Dr. El

Last week, tennis superstar Naomi Osaka chose to forgo mandatory but anxiety-producing post-event press interviews to protect her mental health. She was fined $15,000 by tennis officials and, after being threatened with expulsion from the French Open, withdrew from the event. 

This decision by the world’s highest-paid female athlete has thrust the importance of emotional well-being into the spotlight. 

As a mental health provider in a medically focused field, I see many areas where our own industry could benefit from increased attention to psychological needs. The worker who quits due to stress, the resident whose emotional withdrawal goes unnoticed because it’s not problematic to the staff, the family member who’s channeling their grief into a lawsuit – situations like these are costly to ignore.

While we now regularly assess residents for trauma and depression, there are additional steps we could take to address mental health in the LTC workplace, including the following:

  1. Universal psychology evaluations: Each person entering a nursing home is required to undergo evaluations by various departments such as nursing, speech, recreation and social work, but not psychology. Considering the types of stressors affecting those who arrive at our doorsteps: health conditions, mobility impairments, pain, shared rooms, sudden loss of independence, healthcare-related financial problems and separation from home, family, pets, religious supports, etc., who among us would not feel unsettled under those circumstances? While sometimes an initial consultation is enough to reassure new residents that the facility cares about their emotional experience, more often psychology services are a lifeline during a traumatic transition period and they facilitate compliance with other aspects of care.
  1. EAP services: The United States Office of Personnel Management describes an employee assistance program as “a voluntary, work-based program that offers free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.” Research shows that providing this resource reduces absenteeism and presenteeism, particularly when the program is well-matched to the needs of the workers. Given that the salary of most long-term care employees precludes the financial ability to access mental health care on their own, I’d speculate that EAP benefits are more valuable to our staff than to the average U.S. worker.
  1. Education on mental health basics: The focus of most in-service training in nursing homes appropriately centers on physical health concerns such as infection control and recognizing medical symptoms. To increase recognition of mental health symptoms, provide training sessions on depression and anxiety, as well as on mental illnesses such as schizophrenia and bipolar disorder, particularly in facilities that are seeing an increase in residents with those diagnoses.
  1. Consideration of the milieu: A therapeutic milieu, or emotionally healing environment, can ease emotional distress. Some units are run by calm, efficient nurses and aides who know their residents and promote well-being. Other floors are chaotic, with constantly rotating staff and gruff demeanors borne out of overwork. Prioritize staff retention and train teams to manage environmental factors such as noise levels, temperature, crowding and activities. The payoff will be more tranquil units that reduce both mental and physical distress.
  1. Attending to family needs: Family members are often in as much turmoil as residents, yet their needs yield to caregiving demands. From financial paperwork to clothing provision to end-of-life decisions to learning to live without a loved one, the long-term care process has multiple stress-points for relatives and typically offers inadequate support. For ideas on how to improve this situation, read my column, 7 powerful ways to deliver family-centered care.

Addressing the emotional needs of residents, staff and families can create more humane work and living environments and help to build sustainable organizations. 

And now, on a personal note, for my own sustainability, I’m taking a day at the beach. 

Eleanor Feldman Barbera, Ph.D., author of The Savvy Resident’s Guide, is an Award of Excellence winner in the Blog Content category of the APEX Awards for Publication Excellence program. She also is a Bronze Medalist for Best Blog in the American Society of Business Publication Editors national competition andGold Medalist in the Blog-How To/Tips/Service category in their Midwest Regional competition. To contact her for speaking engagements and/or content writing, visit her at EleanorFeldmanBarbera.com.