Supporting the Mental Healthof Healthcare Workers*
Our healthcare workers are more stressed than ever. With the COVID-19 pandemic extending past 17
months and no clear end in sight, we are also facing growing workforce shortages, adding to the strain on
people’s mental and emotional well-being. Well-being is personal, and usually framed as the responsibilityof the individual. Yet the working environment - whether place, people, or processes – will have either apositive or negative effect on its workers. Leaders can make a powerful positive impact by choosing toaddress well-being from a systems perspective.
How do we set up our healthcare systems to better support our workers? What has the COVID-19
pandemic taught us so far about this?
Over the past year and a half ICSI has been seeking to understand how care systems are addressingthese questions. Through individual interviews, a months-long webinar series and focus groups,
healthcare workers and leaders in Minnesota were asked what they have been learning about supporting
staff well-being during the pandemic. Presented here are the key themes, and suggestions for how
lessons learned can be applied moving forward. This playbook includes a new framework for thinking
about workforce well-being from a systems perspective, examples of specific efforts, and prompts to help
leaders think through and apply the lessons learned in your own organization.

*Healthcare Workers includes all who work in the healthcare field: Hospital staff, clinic staff, executive andteam leaders, support staff (e.g., lab, IT, environmental services), displaced staff.

Background
Literature from previous pandemics and health emergencies (SARS, MERS, H1N1) has demonstrated thatpeople in healthcare responding to these crises have increased needs for mental and emotional wellbeing support, both during the event and through the months and years that follow.1
The COVID-19 pandemic is showing a similar pattern. Initially people’s concerns were focused on basic
safety needs, such as access to PPE to limit spread of the virus. Stressors multiplied quickly beyond
physical safety as workers dealt with new clinical information, different protocols and workflows, changed
schedules and more. Others were suddenly furloughed.
Meanwhile there were also immediate drastic changes in people’s personal lives. Some people weresuddenly caring for and schooling kids at home, many were having to social distance from family andfriends, and even usually simple errands like going to the grocery store suddenly became fraught. In
addition, with the murder of George Floyd, the background of political unrest, institutional racism, healthdisparity and implicit bias was heightened, layered amongst the stressors of COVID-19.
Though we have all adapted in various ways, all of these realities still exist, along with new stressors:
vaccine hesitancy, COVID-19 variants, and further surges in cases and hospitalizations after what seemed
like a promising downturn.
The healthcare workforce as a whole was already challenged prior to the pandemic. Burnout in physicians
and nurses was high even before COVID.2 There had not yet been sufficient changes within mosthealthcare systems or to the macro system (the intersections of care delivery, payment, and regulatory
requirements) to address this stress.

A Systems Framework for Supporting the Workforce
Based on findings from healthcare leaders, there are five foundational elements in implementing astrategy to support workforce well-being:½ Relationship-based Culture: Foster a culture where positive relationships between staff at all levels

are the cornerstone of the organization.
½ Coordinated Infrastructure: Coordination of expertise and services that may traditionally operate insilos with the aim of supporting staff.
½ Bi-Directional Communication: Develop a strong internal communications strategy that enables
direct and frequent “top-down” as well as “bottom-up” engagement to support your staff.
½ Ongoing Needs Assessment: Continually evaluate the needs of staff, paying attention to particularstressors of different work units.
½ Responsive Solutions: Offer systems-driven interventions (e.g., policies, protocols, and programs)
AND staff self-directed interventions (e.g., podcasts, apps) and have an ongoing plan for evaluation.
1 Preti, E, Di Mattei V, Perego G, et al. The Psychological Impact of Epidemic and Pandemic Outbreaks on
Healthcare Workers: Rapid Review of the Evidence. Curr Psychiatry Rep 2020; 22(8):43
2 Shanafelt TD, Noseworthy JH. Executive Leadership and Physician Well-being: Nine Organizational Strategies
to Promote Engagement and Reduce Burnout. Mayo Clin Proc January 2017;92(1):129-146
Supporting the Mental Health of Healthcare Workers | 2© ICSI

These foundational elements are important not only in crisis but need to be embedded in routine organizational structures and processes, with the ability to be amplified, or ramped up, when needed. Organizations that had some or all of these elements in place were better equipped to support their workers when
the COVID-19 pandemic hit as they were able to take advantage and build on an existing foundation.
Healthcare organizations with happier workers don’t rely on small well-being projects; the systematic
pursuit of well-being infuses absolutely everything they do, all the time. To quote Dr. Don Berwick,“Well-run airlines don’t rely on ‘safety projects’; the scientific pursuit of safety infuses absolutely everything
they do, all the time.” The same can be said about healthcare worker well-being.

