Depending on the severity of a depressive episode, Bianca MacPhee can sometimes find it challenging to get out of bed and go to work.
“Sometimes being at work helps because I’m focused on helping patients, and I’m too busy to think about anything else,” said MacPhee, who handles health records and patient registration at Providence Health Care, which cares for people from all parts of British Columbia. “But of course, there are days when it’s tough.”
And among workers in health care settings, MacPhee isn’t alone.
According to a 2022 report by the Mental Health Commission of Canada, 40% of health care workers are burned out, 50% intend to leave the profession, and just 60% are satisfied with the quality of care they provide. The report also highlights health care workers’ need for improved support, psychological self-care, and protection from moral distress.
Recognizing the pressing needs of health care workers, Providence Health Care is prioritizing mental health services for its employees, like MacPhee, through an innovative partnership with Adler University to provide support.
St. Paul’s Hospital’s newest cohort of ACHS interns: From left, Carolyn Kolett, Christine Skwarok, and Octavia Lui. Photo provided by Providence Health Care.
Working with the University’s Adler Community Health Services (ACHS) division, the health system brings in master’s and doctoral students from its Vancouver Campus to provide crucial mental health support.
For MacPhee, who has worked with several therapists over the past five years, the ACHS counsellors have played a pivotal role in addressing her mental health needs.
“The ACHS counsellors have been my favorite and the most helpful,” said MacPhee. “They have helped me work on the underlying causes of my depression.”
She emphasizes the significance of employer-supported mental health services, considering therapy’s usual expense. And she is hopeful more colleagues take advantage of this valuable resource. To her, the collaboration between Providence and ACHS stands as a commendable effort in prioritizing the well-being of health care professionals.
Addressing health providers’ needs
Providence Health Care is a nonprofit health system serving families, patients, and residents from all parts of British Columbia. Today, it operates 17 sites with more than 6,600 staff, 1,400 volunteers, and 240 researchers.
Providence first approached ACHS in June 2021 to help create mental health support programming for its St. Paul’s Hospital site in downtown Vancouver.
“This was during Covid-19 time, so it was very high security,” recalls Damon Elgie, Ph.D., ACHS director of training. “After visiting their units and talking to staff and employees, we were able to figure out what kind of relationships we can form and what support we can provide.”
Since then, the partnership has only grown.
Today, ACHS engages with all aspects of Providence. Many of the interns often meet with employees and staff who work in the ICU, emergency department, and units working with patients struggling with opioid addiction.
Although in-person counselling is only available at two sites — Mount Saint Joseph Hospital and St. Paul’s Hospital — all Providence employees and medical staff have access to ACHS virtual services, including webinars and one-on-one telehealth counselling.
In 2023, ACHS interns — under Adler faculty supervision — saw about 100 Providence employees, providing an average of 14-15 sessions with each client.
“We expect people, especially those who work in health care, to know all about self-care and mental health,” said Francois Botha, Ph.D., ACHS clinical faculty. “But surprisingly, many still need support. Some have severe mental health needs, but often, our interns will meet with clients who just need or want to learn the basics.”
Multi-pronged approach
Last year, when a hospital patient became highly agitated, Jessica Presutto and her fellow ACHS interns were called in to visit the affected employees. Their goal? Help them emotionally and psychologically process the incident.
Jessica Presutto
Security and Vancouver police officers had been brought in to help manage the patient, who had a history of substance use and complex trauma.
“The Providence staff were ultimately able to help the patient, but the experience became too much for some of them,” said Presutto, a fifth-year student in the Doctor of Psychology in Clinical Psychology program. “When something like that happens, it can put a strain on their ability to work and take care of other patients. It can take a toll.”
Presutto and other interns gave the staff the space and time — through group and individual counselling — to express their thoughts and emotions.
“We gave them the tools to feel safer,” she said. “Incidents like that don’t just impact their work, but their life outside the hospital as well.”
A critical incident debrief — meeting with staff when a traumatic incident occurs, such as a patient becoming highlight agitated or the death of a patient — is among the interns’ responsibilities in a multi-pronged approach to ensuring Providence employees receive the support they need.
In addition, ACHS interns provide weekly in-person group sessions, virtual individual counselling, and units can request for interns to visit and share self-care techniques with personnel.
ACHS interns also create and lead webinars offering information on processing trauma and moral distress, regulating emotions, improving communication at the workplace, and preventing or managing burnout.
“Burnout was one of the top presenting concerns for most of my clients shared with me during individual and group counselling,” Presutto said. “Our health care workers give so much of themselves to help our community, so being able to give back a little by supporting their needs was a highlight in my time with ACHS.”
Reinforcing, expanding support
ACHS interns have provided critical incident debriefs and creating webinars since the partnership’s inception. After their success at Saint Paul’s, ACHS was asked to expand its services to include the rest of the health system employees.
“We immediately learned that Adler could offer so much more. And boy, did the partnership take off from there,” said Conor MacPhee, father of Bianca and then-wellness manager who helped usher in the partnership with ACHS.
“Adler came through like no other,” said MacPhee, who now serves as director of protection services at Providence.
Today, ACHS and Providence are focused on strengthening the services offered and ensuring all Providence employees and medical staff know the services are available.
“I only hear good feedback about ACHS from our staff,” said wellness manager Debbie Pratt, who took over the role in August 2023. “But there’s always room to reinforce our support.”
Pratt said she’s looking for ways to improve the promotion of the services. This includes creating a pre-registration function for webinars, reminding unit leaders to share with their staff that the services are available, and continuing to promote it during new employee orientation.
“I’ve never been in an organization that offered this kind of counselling support to its staff,” Pratt said. “It’s such a novel way for Providence, a health care organization, to provide our employees immediate access to needed mental health care.”
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