The COVID-19 pandemic brought extraordinary new challenges to all levels of the health workforce. For healthcare leaders, challenges related to staffing shortages, budget cuts, masking and vaccine mandates, and “the great resignation” from public health has significantly increased daily stress. Compounding these issues, conceptual myths that those in leadership positions have roles that protect them from hardships and lifestyle adjustments have contributed to feelings of isolation in the workplace. Central to the myth is the assumption that leaders are immune to the experiences many on their teams have faced, such as loss, grief, economic instability, and personal struggles with mental health.
Recognizing the clear need for a leadership series, the Northwest Mental Health Technology Transfer Center (Northwest MHTTC) created programs that offer evidence-based information and strategies to support behavioral health for leaders. Furthermore, the Northwest MHTTC wanted to develop this program in the context of a safe place to explore and share firsthand experiences.
The Northwest MHTTC, based in the Department of Psychiatry and Behavioral Sciences at the University of Washington School of Medicine, has a history of creating such resources. With funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), the Northwest MHTTC has supported more than 40,000 workforce members in Alaska, Idaho, Oregon, and Washington (and nationwide) through over 550 training and TA activities related to mental health. The primary purpose of the MHTTC Network is technology transfer: disseminating and implementing evidence-based practices for mental disorders in the field.
The Northwest MHTTC received an additional SAMHSA supplement focused on provider well-being in late 2020. Recognizing the COVID-19 pandemic significantly impacted mental health communities and the workforce, the Provider Well-Being Initiative was created to build strategies for ongoing self-care to enhance personal and professional resilience.
The Provider Well-Being Initiative was established with two foci:
- Building strategies for individual self-care through evidence-based training on adult resiliency, teaching self-care practices like mindfulness and yoga, and holding mutual support sessions to facilitate and share personal wellness strategies, and
- Assisting health and behavioral healthcare agencies in implementing organizational-level well-being interventions through clinical supervision, teambuilding, and addressing the organizational well-being components of leadership, climate, and culture.
The team at the Northwest MHTTC used two main formats to deliver content. The first included large-scale webinars for leadership where major themes and topics were explored using a multicultural lens, including healing-informed leadership, grief, exhaustion, and finding vitality. The second format included small group and virtual learning communities that were interactive, participatory, and promoted professional connections, peer validation, and skill-building. The sessions included a presentation of material, discussion questions, breakout rooms, and summarizing as a group.
The Northwest MHTTC collaborated with several key faculty and presenters to develop the content offered in the webinars, podcasts, skill-building workshops, and learning communities. One of the collaborators is Kira Mauseth, Ph.D., a senior instructor at Seattle University who serves as a co-lead for the Behavioral Health Strike Team for the Washington State Department of Health. Dr. Mauseth’s work and research on resilience, trauma, and disaster behavioral health helped her design fitting webinars and workshop-style skill-building modules. Mauseth spoke on the pertinent topics of burnout, compassion fatigue, managing family and work demands, communication and de-escalation techniques, resilience, grief, and the impacts of the COVID-19 pandemic.
“As leadership topics emerged over the pandemic, we wanted to design training activities which were interactive and unique to people in leadership positions,” explained Mauseth. “These roles are responsible for managing the behavioral health needs and concerns of others on a professional level while often experiencing many themselves on a personal level.”
The intention of this series of webinars, learning communities, and workshops was to directly address—and not shy away from—the experiences that are most salient for leaders in behavioral health.
Attendance, participation, and evaluation results suggest that these efforts have been well received. Participants reported high satisfaction levels and strong intentions to use lessons learned in their daily practices. One hundred percent of attendees surveyed stated they would recommend the series to others. Despite “virtual fatigue,” the virtual environments did not demonstrate negative impacts on the training experience, as reported by both quantitative and qualitative measures by participants. People participating reported enjoying all aspects of the learning communities and reinforced learning, and they wished the event lasted even longer than was planned.
Here are a few examples of feedback received:
“I loved the exercises and the breakout rooms. I learned a lot and felt understood by so many with what a lot of us have been going through.”
“I received validation of bringing my authentic self to my role as supervisor; the value of acknowledging current challenges staff face and allowing space to process.”
“I now think of self-care as a priority and understand the impact of the work on my well-being.”
Through these training activities, the Northwest MHTTC sought to acknowledge the reality of leadership-specific hardships directly and pragmatically, ranging from personal grief to the reckoning done by many about the meaning behind the work. Knowing leadership and their time are strained, the Northwest MHTTC designed a manageable number of sessions and duration of events to increase the likelihood of completion.
Behavioral health training and support specific to public health and healthcare leaders should continue to be prioritized throughout the pandemic recovery. One of the ways the Northwest MHTTC has incorporated the ongoing need for mental health support for leaders is in the development of post-learning communication strategies to reinforce learning, promote connection to the material and each other, and evaluate feedback on numerous aspects of the experience. Ongoing emphasis on training and development for leaders will be increasingly valued as social, political, environmental, and other critical incident stressors will continue to take a toll on the overall well-being of people in these unique and vital leadership positions.
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