A Systems Framework for Supporting the Workforce

Healthcare Workforce

Dial upor down
as needed

Bi-directional
Communication

Ongoing Needs
Assessment

Responsive
Solutions

Coordinated Infrastructure
Relationship-based Culture

Supporting the Mental Health of Healthcare Workers | 3© ICSIRelationship-Based Culture
Employees who feel known and cared for not only are happier, they are more productive. They also are
more likely to feel safe to express needs. Possibly the most important element in supporting health care
worker well-being is ensuring a culture that encourages workers to both ask for what they need and offer
what they can. This happens when relationships are central, intertwined with how work gets done, andhow change is managed.
In the book, Together: The Healing Power of Human Connection in a Sometimes Lonely World, current
and former surgeon general Vivek Murthy argues that human connection is as important as vaccines andventilators to our global recovery.3 We know that compassion has both physiologic as well as psychologic
benefits for both patients and caregivers.4 It follows that a culture with care for relationships at its core will
benefit healthcare workers, and through them, patients, and communities.
In a relationship-based culture leaders attend to getting to know team members and expressing careabout them, including appreciation. In addition, leaders cultivate an environment where staff can do so for
one another. Only when leaders know their employees and listen to them can they create work environments in which they can thrive. When leaders know staff’s needs, not only at the workplace but also athome and in the community, they are able to offer help that is useful and accepted.

Survey and interview
respondents repeatedly
stated that they longed
for compassion to
be communicated,
and for leadership in
combating the stigma
of asking for help.

In addition, leaders model self-care, authentic vulnerability and asking for help.
Survey and interview respondents repeatedly stated that they longed forcompassion to be communicated, and for leadership in combating the stigma
of asking for help. Such modeling by leadership is a powerful way to change
the culture and normalize asking for what you need and offering what you can.
We heard that team camaraderie could be leveraged and that even teams thatwere struggling prior to the pandemic were able to pull together and support eachother through challenging times. There was also some success with the buddy
system, which pairs colleagues together to support one another. Peer referrals
and credible messengers were critical to utilization of well-being resources.

Opportunities for My Organization
How do your leaders ‘make it ok’ to need support? What actions have been successful during the
pandemic that might be useful to continue?

3 Murthy, V. Together: The Healing Power of Human Connection in a Sometimes Lonely World. April, 2020.
4 Treciak S, Mazzarelli A. Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a
Difference, 2019
Supporting the Mental Health of Healthcare Workers | 4© ICSICoordinated Infrastructure
Healthcare leaders interviewed during the COVID-19 pandemic highlighted the importance of a dedicatedcrisis response structure, with allocated resources, specifically for supporting staff’s mental and emotional
well-being.
Critical incident command systems are focused on physical safety needs. When it comes to other forms ofwell-being, in times of crisis, it’s all too common that different parts of the system feel the need to act
urgently and independently, creating redundant or conflicting activities. It’s critical that different departments are brought together quickly to leverage and coordinate their expertise including behavioral health,spiritual care, human resources, and others, such as IT and quality improvement to support the efforts.
A coordinated structure also makes it possible to evaluate changes more quickly. For instance, several
organizations decided at the beginning of the pandemic to put more focus on promoting their Employee
Assistance Programs (EAPs). Those with a coordinated structure were able to identify more quickly
whether the programs were actually being used more consistently, and when they weren’t, quickly put inplace other supports.

Opportunities for My Organization
How is your organization bringing together internal experts to work together in a coordinatedeffort? What did you learn?

