How to Counsel Patients with Mental Health Issues

From the start of COVID, psychiatrists warned that after the pandemic was over, there would be a new pandemic, the mental health pandemic. Unfortunately, that is exactly what we are seeing now. We were already experiencing a mental health crisis in our country before COVID-19, but over the past two years we have seen the COVID pandemic worsen mental health issues such as anxiety, depression and related disorders. to drug addiction.

The pandemic has affected every aspect of our lives, from health to job security, to economic stability and beyond. Mental Health America Online Screening Program, taken by more than 2 million patients, found that 75% of them tested positive or had moderate to severe symptoms of a mental health problem. Of these patients, 68% had never been diagnosed with a mental health disorder before COVID.

It didn’t just affect adults either. In October 2021, the American Academy of Child and Adolescent Psychiatry and the American Academy of Pediatrics declared a national emergency for children’s mental health.

What can health professionals do to help?

There is a national shortage of psychiatrists in our country, and so it will take the efforts of all physicians to get us out of this mental health pandemic. This can make doctors untrained in mental health care uncomfortable, but there are tools every doctor can use to care for patients until they can be seen by a psychiatrist or a therapist.

It all starts with good communication. We, as physicians, are all skilled in the art of communication. The most important part of any medical evaluation is taking a good history, which relies on the doctor’s ability to communicate effectively and ask the right questions. Patients often want to share with their doctors, but may hesitate due to fear and/or stigma.

Doctors can ease this fear by creating a safe environment for their patients to talk. This can be a safe place at the clinic or via telehealth. Telehealth has done great things for mental health care and is a very effective way to communicate with patients.

Regardless of the method used to communicate, physicians can lead the conversation with a simple question: “How are you?” This lets the patient know they are safe and that you care about them. This provides them with the opening they may need to share their feelings.

Patients can feel comfortable opening up when they feel heard

Once patients are comfortable sharing, it is important that physicians listen and let patients speak. If patients are stuck, it can be helpful to ask open-ended questions. Reassure patients that it is normal to feel stressed and overwhelmed during this time, but also advise them that this may be cause for concern or intervention if they are experiencing more severe and troubling depression.

Doctors can encourage their patients to use healthy coping skills to manage stress, such as exercise, healthy eating, meditation, journaling, and other forms of self-help.

It is also essential to advise patients to avoid negative coping techniques such as the use of alcohol or other substances. Substance use disorders have increased dramatically during the pandemic, but patients may be reluctant to admit or open up about their continued substance use. The simple act of encouraging patients to avoid these negative coping skills may be the nudge they need to share their struggles with substances with you and seek help.

After talking with patients, be prepared to provide resources to patients if they need additional help. Be equipped with community referral sources as well as places where patients can seek immediate help if they need it, such as the Suicide Prevention Lifeline Where SAMHSA Disaster Hotline.

As a psychiatrist myself, I would be remiss if I didn’t also encourage doctors to protect their own mental health and take care of themselves as well. Self-care is not selfish. Physician burnout is at an all-time high and many physicians are reluctant to seek help due to stigma and fear of retaliation.

If you are having difficulty and need someone to speak to, the Physician Helpline is available at 1-888-409-0141. This is a telephone helpline staffed by volunteer psychiatrists to provide emotional support. It’s free and confidential.

One of the most important things we doctors can do for our patients and colleagues is to keep talking about mental health. Normalizing mental health care is how we end stigma.

Editor’s note: The opinions expressed in this article are those of the author and do not necessarily represent those of the DO or the AOA.

Related reading:

Is burnout the right term to use?

What to do to improve physician mental health and reduce burnout


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