Media Talking Points

How PSL Came To Life

Mona Masood, DO, moderator of COVID19 Physicians group on Facebook, saw a stream of posts about colleagues’ fears, anxieties, and the crushing pressure to act like a hero, and saw the need for a hotline for physicians, staffed by physicians. She floated the idea on the Facebook group, and the rest of the admin team volunteered to help get such a hotline started. Dr. Ben Pu Cheng was involved in a hotline for health care workers in Wuhan and was able to give insight into identifying potential issues that may arise. Dr. Suzan Song had just completed a survey of 269 physicians across the U.S. and found high anxiety (56%), depression (43%), and insomnia (16%). Almost half (46%) said they would be interested in mental health support for severe anxiety (80%), “I don’t feel like myself” (72%), and being unhappy (55%). As Dr. Gautam looked at the facebook posts of frontline physician colleagues. She felt powerless and guilty that her frontline colleagues were fighting the battle alone and she was not standing shoulder to shoulder with them. When Dr. Masood floated the idea on FB group, she decided to join “to be there for my colleagues.” Dr. Allison Cotton had started noticing that during phone calls and group chats with her own classmates from medical school, conversation increasingly focused on anxiety, depression, guilt, and insomnia when in previous times these conversations were meant for catching up and reconnecting with friends.  When Dr. Masood floated the idea of what would become Physician Support Line in the Facebook group, Dr. Cotton jumped at the chance to be involved with what she believes is a long overdue resource. 

PSL was launched March 30, 2020, and in the first week of calls, almost 600 psychiatrists already reached out to volunteer. There were over 100 calls, all by word of mouth, mostly about anxiety, family stressors, depression, loneliness, and insomnia. In addition, there were many queries about the legitimacy of the hotline. There was an average of 14 minutes for each call, with the most common interventions being: supportive listening, providing resources, and brief cognitive behavioral therapy. Since that first week. average call length has increased as word has gotten out that PSL is available and our volunteers have become more adept at navigating the peer-to-peer telephone platform.

Increased Suicide Risk

Physicians tend to be perfectionists and have high expectations of themselves. That combination can set them up for mental distress. Physicians are at significant risk of dying by suicide. 

Stigma

Physicians are often reluctant to seek help, and institutional stigma is one persistent reason. Many states require annual license renewal applications in which physicians are asked questions about mental health. Doctors fear they'll lose their licenses if they seek psychiatric help, so they don't pursue it. A study conducted by Gold and colleagues that analyzed data from 2003 to 2008 showed that compared to the general public, physicians who died by suicide were less likely to have consulted mental health experts, less likely to have been diagnosed with mental health problems, and less likely to have antidepressants in their system at the time of death.

Moral Injury

Initially defined by researchers from veterans hospitals, moral injury refers to the emotional, physical, and spiritual harm people feel after perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations. It’s when we have to comply with policies that we fundamentally disagree with, putting us in difficult ethical challenges.