Bi-Directional Communication
During times of crisis, a strong internal communications strategy that enables direct and frequent “topdown” as well as “bottom-up” engagement is one of your best tools to support your staff.
Transparent, timely, and frequent communications from executive leaders about organizational direction is
critical. Uncertainty is inherently stressful, and it is even greater in times of crisis. When top-level leaders
communicate as much as they can about what is known, quickly and frequently,
they provide clarity that reduces stress. It’s also important to communicate what
People long for leaders
isn’t known yet, which affirms and validates the ambiguity that all are experiencing.

to demonstrateauthentic compassion
One of the themes that stood out in the information gathered, is how people longand caring throughfor leaders to demonstrate authentic compassion and caring through theircommunications. Leaders who are effective in supporting their staff acknowledge their communications.
the difficulty of the situation, and also that the associated stress is normal. They
recognize that health care workers are being asked to do their jobs in nearly impossible circumstances;and they express gratitude for people’s work and dedication. Empathetic, consistent, and informational
messaging creates calm that is invaluable during times of uncertainty and fear.
Supporting the Mental Health of Healthcare Workers | 5© ICSIIn addition to leaders communicating effectively, it is also important to understand the situation from staff’s
perspective. One of the themes heard from healthcare systems was that leadership did not always know
how staff were doing. Conversely, leaders stated that there was a lack of information from frontline
workers. This disconnect shows the need for systematically building feedback loops to enable strong
bi-directional communication.
Providing systematic opportunities for staff to share their thoughts and concerns is not simply a way toshow care and concern for staff: it provides valuable insights into needs and opportunities. Developing
such channels can also be used to gain specific feedback into what supports are working, and what’s not
as you implement interventions to support people’s well-being.
Tips for effectively sharing information:½ Share what is known and what is unknown½ Be transparent about what the organization is doing to answer questions and address stressors½ Anticipate questions that will be asked½ Use existing trusted communication pathways, but add others and increase frequency½ Choose strength-based language to support self-efficacy½ Be both inclusive (organization-wide) and intimate (team meeting/one-on-one).
½ Incorporate communications into the workday (e.g., during rounds)½ Brief messages delivered by credible messengers are effective (e.g., physicians hearing from physicians)

Tips for actively listening and gaining information:½ Consider unstructured conversations, giving staff freedom to discuss what is of current concern,

including the emotional stresses½ Consider structured conversations, giving all staff the opportunity to hear the same information

and answer the same questions.
½ Start meetings with a personal check-in½ Paraphrase people’s concerns to check your understanding and express gratitude for staff raisingconcerns½ Be diligent about follow-up, systematically documenting and addressing staff concerns

Methods of Communication
MEDIA CHANNELS

VIRTUAL GATHERINGSIN-PERSON GATHERINGS

Daily organization-wide email

Virtual meetings

Hospital rounds

Department emails

Team virtual chats

Team meetings

Team emails

Phone line for questions

Huddles

Newsletters

Town Halls (organization-wide
or by department)

Clinics

Organization intranet
Organization-sponsoredsocial media

Informal meetings (coffee
breaks / lunch)

Supporting the Mental Health of Healthcare Workers | 6

Leadership meetings
Informal meetings (coffee
breaks / lunch)© ICSI

Other Considerations:½ As leaders, connect with staff directly more than usual½ Leaders should share their own stories of struggle that resonate with frontline workers½ Give guidance, but also space for work-unit leaders to figure out how to best communicate with

their teams½ Remember that leaders have also been overwhelmed; they need simple messages too½ Mental health teams have valuable knowledge and tips for staff; integrate this with the communications
team½ Provide variety in communication methods; different people learn differently or tune in to different
channels

Opportunities for My Organization
What methods of communication has your organization used during COVID-19 that wereeffective? What wasn’t effective? How do you know?

As we enter different phases of the pandemic, what communications need to be ramped up andwhat ramped down?

Ongoing Needs Assessment
Understanding the varying stressors for different staff will enable you to conduct a more accurate
assessment of your workforce needs and, most importantly, ensure that interventions are more likely to
be helpful. Some stressors are not new but rather amplified, while others are ones not previously faced.
The same change may negatively impact one individual, while energizing another. There may be different– and no less significant – stressors for people who work in patient-facing jobs compared to stressors forstaff whose role is supportive. As this pandemic evolves, so too will the stressors that each worker
feels. The following table provides potential stressors staff may have or continue to experience during thedifferent phases of COVID-19.

