Medical professionals — especially those working in hospitals — face plenty of stress, even during normal times. But these aren’t normal times. The global pandemic has increased stress and anxiety for everyone, but especially for frontline workers in hospitals and health clinics.
Recognizing that its members are facing a heightened level of anxiety, the Canadian Medical Association (CMA) moved quickly to roll out a Wellness Support Line that was in its incipient stages. The call-in service is for physicians, residents, medical students and their immediate families to access round-the-clock mental health counselling with counsellors trained to address problems faced by medical professionals in urgent crisis or with everyday mental health issues.
Some provinces were already offering 24-hour service with counselling tailored for physicians – supported through provincial medical association, the provincial health ministry or a combination of these – but not all.
“CMA was concerned that some provinces and territories did not all have access to that service,” Dr. Caroline Gérin-Lajoie, CMA Executive Vice-President on Physician Health and Wellness, said in an interview. “Our goal was to make sure that every physician and trainee across Canada could call a wellness support line every day of the year no matter what province or territory you were working in.”
The support line, funded by Scotiabank and MD Financial Management Inc. MD Financial), is provided through a sponsorship with the provincial and territorial medical associations in Saskatchewan, Ontario, Nova Scotia, Newfoundland and Labrador, Yukon and Nunavut.
Gérin-Lajoie heads up a team established in January 2019 by the CMA to focus on physician health and wellness and more recently on medical culture. In part, it was a response to results of a National Physician Health Survey of CMA members carried out in 2017 that concluded that while physicians on average tended to be healthier than the general population, they have higher burnout rates, and it would therefore benefit patients if physicians’ health and wellness issues were addressed. Part of the new team’s mandate was to support and provide resources to physicians.
The survey asked respondents questions related to several factors affecting physicians’ health and wellness including lifestyle behaviours and occupational environments, concluding that factors such as long work hours (on average 48 hours a week, not counting the average 111 on-call hours each month), and not getting the optimal amount of sleep and physical activity were common. In regards to workplace satisfaction, more than half of the respondents were dissatisfied or very dissatisfied with a lack of resources, whether that was equipment or staff, and inefficient practices in their workplace, and nearly one-third said they experienced burnout.
But it was the onslaught of COVID-19 and the pace at which it was spreading that brought the issue of access to mental health counselling to the forefront.
“We knew this was important before, we had plans of doing this eventually, but COVID came and added urgency and that's why everyone worked very hard to make this happen as quickly as possible,” Dr. Gérin-Lajoie said, adding that the CMA was “really appreciative of Scotiabank’s support in this project.”
Early on, the CMA was hearing from its members that they were concerned about access to personal protective equipment and respirators, and worried about being able to provide care to patients if the numbers were to outpace resources and physicians had to make tough decisions about who gets them. The contagion rate also was cause for fear.
“The unique piece with this pandemic is also a fear about getting sick. Fear because it is so contagious, fear about infecting a patient, fear about infecting a colleague, fear about infecting your own family,” Dr. Gérin-Lajoie said.
Where the Wellness Support Line may really become important, according to Dr. Gérin-Lajoie, is in the aftermath. “When you look at the progression, or the lifecycle of pandemics, there is what they call a fourth wave, which is a period where, following all the other events, you may see that increase whether it's anxiety and mood issues or substance use and that's where we want to try to prevent that increase,” she said.
“The mental health of the physician community is so very important, especially now as they continue to battle this pandemic. We hope this Wellness Support Line will provide some relief when and where it is needed,” Alex Besharat, Executive Vice President, Canadian Wealth Management at Scotiabank, said about the Bank’s support of this initiative.