The COVID-19 pandemic’s initial surge of high hospitalization and death rates contributed to emotional distress among physicians and other health professionals. As COVID-19 spread to the surrounding communities, the University of North Carolina (UNC) Health Care System engaged in robust planning to rapidly transform their well-being program.

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“We worked in coordination to develop additional resources in anticipation of increased levels of stress that we knew would be experienced by our health care professionals,” Nadia Charguia, MD, medical director of outpatient psychiatry at U N C, said during a session at the International Conference on Physician Health, which is a collaborative meeting of the AMA, Canadian Medical Association and British Medical Association.  

To do this, UNC Health took a “multifaceted approach in order to determine, create, utilize and expand upon existing resources to determine the myriad of levels of needs,” said Dr. Charguia.

Early in the pandemic, UNC launched an initiative called the Healing Heroes Helpline. From March to December 2020, there were a total of 232 interactions with some calling in more than once.

The healing heroes helpline “was a combination of incoming calls” and outgoing calls,” said Echo Meyer, PhD, vice chair of psychological services at UNC. And it “was available to all staff, employees and faculty to call in to speak with a mental health professional.”

This “wasn’t a crisis line. It was a support line—or a warm line as we called it—and it still is running,” she said.

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UNC also implemented stress first aid, which was developed to recognize the type of stress injuries experienced during times of crisis, explained Meyer. Following stress first aid, it helps individuals experiencing stress “to be morally strong, to be stoic, to be loyal and to work in excellence at all times when they are in crisis and how difficult that is when you’re working in unprecedented times.”

“Stress first aid interventions were highly well received and utilized particularly well in our MICU [medical intensive care unit], emergency medicine and palliative care teams,” she said. “Although, the interventions spread much beyond over the course of the last year—it’s a very novel experience.”

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Between April and December, 17 webinars and 64 support groups were developed, covering a range of topics.

“It’s been important and critical that we continue to just try to both anticipate what is needed at times” and respond nimbly when other events arise, Dr. Charguia said. Among the emerging needs are help to address issues of “diversity, equity and inclusion and we have created more webinars—and support groups as well—to address both those needs.”

There have been 10 support groups created on the topic of diversity, equity and inclusion to help health professionals process and move through what they are experiencing, she explained.

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The Taking Care of Our Own Program at UNC began in 2012 and was initially developed to address physician burnout. This program is a service offered to all physicians, faculty and house staff within the UNC Healthcare System who would benefit from convenient and confidential expertise in wellness and mental health. 

“But as we experienced the pandemic, we recognized that it’s not just physicians who have this struggle and have this need,” said Dr. Charguia, who directs the program. “Just looking at the physician population alone … we saw a significant increase in the utilization of this program, with a 150% increase in our faculty and over 200% increase in trainees.”

With the expansion to all health professionals, the program went from 12 clinicians to more than 32 staffing the program. This has yielded 100 clinical counselors with an average of six new intakes per week.

“This program meets needs on an individual level, so we are meeting one-on-one with individuals,” she said. “We also recognized the need to create immediate access for this program and created online portals.”

The effort not only assists the health professionals seeking help, Dr. Charguia said. It gives the clinicians doing the counseling “a way to give back to the community.”

The AMA offers resources to help physicians manage their own mental health and well-being during the COVID-19 pandemic and provides practical strategies for health system leadership to consider in support of their physicians and care teams during COVID-19.

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