Supporting the Mental Health of Healthcare Workers | 7© ICSIStressors on the Healthcare Workforce
INPATIENT(Hospital Staff)

OUTPATIENT(Clinic Staff)

EXECUTIVE &TEAM LEADERS❑ Uncertainty ofmanaging new
disease❑ Deploying newcare modalities(telemedicine)❑ Staying current
with evolving
information❑ Uncertainty ofeffectiveness ofvirtual care for all
conditions❑ Rapid need for
new strategies/
policies balancedwith ongoingregulatory
requirements❑ Stigma from higher
risk of exposure❑ Basic needs
during long shifts❑ Balancing
professionalismwith personal risk
❑ Coping with death,especially with novisitor policies❑ Managing scarce
resources❑ Futlity of care

❑ Uncertainty ofmanaging new
disease❑ Staying current
with evolving
information❑ Balancing
professionalismwith personal risk
❑ Coping with deathof long-term
patients❑ Loss of teamconnections❑ Weighing ethicalimplications ofpolicies❑ Making decisions
without adequate
information

SUPPORTSERVICES(e.g., Lab, IT)DISPLACED STAFF(Reassigned /Furloughed)❑ Increased
workload❑ Uncertain job
and/or personal
financial situation❑ New and changing
protocols❑ Increased need tolimit contamination❑ Increased
pressure for speed
and accuracy❑ Changed decisionmaking structures❑ Being asked tolearn new skills or
re-learn old skills
in a high-stakes
situation❑ Guilt and/or
frustration with not
being able to help

❑ Providing
emotional support
to staff❑ Leading effective
crisis meetings❑ Financial
uncertainty fororganization

UNIVERSAL STRESSORS❑ Personal safety❑ High volume and/or changing and/or sparse Information❑ Financial concerns❑ Loss of team connectedness❑ Personal wellness❑ Death/dying of loved one/patient/colleague❑ Anticipatory grief❑ Family concerns (related to partners, children, relatives)❑ Health disparities/racism❑ Frustration with vaccine hesitancy❑ Compassion fatigue

The framework above can be modified as needed to represent your staff’s situation, then used todetermine the different groups of staff that would benefit from targeted interventions.
In assessing needs, some healthcare leaders reported that incorporating this into the workday was helpful(e.g., chaplains assessing needs during rounds). Early on, targeted assessments on a work unit level arealso useful in identifying specific needs. As you assess your staff’s needs, consider which populations may
be at higher risk and warrant more urgent or intense interventions. Also consider ways to monitor forincreasing or changing stressors in various settings.

Supporting the Mental Health of Healthcare Workers | 8© ICSI

Opportunities for My Organization
How is your organization assessing the needs of your staff? How often?

Responsive Solutions
Once you have determined the main stressors affecting your workforce and which staff will be affected(and how), choose potential supports to implement. As you are considering various interventions, consider
the assets you already have in your organization and/or community as a way to maximize resources andmore speedily make changes. Also, consider how you will monitor and make changes ongoing.
The most effective interventions for supporting the workforce are chosen thoughtfully, and modified, basedon your understanding of the problem with input and feedback from the people you hope to support.

Not all firstinterventions
are going to be
successful.
We need tofrequently study
how it’s working.

However, in the real world, it may be that you need to provide some supports urgently,
and without much planning, as many healthcare systems reported. It’s not surprising,then, that not all first interventions are going to be successful. In fact, in any quality
improvement effort, we know that the first small test of change is only a hypothesis, andthus we need to frequently study how it’s working and either adopt, adapt, or abandon
the change.5
As you are identifying potential solutions, this effort as well, it is necessary to evaluate
both your staff’s needs and your interventions ongoing, then modify the interventions
based on how they work (or don’t).

Look for Assets
What are the existing programs, relationships and channels of communication in your organization and/or
community that could be further leveraged or adapted to support well-being? Some examples include:½ Existing team huddles and/or department meetings½ Employee Assistance Programs½ Integrated behavioral health½ Wellness programs½ Community partners, e.g., local public health, park associations, community mental health

Caution – if a program isn’t being utilized well by your target population prior to COVID-19, it may not be
the best choice for delivering an intervention now. Organizations with poor utilization of Employee Assistance Program coaching/counseling prior to the pandemic found that this resource was not well utilized
during the pandemic, either.
5 Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. The Improvement Guide: A Practical
Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-Bass Publishers; 2009.
Supporting the Mental Health of Healthcare Workers | 9© ICSI

