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MGMA 2022: Physicians don’t have to be mental health experts to become mental well-being advocates


Lack of providers, stigma are barriers to seeking needed care, but meaningful conversations can help.

MGMA 2022: Physicians don’t have to be mental health experts to become mental well-being advocates
Leia Spoor, MPH, DABLM
Photo courtesy of Holmes Murphy & Associates

Leia Spoor, MPH, DABLM
Photo courtesy of Holmes Murphy & Associates

Not every physician has to be a mental health expert to assist their colleagues, staff, and patients in improving their mental well-being.

Mental health is not just about people who suffer from mental diseases, which may be about 5% of people, said Leia Spoor, MPH, DABLM, clinical director in the Texas offices of employee consulting firm Holmes Murphy & Associates. Spoor presented “Create a Culture Where Mental Wellbeing is OK,” during the 2022 Medical Practice Excellence Leaders Conference of the Medical Group Management Association.

Rather, everyone has mental well-being, which exists on a spectrum with four categories that can change by the day, hour, or moment, depending on circumstances, Spoor said. Apart from mental disease, other people may be languishing, or demonstrating functional impairments due to extreme stress, depression, or self-medication.

Most people, an estimated 75%, live and work each day with moderate mental health, dealing with regular life stressors that could be better managed. The goal is to support a general shift for everyone toward flourishing, being in great spot mentally and physically in life, Spoor said.

One Gallup poll showed a national backward slide from 2019, when 76% of people said their mental health was excellent, to 2021, when that figure dipped to 34%. It was the largest decrease in a lifetime, due to factors such as the COVID-19 pandemic, the nation’s contentious politics, and societal unrest, Spoor said.

While it’s clear more people could use help, the national average wait time for behavioral health services is 48 days. Lack of providers is on the list of reasons why people don’t seek help, but so is stigma – a negative perception that causes someone to think less of a person, or stereotyping or labeling a person because of a condition.

Physicians and health care staff can help overcome that by becoming advocates willing to do three things:

  • Notice changes that are not typical or unusual for a person.
  • Talk to that person, checking in and letting them know you care.
  • Act, by offering to connect that person to appropriate services and supports.

Advocates do not have to suggest diagnoses or treatment options, and Spoor used a medical analogy to describe the role. Not every person is a cardiologist, but many people learn CPR so they might help others if needed.

Likewise, not every person must become a mental health expert. But they can engage others in meaningful conversations, Spoor said.

Her advice:

  • Keep asking. Questions do not have to be complicated or invasive to start a conversation.
  • Be real. Be authentic, describe what you are hearing, and ask the person to clarify if that is what they mean.
  • Be relatable, and don’t worry over what to say back. The goal is not to solve the problem, but to listen, show interest, help the person feel heard and less alone, so they feel less stressed.

In health care, physicians and leaders must remember that the whole person comes to work every day, with concerns about their careers, finances, social and emotional connections, community involvement, and physical health, Spoor said.

Leaders should compile information and help staff understand resources available, starting with employee health benefits, and possible other resources such as health and wellness, weight loss programs, advocacy, and caregiving services.

An easy resource is the new 988 National Suicide & Crisis Lifeline, which started in July, Spoor said.

Leaders also should be practical because not every solution requires a new vendor program or website. For example, if a worker is stressed over a family situation, help may be as simple as allowing comp time or flexibility to start 30 minutes late, then make up time later in the day, she said.

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