Finding the Right Words: The Role of Peer Support with Mental Health

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Tom Haederle
For health care workers finding the right words to support a colleague struggling with their mental health or with thoughts of suicide can be challenging. They want to help. But the stigma surrounding the discussion of mental health concerns, along with the fear of potentially saying the wrong thing to the struggling colleague, can deter health care workers from checking in with each other.

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Tom Haederle
But according to Luci New, assistant professor of nurse anesthesia at Wake Forest University School of Medicine, the best thing you can say to a struggling colleague is simple. I care about you. Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA Communications. In this podcast, Luci joins Jordan Steiger, senior program manager of clinical affairs and workforce at AHA, to share how her organization is using a peer support model and QPR...that's “Question, Persuade, Refer” suicide prevention training

00;01;07;25 - 00;01;30;29
Tom Haederle
to empower and educate the workforce to respond to colleagues who are experiencing mental health concerns or suicidal ideation. This work is part of an ongoing AHA initiative to support hospital and health system leaders in their efforts to enhance the mental well-being of the health care workforce and prevent health care worker suicides.

00;01;31;16 - 00;01;43;20
Tom Haederle
The work of the initiative has been captured in a newly released guide from AHA titled "Suicide Prevention Evidence Informed Interventions for the Health Care Workforce." And now let's join Jordan and Luci.

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Jordan Steiger
Thanks, Tom. So, Luci, we're really excited to have you with us today. You are such an expert in this field and in this space, and I think you are going to be able to help our membership really understand the issue of suicide prevention a little bit better today. Could you just tell us a little bit about your connection to workforce well-being and suicide prevention?

00;02;03;06 - 00;02;31;23
Luci New
Yes. And first of all, thank you for having me, Jordan. It's an honor to have been selected as part of this collaborative. It's a passion I've had for many years and I just am grateful to be able to share a little piece of my contribution to this vital topic. So I when I was pursuing my doctoral degree, I became passionate about second optimization and peer support programing, and that is what I pursued for my doctoral work.

00;02;31;23 - 00;03;00;23
Luci New
And I implemented a pilot peer support program at the facility of which I was employed as a full time CRT. And again, the intention of the organizational leadership group time and 100% grassroots efforts because one's friends and more people want to buy into the program. Our facility leader and the hospital where I was employed said, Hey, there's a survey on suicide prevention from the American Hospital Association, maybe you can fill this out. 

00;03;01;13 - 00;03;21;24
Luci New
And so I filled it out, not thinking that I would be selected, but I was and very honored to have been selected for that. And then coming back this year as well to part to participate in the collaborative of everyone putting their money where their mouth is, you know, let's do something about it.

00;03;21;24 - 00;03;45;27
Luci New
But with second victimization encompasses so much more than just being involved in an adverse event. When you look at the down stream effects of being involved in adverse events or medical error, there are certain trajectories that we all go through. Anyone in health care, it's not just physicians or nurses. It can be anyone that's working inside the hospital at the time.

00;03;46;19 - 00;04;20;07
Luci New
And so my passion has grown and extended to other areas as well. Burnout, suicide prevention, I think. And unfortunately, all in health care probably know of someone that has attempted or died by suicide. And certainly we want to prevent that from occurring. And we have to is multi-layered. We have to look at mental health conditions, mental wellness and get started on getting these efforts implemented across the country.

00;04;20;24 - 00;04;33;08
Jordan Steiger
Absolutely. It's a vital topic and we're really excited that we have your expertise to help the collaborative along. Tell our listeners what the collaborative is like. What have we worked on so far? What have you learned from it?

00;04;33;16 - 00;05;04;12
Luci New
Well, I've been in each time it's it's exciting connecting with people from across the country. Of course, we're looking at based on a report that was released last fall, on looking at the drivers of suicide, stigma and job related stressors and access and those to find likelihood of a mental health condition or of suicide. And so we're looking at how to mitigate those barriers for health and the health care workforce can definitely make an impact down the road.

00;05;04;12 - 00;05;33;22
Luci New
And that's why I had implemented a peer support program. I selected the job related stressors because I actually had already and I got ahead of the game before I even knew this was going to be a collaborative group. Because as in my faculty, where I'm a faculty member, we actually do a suicide prevention training every year for all faculty, staff and our learners and the nurse anathesia program.