It’s also helpful to identify psychological strengths present in individuals and teams. Humans are resilient.
Strengths you might recognize and intentionally foster include:½ Bonding – Feeling of being part of a crisis team
½ Universal concepts such as gratitude, compassion, acceptance and meaning½ Creating new knowledge/practice to support others½ Get interested clinicians involved to teach self-care practices to staff,

simultaneously encouraging them to practice self-care.
Remember, that what may be a stressor for some staff may be an asset for others. For example, while
the challenge of telemedicine might be daunting to some, the implementation of new technology may
be exciting to others. You may be able to engage those who are thriving in new environments to support
their colleagues.
Take Action
The COVID-19 pandemic has put many leaders in an innovation and adaptation mindset. In this uniquetime, we all have been given permission and encouragement to be flexible and to think and act in new
ways. Consider the following as you develop interventions to test:½ Offer systems-driven interventions (e.g., policies, protocols, and programs) AND staff self-directedinterventions (e.g., podcasts, apps)» Solutions integrated into workflow gave recipients tools without requiring much effort» Targeted work assessments and plans were important because of the variation ofstressors between work units.
½ Consider expanding already available resources or using existing resources in a new way.
½ Consider circumstances outside of the workplace that may be increasing stress. If basic needs are notmet, it may be too difficult to start a gratitude practice.
½ Look for solutions that enhance connections and shared experiences½ Create new resources when needed, being mindful not to put too much time/energy into an intervention until you evaluate effectiveness.
½ Seek good ideas from the community and nationally – no need to reinvent the wheel if someone has atested great idea.
½ As the circumstances (external and/or internal) evolve, so too will the needs of staff and the interventions that are useful. For example, early on in COVID-19, a healthcare organization provided on-site
groceries to overworked staff. As the pandemic has evolved, this service became less needed.
For more on interventions, see the Appendix for promising practices instituted by local organizations.

Supporting the Mental Health of Healthcare Workers | 10

© ICSI

Evaluate & Adapt
While it may not seem to be the time to create a formal plan to evaluate yourinterventions, it’s critically important to know if what you are doing is actually
helping people. Nearly all the healthcare systems interviewed expressed regretthat they were not yet doing enough to evaluate the effectiveness of their interventions and were now working to do so.

Nearly all thehealthcare systems
interviewed expressed
regret that they were
not yet doing enoughUsing the elegantly simple framework of the Model for Improvement, ask yourself
to evaluate thethese questions, “What are we trying to accomplish? and “What changes can we
make that will result in improvement?”, and “How will I know that the intervention effectiveness of theirinterventions and wereis an improvement? Keep it simple.
now working to do so.
½ Regular, qualitative feedback from staff is essential. Use the feedback loops

you identified in the communications section above.
½ Don’t be afraid to abandon what isn’t working or modify something that has potential if done
differently.
½ Remember to continuously monitor stressors for the work units as they may change over time,
as may the work units themselves

Opportunities for My Organization
What assets can be strengthened or sustained?

What novel interventions have been tried? What have you learned?

How are you monitoring effectiveness of interventions? How are you regularly seeking feedback
from staff?

Supporting the Mental Health of Healthcare Workers | 11

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Conclusion
With the COVID-19 pandemic continuing and disruptions in healthcare seemingly never-ending, the needto take the mental health of our workforce seriously is more important than ever. Collectively we havelearned a lot about what is helpful to healthcare workers’ mental and emotional well-being during crisis,
yet it’s still a young science - and implementation is tricky.
The framework developed and offered here is based on what healthcare leaders in mental health, quality
improvement, and incident command have generously and honestly shared about their own efforts, bothwhat worked, and what didn’t.
Supporting workers’ mental health needs to be a priority moving forward, not just in times of crisis but at all
times. We know that mental health and well-being has a direct correlation with the quality of work and carestaff can in turn provide. It’s time it was considered, resourced, and evaluated systematically, as we doother aspects of organizational functioning.

Supporting the Mental Health of Healthcare Workers | 12

© ICSIAppendix: Examples of Promising Practices
Inpatient Support
HealthPartners: Regions Hospital Grocery 2Go Program
Brief synopsis:
Regions Hospital is offering essential grocery items (milk, eggs, rice, butter, bread, fruits and vegetables, toilet paper) to employees. Items are ordered online through the hospital’s existing cateringordering system. Items are ready within 1-2 days for pick-up. The purpose is to alleviate stress for
employees so they can easily pick up items and go home, rather than face the prospect of finding storesthat are open (especially hard for shift workers with stores reducing hours), finding supplies that are often
sold out (e.g., toilet paper and eggs), and worrying about additional exposure to coronavirus, both forthemselves by going into stores and for others, realizing that hospital workers may be vectors. This
program not only benefits the workers who shop for these items but provides work for the catering andnutrition services staff which helps them avoid furlough. The program is gaining traction and additional
communication is being developed to ensure all employees are aware of this helpful service.
What resources are needed (e.g., staff, time)?
This was an expansion of existing catering and dining retail operation and a key to the success was theability to partner with existing vendors to meet this specific need; special boxes are fruits and vegetables
were created, as well as procuring “retails sized” quantities of packaged items, like eggs, were important(rather than the industrial sized orders for a restaurant kitchen)

