COVID-19 and Department of Psychiatry at URMC

Our Journey Forward

Hochang Benjamin Lee, M.D.

John Romano Professor and Chair

Department of Psychiatry

1

Objectives

1. Introduce Department of Psychiatry at URMC.

2. List challenges posed by COVID-19 on delivery of psychiatric services

in both inpatient and outpatient settings at URMC.

• Emphasis on telepsychiatry and innovative models of care.

• Recent issues related to overcrowded CPEP

3. Discuss our journey forward as psychiatry is at the forefront of

socioeconomic and racial reckoning in our society.

4. Highlight the need to address the Staff and Faculty Wellness

2

Origin of Department of Psychiatry at URMC

Friendship between a psychiatrist and an

internist began in Boston (1941).

• Soma Weiss, Physician-in Chief at Peter Bent

Brigham Hospital

John Romano – an “embedded” psychiatrist

in the medicine unit.

George Engel – a “graduate assistant” in

the same medicine unit.

Recruited to Rochester in 1946 from

University of Cincinnati3

University of Rochester: Home of Biopsychosocial Model (Engel, 1977)

“Illness experience results from complex

interaction among biological,

psychological, and social factors that

impacts clinical care between the patient

and physician.”

THE organizing principle for training of

nearly all medical schools and psychiatry

residencies in the United States.

4

Our Vision: “Psychiatry without Boundary”

Rochester Psychiatry with what John Romano has once called a “permeable boundary” across disciplines, roles, and departments.

1. A multi-disciplinary department that maximizes the strength of each discipline while aspiring to move the field forward together as a team.

2. A department with integrated missions—clinical care, community service, research, and education—and without the silos based on academic and clinical roles (e.g. researchers, clinicians, educators, etc.)

3. A biopsychosocial department that strives to integrate behavioral health service vertically and horizontally across the URMC and deliver a world class, compassionate care for psychiatric patients in our community and beyond.

5

URMC Psychiatry:

“Department of Permeable Boundaries”Chair

Ben Lee

Child & Adolescent

Psychiatry

Co-Chiefs

Michael Scharf

Peter Wyman

Collaborative & Consultative Psychiatry

Co-Chiefs

George Nasra

Susan McDaniel

Acute and Adult Psychiatry

Co-Chiefs

Sue DiGiovanni

Wil Pigeon

(interim)

Community Psychiatry and

Outreach Medicine

Co-Chiefs

Rob Weisman

Steve Lamberti

Geriatric Psychiatry and Memory Care

Co-Chiefs

EJ Santos

Anton Porsteinsson

Yeates Conwell

Associate Chair of Diversity and

Inclusion

Telva Olivares

Vice Chair of Faculty Affairs

Yeates Conwell

Associate Chair of Research

Steve Silverstein

Associate Chair of Education

Deborah King

Associate Chair of Clinical

Sue DiGiovanni

Department of Psychiatry at URMC

•Training and Education – largest pipeline of behavioral

health service providers outside of NYC (135-150 trainees

at any given moment)

• Psychiatry Residency (adult: 8 per year; child: 4 per year)

• Fellowship in Forensic, CL, Geriatric, and Child (Addiction next)

• Pre- and Post-doc Psychology Fellowship (16 per year) program.

• NIMH T32 post-doc fellowship in suicide prevention.

• Master’s degree in Family and Marriage Counseling (n = 26),

Social workers, LMHPs, CASACs,

• Partner with School of Nursing: Psychiatric APNs (n = 52)7

Psychiatric Research: $21+ mil in 2020

Center for the Study and Prevention of Suicide

• The only CDC-funded suicide prevention research center in US (PI: Caine)

• The only VA Center of Excellence for Suicide Prevention in US (PI: Pigeon)

• Rochester Roybal Center for social Ties and Aging Research (PI: Kim Van Orden and

Kathy Heffner)

One of three Regional Center of Excellence in Substance Abuse education

• $9.5 million HRSA grant over next three years – Recovery Center of Excellence

Del Monte Neuroscience Institute – Psychiatry collaboration – NYFirst Grant

• Schizophrenia (Vision), Alzheimer’s disease (Clinical Trials), and Chronic Pain

research based on neuroimaging modalities – fMRI, DTI, EEG, PET, etc.

