Loss and grief: Personal stories of doctors and other healthcare professionals

This collection of personal narratives is just that: stories intended to chronicle the journeys of a small number of health clinicians and other professionals who have been struck by personal illness and/or loss. What these stories do not assume is that there are answers to the universal experiences of loss and grief, courage, and survival implicit in the telling. While the past is gone, the meaning of it, however, is forever in flux, forever being worked and reworked in our conscious and unconscious minds. Each memory is a redoing of what it represents and brings forth within our sense of ourselves and in our relationships with one another. Grief challenges us physically, emotionally, and psychologically to recast the loss again and again. And, in recasting the past and the passage of time, refashioning memory to meet the needs of the moment in which the lost object and our response to it either helps us to move forward in our life or keeps us stuck, unable to engage with a future that requires acceptance of giving up the life lived before. The COVID pandemic further highlighted the internalization of expectations. Drilled into us in training is the "prime directive", the ethical responsibility of patient care and that one should deal with personal things on one's one time. The stories written in this collection were a draft perhaps unending versions telling of the experience. Some stories were written in one setting, others over many weeks or months as the writer lost and regained footing along the tale's trail. The shame, the sadness and weeping, the anger and guilt, and the shame of feeling relief of the pain and suffering for ourselves or those we love(d) and the "weakness" of not being able to manage it all echo through these stories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Clinician experiences with conducting suicide risk assessments and interventions

Rates of suicide across the United States have been found to be increasingly prevalent and acute in recent years (Centers for Disease Control, 2018). To address this nationwide health crisis of suicidality, mental health clinicians are relied upon to prevent, assess, and intervene accordingly. Yet despite the ubiquitous nature of client suicidality, existing research has not yet examined how clinicians are experiencing working with such intense and acute risk for suicide. This qualitative phenomenological study sought to capture the descriptions of clinicians' internal and external responses to assessing for and intervening with client suicidality in an effort to better understand the struggles and needs of these practitioners, as well as the lessons and guidance that they can offer from their direct experiences in this regard.Ultimately, one- to two-hour semi-structured interviews were completed with nine clinicians. The subsequent data were used to identify seven main themes: (a) belief in the benefits of viewing suicidality through a systemic lens, (b) concerns over the accuracy of client disclosures, (c) the role of fear in clinical decision-making, (d) the emotional and personal impacts of treating suicide risk, (e) the impact of training and experience, (f) the negative effects of the COVID-19 pandemic, and (g) essential sources of support for clinicians. Based on the findings of this study, implications were identified in the areas of future research directions, the need for more thorough clinical training in treating suicidality, and applications for current clinical practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Loss and grief: Personal stories of doctors and other healthcare professionals

This collection of personal narratives is just that: stories intended to chronicle the journeys of a small number of health clinicians and other professionals who have been struck by personal illness and/or loss. What these stories do not assume is that there are answers to the universal experiences of loss and grief, courage, and survival implicit in the telling. While the past is gone, the meaning of it, however, is forever in flux, forever being worked and reworked in our conscious and unconscious minds. Each memory is a redoing of what it represents and brings forth within our sense of ourselves and in our relationships with one another. Grief challenges us physically, emotionally, and psychologically to recast the loss again and again. And, in recasting the past and the passage of time, refashioning memory to meet the needs of the moment in which the lost object and our response to it either helps us to move forward in our life or keeps us stuck, unable to engage with a future that requires acceptance of giving up the life lived before. The COVID pandemic further highlighted the internalization of expectations. Drilled into us in training is the "prime directive", the ethical responsibility of patient care and that one should deal with personal things on one's one time. The stories written in this collection were a draft perhaps unending versions telling of the experience. Some stories were written in one setting, others over many weeks or months as the writer lost and regained footing along the tale's trail. The shame, the sadness and weeping, the anger and guilt, and the shame of feeling relief of the pain and suffering for ourselves or those we love(d) and the "weakness" of not being able to manage it all echo through these stories. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

The impact of the COVID-19 pandemic on psychological service provision, mental health practitioners, and patients in long-term care settings: Results from a rapid response survey

Public Significance Statement The COVID-19 pandemic has disrupted the provision of mental health services in long-term care (LTC) settings, resulting in negative impacts not only for LTC residents who had previously been receiving mental health services but also the clinicians providing the services. This study examines the impact of the COVID-19 pandemic on mental health providers' ability to provide mental health services in LTC settings, patient functioning, and providers' personal well-being and professional functioning. The authors hope that information within this article will assist in elucidating critical insights that can serve as a guide for policymakers, administrators, employers, and mental health clinicians regarding the provision of mental health services to residents in LTC settings during future pandemics. Due to the rapid spread of COVID-19 in long-term care (LTC) settings and the subsequent mandatory visitor restrictions that were put in place, the provision of behavioral health services in LTC settings was impacted. To examine the pandemic's effect on the provision of psychological services in this setting and its impact on clinicians and their patients, we surveyed 126 licensed mental health clinicians working in LTC settings during the pandemic. The sample consisted of psychologists, social workers, and psychiatry mid-level practitioners from 31 states who had provided mental health care services in LTC settings during the initial 7 months after the COVID-19 pandemic was declared a national emergency. This exploratory study revealed that the pandemic significantly impacted the availability and use of mental health services in LTC settings. Although there was a reported increase in the use of telehealth services compared to prepandemic frequency, it was noted that LTC residents went long periods of time without access to mental health services. Government-imposed visitor restrictions and pandemic-related restrictions were perceived as negatively impacting the emotional well-being, loneliness, and quality of life of LTC residents. Perceived factors contributing to the financial and emotional impact of COVID-19 on clinicians were explored, and it was noted that more than half of the sample reported experiencing burnout and nearly one third of surveyed clinicians believed they had experienced trauma by providing mental health services in LTC settings during the COVID-19 pandemic. Understanding this impact has implications for providing mental health services during the current and future pandemics.

Experiences of Safety-Net Practice Clinicians Participating in the National Health Service Corps During the COVID-19 Pandemic.

OBJECTIVES: The impact of the COVID-19 pandemic has been particularly harsh for low-income and racial and ethnic minority communities. It is not known how the pandemic has affected clinicians who provide care to these communities through safety-net practices, including clinicians participating in the National Health Service Corps (NHSC). METHODS: In late 2020, we surveyed clinicians who were serving in the NHSC as of July 1, 2020, in 20 states. Clinicians reported on work and job changes and their current well-being, among other measures. Analyses adjusted for differences in subgroup response rates and clustering of clinicians within practices. RESULTS: Of 4263 surveyed clinicians, 1890 (44.3%) responded. Work for most NHSC clinicians was affected by the pandemic, including 64.5% whose office visit numbers fell by half and 62.5% for whom most visits occurred virtually. Fewer experienced changes in their jobs; for example, only 14.9% had been furloughed. Three-quarters (76.6%) of these NHSC clinicians scored in at-risk levels for their well-being. Compared with primary care and behavioral health clinicians, dental clinicians much more often had been furloughed and had their practices close temporarily. CONCLUSIONS: The pandemic has disrupted the work, jobs, and mental health of NHSC clinicians in ways similar to its reported effects on outpatient clinicians generally. Because clinicians' mental health worsens after a pandemic, which leads to patient disengagement and job turnover, national programs and policies should help safety-net practices build cultures that support and give greater priority to clinicians' work, job, and mental health needs now and before the next pandemic.