Executive & Team Leader Support
CentraCare: Frontline COVID Leader Touchbase and Leadership Support Page
Brief synopsis:
Frontline Leader Touchbase: Leadership Development and Spiritual Care Chaplains are reaching out toleaders within identified teams (both clinical and support teams) that are experiencing increased stressdue to the treatment of COVID-19 patients. This allows the leader to get support and have an avenue todiscuss the challenges they are facing, as well as determining needs they may have to support their staff.
Based on needs, leaders may be referred to EAP, leadership coaching, mindfulness Huddle moments
information, spiritual guidance, community resources, or emotional coaching by a CentraCare Behavioral
Health clinician. Examples of teams identified: Units treating COVID + patients, Emergency Departments,
EMS, Supply Chain & Logistics, Long Term Care, Respiratory Therapy, Laboratory, Nursing Supervisors,
Environmental Services, Information Services, Facilities, Clinical Engineering.
Leadership Support Resource Page: CentraCare developed a resource page on the organization’s COVID
19 SharePoint site that has a variety of resources and material available for leaders to support their leadership needs during the pandemic. Examples include: recorded presentations on self-care & resiliency,
psychological first aid tips sheets, Leading with the SCARF model (understanding motivation), and Leading
through Change (building trust, compassion stability and hope within your team)
What resources are needed (e.g., staff, time)?
Utilizing leadership development team members and Chaplains to make outreach calls. Behavioral HealthSupporting the Mental Health of Healthcare Workers | 13

© ICSIclinicians are available for appropriate referrals. All calls and ongoing coaching (leadership, spiritual, andemotional) will be scheduled around other work duties and scheduled appointments. The resource pagerequired support from the Communications team to build the page and update as needed. It also involves
collaboration between Human Resources and COVID Staff Support Response Team to curate materials.

HealthPartners: EAP Leaders Support
Brief Synopsis:
HealthPartners EAP is using a resource already existing pre-COVID to help leaders get help for teams.
This includes rapid response critical incident, which is on-site support to help a team following a
traumatic event, dealing with employee sickness/death, managing change. The goal is to promote theoffer of practical and emotional support to those affected and direct our efforts towards fostering naturalresilience and coping. In addition, they offer Leading through Crisis, which is four learning events to
prepare managers as first responders.

What resources are needed (e.g., staff, time)?
This utilizes resources already available prior to COVID-19 pandemic.

Support Services Support
Sanford Health: Supporting the Support Staff (IT, Patient Access, Lab)
Brief Synopsis:
Sanford Health identified three areas of support staff at increased risk of stress and burnout: IT, Lab, andPatient Access. All three of these areas have had to quickly adapt their processes to the changing needs
for COVID-19. The behavioral health team created a slide deck presentation on mental health wellness.
The presentation is ~30-60 minutes and delivered during team huddles by behavioral health and/or
other clinical staff. Presentations ordinarily are done by two facilitators. After the presentation, there is an
open discussion where staff share feelings and/or ask technical questions. The goal is to raise awarenessabout wellness, create a safe environment to share, and demonstrate the organization’s commitment tosupporting staff. The next step for the team has been to expand to primary care and nursing staff in
Sanford’s long term care facilities, another area of high stress and burnout.
What resources are needed (e.g., staff, time)?
12 people were trained to do the presentation (psychologists, therapists, physicians, organizational development consultants, administrators), although this number is best determined by each organization’s
available resources. As of 5/15/20, 67 presentations have been made to over 3,700 employees. Sanford
Human Resources assigned two full time employees to coordinate scheduling via an internal phone numberthat managers/supervisors could call to arrange a presentation. A shared spreadsheet among the 12
available presenters allowed the HR assistants to schedule presentations as requests came in using eachpresenter’s Outlook calendar as a guide to available times. The time to reach out and schedule interventions
takes less than 3 minutes as the HR assistant simply asks the manager what date/time they desire and thencross references availability by the presenter spreadsheet. The time to lead presentations varies dependingon the “version” that is requested. The presentation can be delivered in 30-, 45-, or 60-minute formats which
offers slightly more or less depth on topics and time for facilitated dialogue and/or Q/A.

