Emergency Room Medical Providers: Mental Health Needs

Purpose: Little is known about mental health needs of emergency room staff (ERS). Occupational stresses (having higher casualty rates among patients, dealing with uncertainty, explaining worst case outcomes to families and witnessing patients' trauma) take their toll. Such stresses may increase turnover among ERS. This study takes a first step at assessing mental health needs of ERS. Study Design: An in-depth interview was conducted with ERS of a large, urban teaching hospital. Interview data was analyzed to identify ERS mental health needs. Results: ERS reported difficulty talking about their experiences to family and friends outside the ER. Circumstances when the ER was overwhelmed with difficult cases from multiple car accidents or large fires were described as being the most difficult. ERS discussed colleagues as providing critical emotional support yet recognized that this added personal stress. High turnover was recognized as part of the job and discussed in terms of personal strengths that allowed a few staff to remain for years. ERS admitted needing mental health support but none reported using available employee programs. They recommended developing interventions to improve coping skills and stress reduction. Having an independent mental health provider to debrief staff on a regular and as needed basis might be beneficial. Conclusions: ERS' quality of life may be lowered if problems (PTSD) or symptoms (difficulty sleeping) go unaddressed. Hospitals must continually re-train staff and deal with losing talented staff. Further research is needed to understand ERS' mental health issues and to develop effective interventions.