Intervening to support struggling colleagues
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The Medscape National Physician Burnout & Suicide Report 2020 found that nearly a quarter of survey respondents said they had contemplated ending their own life. Of these, about one in five indicated that they confided their suicidal thoughts to a friend or colleague. But what is one to do upon noticing signs of distress in a colleague? Forum Editor Jean Fisher Brinkley spoke recently to Dr. Christine Moutier, Chief Medical Officer of the American Foundation for Suicide Prevention. She asked Dr. Moutier to give some practical suggestions for how to intervene with a colleague who may be on the verge of crisis.
Jean Fisher Brinkley: It seems to me that most medical professionals would be willing to help a colleague struggling with depression or suicidal thoughts but may not know how. Can you offer some strategies?
Dr. Christine Moutier: I think the first thing to know as a physician is that when it comes to your colleagues and your trainees, you are not their treating physician. This is your colleague, this is your community, and so you can treat them much more like you would treat a neighbor, or someone in your faith community. When you work side by side with people, over time, you learn their mannerisms and their daily little quirks and habits. We all do that, so trust your instinct when you notice that something seems off. It might be subtle. It could be that someone shows up late who is usually on time, or it's their tone of voice, or that they're speaking in a way that makes them seem more overwhelmed or hopeless, despondent, trapped – like they feel like they are a burden.
JFB: What should you do if you see some of these indicators in a colleague?
CM: What I would do is engage them in a caring and private conversation. You can consider it like a coffee-chat type conversation where you simply begin a conversation in a very open-ended supportive way. You can tell them, “I'm not here to judge you, I really want to understand what you're going through so that I can be a supportive colleague” and really just let them share. You might need to tell them why you are initiating the conversation. Remember, if they are in distress, they might be thinking, “Am I in trouble? Did I do something wrong?” So, offer a lot of reassurance and let them know you are approaching them because you noticed they don't seem like themselves. Just say, “I'm wondering if you're OK and how I might support you better but really I just want to understand what you're going through.”
JFB: What if the person you are worried about says “Hey, thanks for your concern, but I'm fine,” and you really don't believe them? How hard do you push?
Dr. Moutier: I appreciate you bringing that up because I think it will happen a good portion of the time. Your timing may not line up with their readiness to share. I think just saying, “Hey, that is no problem at all, but just know that I'm here.” And then over days and weeks, if you continue to notice the same things or the situation seems to be worsening, I would try again. And you have to fight your own instinct to feel like you're being intrusive or a pest and remember, especially in the profession of medicine, we are here to help. In that way we are our brothers’ and sisters’ keepers in that we are also protecting them and the profession by kind of going out of our way a little bit extra.
For more information and resources, visit the American Foundation for Suicide Prevention online and look for the best option under “Get Help”. Or visit one or more of the sites below to find mental health resources for clinicians.
Physician Support Line: 888-409-0141 or physiciansupportline.com
Emotional PPE Project: emotionalPPE.org
Project Parachute: project-parachute.org
Hear more from Dr. Moutier
Dr. Christine Moutier is the featured guest on the first episode of NCMB’s new podcast, MedBoard Matters. Listen in to hear an extended interview with her on the prevalence of suicide in healthcare, stigma and the best resources for getting help. Find MedBoard Matters on your podcast platform of choice.
Jean Fisher Brinkley: It seems to me that most medical professionals would be willing to help a colleague struggling with depression or suicidal thoughts but may not know how. Can you offer some strategies?
Dr. Christine Moutier: I think the first thing to know as a physician is that when it comes to your colleagues and your trainees, you are not their treating physician. This is your colleague, this is your community, and so you can treat them much more like you would treat a neighbor, or someone in your faith community. When you work side by side with people, over time, you learn their mannerisms and their daily little quirks and habits. We all do that, so trust your instinct when you notice that something seems off. It might be subtle. It could be that someone shows up late who is usually on time, or it's their tone of voice, or that they're speaking in a way that makes them seem more overwhelmed or hopeless, despondent, trapped – like they feel like they are a burden.
JFB: What should you do if you see some of these indicators in a colleague?
CM: What I would do is engage them in a caring and private conversation. You can consider it like a coffee-chat type conversation where you simply begin a conversation in a very open-ended supportive way. You can tell them, “I'm not here to judge you, I really want to understand what you're going through so that I can be a supportive colleague” and really just let them share. You might need to tell them why you are initiating the conversation. Remember, if they are in distress, they might be thinking, “Am I in trouble? Did I do something wrong?” So, offer a lot of reassurance and let them know you are approaching them because you noticed they don't seem like themselves. Just say, “I'm wondering if you're OK and how I might support you better but really I just want to understand what you're going through.”
JFB: What if the person you are worried about says “Hey, thanks for your concern, but I'm fine,” and you really don't believe them? How hard do you push?
Dr. Moutier: I appreciate you bringing that up because I think it will happen a good portion of the time. Your timing may not line up with their readiness to share. I think just saying, “Hey, that is no problem at all, but just know that I'm here.” And then over days and weeks, if you continue to notice the same things or the situation seems to be worsening, I would try again. And you have to fight your own instinct to feel like you're being intrusive or a pest and remember, especially in the profession of medicine, we are here to help. In that way we are our brothers’ and sisters’ keepers in that we are also protecting them and the profession by kind of going out of our way a little bit extra.
For more information and resources, visit the American Foundation for Suicide Prevention online and look for the best option under “Get Help”. Or visit one or more of the sites below to find mental health resources for clinicians.
Physician Support Line: 888-409-0141 or physiciansupportline.com
Emotional PPE Project: emotionalPPE.org
Project Parachute: project-parachute.org
Hear more from Dr. Moutier
Dr. Christine Moutier is the featured guest on the first episode of NCMB’s new podcast, MedBoard Matters. Listen in to hear an extended interview with her on the prevalence of suicide in healthcare, stigma and the best resources for getting help. Find MedBoard Matters on your podcast platform of choice.