Mental Health Minnesota: Supporting Peer Specialists
Supporting the Mental Health of Healthcare Workers | 14

© ICSIBrief Synopsis:
Mental Health Minnesota (an affiliate of Mental Health America) offers peer-to-peer support for mental
health wellness and recovery. With COVID-19, Mental Health Minnesota’s Certified Peer Specialists haveshifted to working remotely, rather than being together to field calls coming into the organization’s
Minnesota Warmline service. During shifts, staff utilize Google Chat to stay connected and support one
another. Supervisors check-in with staff members individually during each shift. A volunteer mental healthprofessional has been added to help staff with processing calls, and Warmline staff meetings haveincreased in frequency from once a month to every other week. Mental Health Minnesota has also
contracted with the Sibly app to provide staff with text-based mental health coaching on an as-neededbasis. Additionally, weekly online support groups are available to peer specialists working in thecommunity (including but not restricted to staff at Mental Health Minnesota).
What resources are needed (e.g., staff, time)?
Initially, additional staff time was needed as staff moved to working remotely. Keeping the Warmline staff
connected during their evening shifts was of key importance to the organization in its effort to not only
support community members, but its own staff as well. As a non-profit, the organization was able to attain afree six-month trial of the Sibly app to use during this time, with the potential of contracting in the future.
The organization has been able to utilize volunteers to help provide support to staff as well, through theassistance of mental health professionals as well as support group leaders.

Displaced Staff Support
CentraCare: Outreach to Furloughed Workers
Brief synopsis:
CentraCare’s external EAP Program is making outreach calls to all furloughed workers. As positions
change, an updated report of furloughed staff is given to the EAP team for updated outreach. The EAP
clinicians indicate to the employee that they understand job duties may have recently changed due to
COVID and want to ensure they are aware of the free services available for employees and their family
members. The main goal is to support these employees while away from work, so they don’t feel disconnected and know they have a support system available.
What resources are needed (e.g., staff, time)?
This is an expansion of existing programs via EAP.

Universal Support
Carris Health/CentraCare: Resiliency Building and Staff Survey
Brief Synopsis:
Resiliency Building: The well-being team at Redwood, a local health system within Carris Health/CentraCare, created a bite-sized resiliency presentation (based on the Duke University WISER program).
Local leadership was engaged and encouraged to use in calls/huddles. Then, local staff was engaged
by making the presentation available on-demand. It is currently being offered as an on-demand tool
throughout CentraCare statewide with the local well-being team available to support leaders. The
presentation is 10-12 minutes and covers coping strategies, self-goals, colleague support, self-care tips,

Supporting the Mental Health of Healthcare Workers | 15

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and mindfulness tips.
Staff Survey: A survey was distributed to all Redwood Carris Health employees to better understand staff
needs/concerns. The survey averaged ~10 minutes to complete and had a 40% completion rate. Somedifficult responses (e.g., how do I receive help coping with too much drinking by a spouse or self; “myanxiety is just too much to bear”) are addressed globally by EAP and Behavioral Health support within thegreater Carris Health/CentraCare organization. In addition, responses helped shape overall programming
to add: one to one phone call by the well-being team (to address some of the more difficult/personal
issues), one-page handouts/emails for resiliency tips, virtual lunch and learn programming. A second roundof surveys is scheduled for late June. The goal is to study effectiveness of the programming to-date,identify ongoing care needs, and learn needed programming changes/updates.
What resources are needed (e.g., staff, time)?
For larger organizations, it may be helpful to engage leadership to contact have one-to-one contact
with direct reports. It may be useful to supply leadership with a script and list of resources. Otherwise,a group of volunteers or employees with Well-being (e.g., Behavioral Health, Spiritual Care) may also
support one-to-one phone calls to each staff member. Surveying may use common web-based survey
tool taking about 30-minutes to create and distribute/advertise; 10-minutes to complete on the user side,
open for 14 days. Employee Well-being staff would need to engage weekly for about 1-2 hours to help
with programming and follow-up to surveying, reviewing ongoing plans, then re-survey to determine
programming efficacy.