00;05;34;04 - 00;05;56;20
Luci New
So I took a suicide prevention course and became an instructor in that course. So as I was taking that course last fall, I thought, wow, we really need to incorporate this into our peer support programing. And so when we got a letter asking for us to return, I thought, I've already got something, yah! And so it was kind of easy and easy.

00;05;56;24 - 00;06;28;27
Luci New
So like for us and the current facility I'm working with, they started their implementation process last fall and the force behind them really aggressively starting to seek out peer support. And this was related to a suicide of one of their colleagues. And so they have chosen to honor this this teammate by having the name in this person's memories and so approach the CNO.

00;06;29;15 - 00;07;04;27
Luci New
So that facility and she says, oh, yes, come in because because, you know, suicide prevention was why we first were kind of really pushing towards going ahead and getting this peer support program developed. So it was not a tough decision on what to do. Of course, there are barriers and we recognize that and the networking that we do in that group, there's challenges, of course, with and including in my own organization, we have three people that do our peer support training, our EAP director and my long standing partner in crime who's a CRNA. Dr. Bernadette Johnson, is her name.

00;07;04;27 - 00;07;27;19
Luci New
I want to give her credit as well. We were implementing pilot peer support programs, so we joined forces in creating this peer support program. And so there begins to be an exponential increase in the desire of different facilities and departments that while we want the peer support program in and it's like you can't do it fast enough because these resources are certainly needed.

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Luci New
So I've enjoyed the networking and got lots of great ideas. I mean, we're all very sharing with each other and share what we have. I mean, why reinvent the wheel for anything? And I've really loved Speaker, simply proud to share their passion and their expertise on the different subjects related to suicide.

00;07;50;03 - 00;08;07;08
Jordan Steiger
Great. Thank you for sharing that. And I know, yeah, you've had your peer support programs going for a while. I think you're ahead of the game, which we love to see. I know one of the things that you've incorporated is QPR training. Could you tell our listeners a little bit about what QPR is?

00;08;07;24 - 00;08;34;13
Luci New
Yes, QPR is a program. It's been around for a long time. I was surprised. I first took the what they call a game keeper training, which is kind of like if you equate it to CPR, QPR and the gamekeepers kind of like someone that just has the basic life support skills. But QPR, they have an instructor level, which is a course that you can play online.

00;08;35;02 - 00;09;11;25
Luci New
It goes through the history of QPR or history QPR, yes, but the history of suicide and shares different cultural beliefs and values around the history of suicide. And then it goes through specifics of conducting this training because of course it is a very heavy topic and it it really summarizes everything into a one hour course to just equip people to be able to have the courage to ask someone, are you thinking of hurting yourself?

00;09;11;25 - 00;09;39;17
Luci New
Because so many times we don't know what to say to someone. You know, we know someone's struggling and so we think we don't have the words to say or something to say might make them feel bad or feel worse or really go through with hurting themselves when actually by ignoring and just walking away, they're even wrestling with more intense emotions or more like nobody cares or nobody.

00;09;39;24 - 00;10;08;27
Luci New
You know, everybody thinks that because I made this medical error that I really should be in practice. And so by not being able to do it or at least find someone, you know, if you know someone's struggling to be able to go and say, hey, we have this peer support program here, or hey, we have these resources that might be helpful to you because I care about you and what you're going through and because a lot of people don't know the resources are there.

00;10;09;07 - 00;10;42;13
Luci New
A lot of organizations have an abundance of resources. People aren't aware of those resources, or they may think they're not a benefit for being an employee there or finding resources. Sometimes a lot of health care organization and trauma can be challenging to navigate sometimes, especially for someone like me who's not very tech savvy and you're trying to find information and it can be difficult to find and you're afraid or embarrassed by the stigma, right, of reaching out and asking someone or telling someone, I need help.

00;10;42;19 - 00;10;45;15
Luci New
I'm struggling and I need someone to help me.

00;10;46;03 - 00;10;57;29
Jordan Steiger
So what I'm hearing from you now is just thinking about empowerment, thinking about education, making sure people have the resources in their hands, and just encouraging them to speak up. Could you tell us what QPR stands for?

00;10;58;25 - 00;11;30;28
Luci New
Yes. Is question persuade and refer. It's been around since the eighties. I was surprised that it has the longevity that is, that it has had. And and again, I guess when you look at the statistics for suicide, they have gradually increased over the years, especially since 2000. I think they've steadily increased. They dipped a little bit, I think in 2021, but now they're they're increasing again.

