mental exhaustion that involves a sense of reduced accomplishment and loss of personal identity. Burnout actually tends to happen over time in relation to the work environment as a whole. So, understanding the definition of burnout, and then recognizing and identifying the reasons for burnout is really important.

You should also identify your coping styles. Your coping style is your characteristic way you respond to stress. Some coping styles are actually—some people just want to work more as a distraction from stress. This can make people very productive, but it also can actually cause more stress. But then you can also involve actions, smaller actions that can help with coping with stress, such as decreasing your screen time, practicing mindfulness or self-compassion. Sometimes taking a break from social media can help. And then connecting with others as well, which, unfortunately, it's been especially challenging during the pandemic. But these can all be healthy types of coping styles.

Remember to be compassionate with yourself. Take breaks, and then also set healthy boundaries with yourself and at work. So being able to say “no” is very important.

And then lastly, creating a self-care plan needs to be realistic, and work for you. So, it needs to be reasonable, it should be feasible. Self-care can be a part of a daily or weekly routine. And you can even actually do it at work. Pharmacists have busy jobs, they have busy lives. But fortunately, we're also really good at multitasking. Consider ways that self-care can be right now, and think of the areas in your life, whether that's cognitive, relational, spiritual, physical, or creative, and maybe pick 1 or 2 of those self-care goals that you can work into practice, let's say even in the next 30 days or so.

For example, maybe you want to start exercising a little bit more, eating healthier, journaling, or just taking more time for yourself. These are all activities that can be incorporated into a daily routine and can help be part of your self-care plan.

Lorenz-Fisher: Love your point on self-care. I think it's important for us all to recognize that it looks different for everyone. And it's really important to do what resonates with you and to lean into it.

As we close out this conversation, I'd love if you could just share a couple of final takeaways with us.

Briggs: Pharmacists spend so much of their time taking care of others, whether that's their family, their patients, or if they own or manage their own pharmacy, they're taking care of their staff. So, don't forget to take care of yourself because it's just as important.

And I would like to say that Americares has a resource center that has mental health and psychosocial support resources and training. It was specifically developed during COVID-19, so it's free, and all you have to do is register. If you go to learn.americares.org, there are courses about building resilience in the workplace, self-care strategies for health care workers, and there's even a course on strategies for improving sleep, so I would recommend using these resources if you feel like you would benefit from them.

Lorenz-Fisher: That's an excellent recommendation, Erin, and I hope all of our listeners will take advantage of that opportunity.

Really enjoyed our conversation today. And one of the things that comes clearly to me is that community pharmacists have been an incredible resource for care, education and hope during this pandemic. But prioritizing and protecting their mental health is really critical to ensure that they can continue their inspiring work.

I really enjoyed talking with you today and I look forward to AmerisourceBergen Foundation's continued partnership with Americares and the work we've been collaborating on around mental health.

Briggs: Thank you, you too, Susan.

Editor's note: This transcript has been lightly edited for style and clarity.