CentraCare: Well-Being Tips at Huddles
Brief synopsis:
Brief well-being tips and messages are being incorporated into daily huddles for teams. These tips are 2
minutes or less. Huddles have already been utilized across CentraCare as a part of Performance Excellence
initiatives, and the materials were created for the huddle leaders to easily incorporate into the structure of
their huddles. Information is published weekly in the form of a PowerPoint where the slide for the day canbe printed and taken to the Huddle or displayed virtually for remote workers. The information is disseminated on our Leadership Support page on the COVID- 19 SharePoint CentraCare is utilizing to communicate organizationally during the pandemic. Examples of Well-being tip categories include: How our brain
works, Physical self-care and habit changes, Humor and connection and Reflection.
What resources are needed (e.g., staff, time)?
A team of Behavioral Health clinicians, Resilience and Engagement staff, and Chaplains created the material.
The Communications team will update the resource page once a week with submitted Power Points.

Essentia Health: Grief Support Services
Brief Synopsis:
Essentia Health has a long-standing grief support services team offering support groups, peer emotional
first aid during crisis, educational library, and a remembrance service honor employee(s) who died in thepast last year. During COVID-19, grief support services has offered virtual visits to staff and on-site support
from chaplains.

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What resources are needed (e.g., staff, time)?
These services utilize the existing program centered on grief support services.

M-Health Fairview: EAP and Other Services
Brief Synopsis:
M-Health Fairview is honing its long-standing Employee Assistance Program (EAP) and the Provider Resiliency Program (PRP). The program includes a dedicated lead counselor for the EAP who is embedded into
the organization, attending clinic leadership meetings, advisory council, provider well-being committee,
and peer support programming. In this way physicians and other providers gain familiarity with her, which
is a key way for providers to feel more comfortable then reaching out for support. Through this service, thecounselor provides assessment and sometimes referral to a higher level resource such as psychiatry.
During the COVID-19 crisis, the service is provided virtually, however, one site that is dedicated to
COVID-19 patients has two counselors who are on-site to deliver services face-to-face. The EAP program
overall has been expanded with resources with tips on working from home, distance learning, issues withdomestic violence, and other needs.
What resources are needed (e.g., staff, time)?
Extension of a long-standing program utilizing the same resources delivered virtually instead of in-person.

Mayo Clinic: EAP and Other Services
Brief Synopsis:
Mayo Clinic is utilizing their long-term internal Employee Assistance Program (EAP) to support employeeswith additional program services during COVID-19. The EAP continues to provide counsel services during
this time for family, mental health, and work-related issues, with distance sessions appreciated. Some
additional COVID-19 specific EAP activities have been very popular with a lot of good feedback. These
include creation of a supervisor and employee video regarding tips for managing employee behaviors andindividual emotional health; articles for Mayo employees on emotional health and self-care, as well as
management articles on ways to manage the workforce during COVID-19; and a phone model for quarantined workers for emotional and practical life management. One of the most beneficial activities of the EAPteam has been supporting many Mayo administrative groups in planning ways to support employees andleaders during challenging workplace changes. In addition to EAP, Mayo is offering a few other resources:
wellness information specific for those who are quarantined, chaplain services, training for psychologicalfirst aid, peer support and a warm phone line.
What resources are needed (e.g., staff, time)?
EAP services existed prior to COVID and were delivered 80% face-to-face. With COVID-19, they werechanged to virtual services, utilizing the same personnel. A move to virtual delivery seems to haveincreased the volume of interactions.

Vail Place: Theme Days for Staff
Brief Synopsis:
Vail Place has 39 years of experience providing community-based services for adults with serious andpersistent mental illness in the Twin Cities metro area. Much of Vail Place’s staff has shifted to working
virtually, using Microsoft Teams as the organization’s central internal communication platform. In addition to
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© ICSIincreased check-ins and staff chats, one creative way to lift morale has been implementing weekly theme
days (e.g., 80s day, hat day, superhero day, etc.) for staff to dress up during a team meeting. People havebeen posting snapshots in our Staff Teams feed, which keeps people interacting about more than justwork. It has become a fun way for people to bond across teams and gives people a reason to smile!
What resources are needed (e.g., staff, time)?
No additional resources are needed except for a team lead to spearhead the weekly themes. Vail Place’s
HR Coordinator took a poll to generate ideas, then sent out weekly calendar invites with the theme, so
people can plan ahead!

Dvorkin J, Ellison D, Hemmila T, Neely C. Supporting the Mental Health of Healthcare Workers. Institute forClinical Systems Improvement (ICSI) November 2021.
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