00;11;31;00 - 00;11;47;10
Luci New
So it is certainly a great program. I mean, it's not just for health care, civic organizations and houses of worship or faith schools, first responders. It's not just tailored specifically for health care workers.

00;11;47;21 - 00;12;09;16
Jordan Steiger
I think that approach makes a lot of sense. And it sounds like there are community benefits to training on QPR as well as benefits to health care workers. We know that health care workers are at a point right now after the pandemic is slowing down, the public health emergency has ended, but those mental health effects from being a caregiver during these last few years are not going to just go away.

00;12;09;16 - 00;12;11;17
Jordan Steiger
So this sounds like a really great approach.

00;12;12;05 - 00;12;36;00
Luci New
Yeah, and there's actually research that I did for a paper looking at the workplace challenges and the risk of substance use in the health care workforce. And one of the things that I wrote about was COVID. And we we like I think we're all kind of a little bit happier because we're like, yes, it's done. It's behind us.

00;12;36;11 - 00;13;18;05
Luci New
But really, when you look at the lingering effects of especially for so many those on the frontline, our ICU nurses, they saw so many sick patients and and there was exposure to a lot of patients dying and ... that certainly contributes to seeing that day in and day out is certainly can weigh on your emotional state and a lot of those ICU nurses I think were exposed to very traumatic experiences.  Saw them very early in their career and more abundant than than what is seen over long periods of time for other people.

00;13;18;16 - 00;13;30;28
Jordan Steiger
Absolutely. I think the support that we're going to provide now in the next few years is going to be critical, especially for that younger workforce. What positive outcomes have you seen from this project so far at your organization?

00;13;31;18 - 00;14;01;17
Luci New
Well, the positive outcomes, we have almost hit our benchmark because we've done two peer support training sessions since we started our action plan, we have one tomorrow as well. And the feedback we've gotten from our surveys, we do have tracking metrics. One of our tracking metrics is on if you provide peer support, what is the reason for providing that peer support, whether it's a medical error or a near miss?

00;14;02;01 - 00;14;33;16
Luci New
And we do have one of our boxes that can be tracked is suicide, and that could even be from a patient as well. I mean, because certainly that's a traumatic event too. But as far as some of the comments we have received from doing the training, people said it was done well. They had never heard of this training and they hope they never need it, but they're glad they have that skill set in addition to their peer support skills, and that it was incredibly helpful.

00;14;33;28 - 00;14;59;21
Luci New
And then one person stated, which this really makes a lot of efforts that you in time that you commit outside even your normal work time and environment. One of the persons commented that I'm ready to help my peers. A good friend and mentor of mine at one point said, if you help one person, its successful, we have to help people.

00;15;00;03 - 00;15;03;26
Luci New
But you want to do more. Of course you want to get out there for everyone.

00;15;04;16 - 00;15;11;26
Jordan Steiger
Luci, as we wrap up, what is your big takeaway? What do you want our listeners to know about suicide prevention or the work that you're doing?

00;15;12;25 - 00;15;45;10
Luci New
Don't be afraid. Don't hesitate. You know, sometimes its as simple as saying, I care about you and I care what you're experiencing. Let's go see what options or resources there are to help you through this. A lot of times when people get to that point of despair, you do think that that nobody understands and you might not understand 100% what someone's going through, but you can just say, I care about you.

00;15;45;26 - 00;16;06;15
Jordan Steiger
I think that's something everybody listening to this today can commit to doing. It's four very simple words: I care about you. I think that's very powerful. Luci, thank you so much for joining us today and for sharing your insights. We're so happy to have you as part of our AHA collaborative, and we're looking forward to our continued work together.

00;16;07;02 - 00;16;24;01
Luci New
Yeah, thank you again for having me so much. And again, it is such an honor to be working side by side with so many people that have this same passion about promoting and developing plans to help reduce suicide in our health care workforce.

00;16;24;28 - 00;16;36;08
Jordan Steiger
If you're interested in learning more about our suicide prevention work for the health care workforce, please visit aha.org/suicideprevention/healthcareworkforce.

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Tom Haederle
Development of this product was supported by Cooperative Agreement ck202003 funded by the U.S. Centers for Disease Control and Prevention, CDC, the National Institute for Occupational Safety and Health. The contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC or the Department of Health and Human Services.