11. TIME IS OF THE ESSENCE: ONE RESIDENCY PROGRAMS APPROACH TO BREAKING DOWN BARRIERS TO ACCESSING MENTAL HEALTH RESOURCES

Abstract

Background Physician burnout is a serious, well-documented phenomenon that occurs at all levels of medical training that contributes to a higher incidence of suicide compared to age-matched peers. Surveyed students and residents ranked barriers to accessing care, which showed that time constraints (52%) were the primary barrier, followed by fear of retribution, and the stigma associated with mental illness. Aim The aims of the project are three-fold. 1. To decrease barriers and stigma preventing residents from obtaining mental healthcare; 2. Expose training physicians to the system of mental health resources prior to need; 3. Improve long term wellbeing through dedicated time and support for accessing mental health resources. Intervention A 5 question survey was administered to assess baseline attitudes toward counseling and knowledge about the Employee Assistance Program (EAP). Beginning January 2019, residents were provided at least 3 opportunities to schedule a “wellness check-in” with a counselor or psychologist during designated rotations throughout each training level. Time was free from clinical obligations and flexible for scheduling with advanced notice (2-3 weeks). A map of vetted providers in close proximity to the institution and detailed instructions EAP system access were provided prior to each rotation. Post surveys were distributed monthly. Results Baseline data revealed 49% of respondents knew where to find EAP resources compared to 62% post intervention. Over the 12-month pilot phase, 30% of eligible residents utilized the program. Of those who did not, three major barriers were noted: EAP system navigation (26%), provider availability (26%) and awareness of the program/time to schedule (22%). In addition, 5% more respondents rated counseling favorably compared to prior to the intervention. Of the respondents, 35% reported not feeling the need for an appointment. Conclusion and Next Steps As a result of the pilot phase, we have automated the notification system to send reminders 3, 2, and 1 month prior to an eligible rotation to increase awareness and time for scheduling. As a result of these interventions, we hope to increase utilization of the program, normalize counseling and decrease barriers to seeking mental health resources. Next steps also include expanding the vetted counselor map including reviews to increase the ease of making the first appointment.