How The Pandemic Has Changed Discussions of Wellness, Mental Health Among Hematology-Oncology Pharmacists

Pharmacy Times interviewed Zahra Mahmoudjafari, PharmD, BCOP, DPLA; Alison Gulbis, PharmD, BCOP; and Kamakshi Rao, PharmD, BCOP, FASHP, on a 2022 ATOPP Summit session titled “Throw Me a Rope - Wellness & Mental Health for Health Care Professionals: Can’t Pour from an Empty Cup.”

Question: How has the pandemic changed discussions of wellness and mental health among health care professionals?

Zahra Mahmoudjafari: I have been working at my institution for 12 years, and it's never been more comfortable or easy to talk about it until now. I think mental health is no different than physical health, and if you exercise 4 or 5 times a week, it should be just as acceptable as saying that you are looking into opportunities to learn more about mental health and to take care of yourself and your own emotional wellbeing.

It's also opened up a door to check in on each other and to be honest with each other about what it is we're experiencing, what we're stressed out about, and what we need, and there's a vulnerability there that hasn't been there before. While it was difficult to talk about it and adjust at first, it's definitely been for the better, more so than I think it ever has been.

Kamakshi Rao: I would only add to that is I think the pandemic pushed many health care professionals—pharmacists included—way past the initial stages of poor mental health and wellbeing, I think it really absolutely pushed us to the extremes. That opened up the recognition that there's residual trauma from that that needs to be addressed.

I think I'll give a nod though to our younger generation colleagues. I have the opportunity to work with new residents and students on an annual basis, and it amazes me that they are far more comfortable than I am at talking about and engaging in discussions around mental wellbeing and mental health or behavioral health. They have thankfully grown up in an environment where those things are far easier to talk about. So if you stop and listen to them and follow their lead on, they've actually led us into some really good places. It was great to see that the old guard, like us, can learn new tricks.

Sometimes it actually does take some of the some of the younger generation to help us work through historically the types of programs we've gone through in the work environments we have been in, which have not traditionally put a highlight on wellbeing—it’s sort of been that understood thing you don't talk about. But I'm actually quite thankful to the younger generation for helping us open those discussions.

Question: Has support for health care professionals to pursue and take time for wellness and mental health endeavors, especially among those on the front lines, adjusted to meet the current need, and if not, what would be necessary to effectively do that?

Alison Gulbis: I think some institutions are actually working on this. I can say for mine, we've actually instated something called Wellness Leave, which is great, but employees have to use it. They have to remember that it's there, and a lot of us as managers have to encourage people that, ‘Hey, have you taken your wellness leave? Have you taken just time off to take a mental break?’

There are other things that institutions are putting out around burnout and counseling that they can offer, but it's really 2 pronged. It's not just the institution providing it—the employee needs to take advantage of it to the maximum. I think that's where we might have to encourage them as managers or supervisors or directors, to tell them this is there for you. It's okay to use it. Do it.

Zahra Mahmoudjafari: I 100% agree. I think one of the other challenges is maybe what institutions weren't anticipating, which was the sheer volume of need and requests for support. My institution has also been wonderful and has been providing all kinds of resources, including traditional time off, but one challenge has been that if you call for support, they may not be readily available to get you slotted in the time you need it. So you have to schedule it however much time in advance. So I think that continues to be a time. So yes, I think institutions have done a great job providing additional support. I think I completely agree with Allison that we have to meet our employees halfway and encourage them to use it, but then, also, I think some of them are a little overwhelmed with the demand in general.

Question: What can hematology-oncology pharmacists do if they are struggling with wellness and mental health challenges?

Kamakshi Rao: I think it's such an individual journey. What is contributing to every individual's mental health or mental health challenges can be very different, and I think it's important as organizations and institutions that we realize that mental health is not a one size fits all approach, so we need lots of resources available, and we need to remind our employees that they're there constantly so that you catch them when they're at a good position.

I think there's also value in empowering colleagues. A manager has a certain amount of responsibility and ability to resource their employees, but when you think about who you're most likely to turn to, in your moment or in your hour of need, it's the people you're surrounded with day to day.

At my institution and a couple others that I've worked with, they're instituting training for colleagues. So we're doing colleague Mental Health First Aid training that allows colleagues to respond when they see a friend or a coworker who is exhibiting symptoms of a mental health challenge and gives them the tools and the words in ways that work to help support them. So it's not about having resources on a website, it's also about training the people who can then direct a person who's maybe not at the point to recognize what they need and help them engage with that help. So that's not just a hematology/oncology pharmacy directive, that's for all of us as healthcare workers. We spend a lot of time looking out for every detail of a patient's wellbeing, and we've got to start turning and looking at each other and offering that same level of care for each other as well.

Alison Gulbis: Yeah, and there's tools out there actually, where people can take quick 5-minute 5 question assessments to see what their wellbeing indexes are, where they stand, and how do they compare to other health care professionals so that they kind of get an idea of: Am I going in the wrong direction here and do I need to say something?

For a lot of these tools, you can even schedule every 3 months, every 4 months that you reassess yourself, and I think that that's something that we need to provide to employees or residents or students or anyone that we know, ‘Hey, why don't you take this and keep a pulse on how you're feeling in terms of mental health because maybe it's going to pick up on something that you haven't picked up on yet that you're heading in the wrong direction in terms of your burnout or mental wellbeing.’