Developmental Psychology and Child Psychiatry

• The Rochester ECHO Project (PI: O’Connor)

• Sources of Strength in High School (PI: Peter Wyman)

Outreach/Advocacy Research in Psychiatry

• Forensic ACT team (PI: Lamberti), Women's Initiative Supporting Health-Transitions

Clinic (PI: Morse), Laboratory Interpersonal Violence and Victimization (PI: Cerulli)

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URMC Psychiatry – A Clinical Department

• 140 full and part-time faculty members (45 faculty recruits in 3 years)

• About 1300+ employees in total.

• 93 certified psych inpatient beds (includes 24 child and adolescent beds)

• Operates a 20-bed Med-Psych Unit -to be expanded by additional 10 beds.

• Partial hospital programs for child and adolescents.

• 370K outpatient visits annually (largely from OMH-certified programs)

• CPEP (Psychiatric Emergency Program) seeing over 10,000 visits annually

• Telepsychiatry program – 60 nursing homes and 3 regional hospitals

• Numerous collaborative programs in primary care and specialty care settings –

inpatient and outpatient.

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URMC Psychiatry has a broader scope than most other academic psychiatry department

Vast majority of DEMENTIA CARE in our community is under Department of Psychiatry through Memory Care Program (Director: EJ Santos, M.D.)

• AD-CARE Program also resides in Department of Psychiatry (Director: Anton

Porsteinsson)

• Finger Lake Center of Excellence – (Director: Carol Podgorski, Ph.D.)

URMC Psychiatry is the only academic department in US that operates MEDICINE IN PSYCHIATRY (MIPS: Director: Telva Olivares)

• iMIPS inpatient unit (Director: Marsha Wittink, M.D.)

• MIPS Primary Clinic (Director: Kevin Brazile, D.O.)

URMC Psychiatry operates the employment-based wellness and behavioral health programs – 65K UR employees, retirees, and adults dependents.

• EMPLOYEE ASSISTANCE PROGRAM

• BEHAVIROAL HEALTH PARTNERS10

URMC Department of Psychiatry Volume: 10% inpt and 40% outpt increase between 2017-2019

Fiscal Year 2015 Fiscal Year 2016 Fiscal Year 2017 Fiscal Year 2018 Fiscal Year 2019Adult Division• Inpatient• Outpatient

18,49087,778

18,91293,809

19,08995,647

19,241102,585

20,046110,333

Child and Adolescent• Inpatient• Outpatient

7,81424,929

6,68626,172

7,34426,660

7,56640,352

8,28650,273

Medicine in Psychiatry• Inpatient• Outpatient

7,1625,500

6,4786,413

5,7007,924

6,4368,414

7,2048,180

Addictions Psychiatry• Chemical Dependency• Methadone (OTP)

13,51762,607

16,78368,118

21,22269,842

20,48789,721

18,871110,295

Total Patient Volume• Inpatient• Outpatient

33,466194,331

32,076194,512

32,133200,073

33,243241,072

35,536279,081

% Change Year over Year• Inpatient• Outpatient

(4.2%)0.9%

1.8%2.9%

3.5%20.5%

6.9%15.8%

Then comes the Age of COVID-19

12

Li Wenliang,M.D.(died on 2/7/2020)

13

South Korea becomes one of

the epicenter of COVID-19

Initial spike in COVID19

in South Korea was in a

geriatric psychiatry ward

Entire 101 patients and staff were

infected (except 2 people)

• Whole floor with units were

“cohorted” and quarantined.

• 7 died of COVID-19

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URMC Psychiatry Response to COVID-19

March 2nd – Faculty Meeting about coronavirus.

March 7th – “No More Handshakes and Hugs” Letter to Department

March 10th- Departmental COVID-19 Huddle – 12 PM (Tuesday, Friday)

• Steering Group: Ben Lee, Sue DiGiovanni, Carole Farley-Toombs,

Telva Olivares.

• Members: Clinical Chiefs of 5 Divisions (EJ Santos, George Nasra,

Rob Weisman, Michael Scharf, Sue DiGiovanni), Program/Service

Directors (Marsha Wittink, Noni Niculescu, Patrick Seche), Nurse

Liaison (Laura Inclema), and Social Work Liasion (Jewel Hopkins).

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Psychiatry Department: COVID Response

Psychiatry Dept huddle –Tues/Friday

Ben Lee

Ambulatory Leadership Daily Huddle

Carole Farley Toombs

Ambulatory Nursing Daily HuddleKerri/Laura Inclema

Inpatient Leadership

Daily HuddleSue DiGiovanni

Inpatient Nursing Daily HuddleKerri/ Heather Jackson

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Division-based Clinical Decision structure

Steering Committee

Ben Lee , etc.

Child

Michael Sharf

Child Amb

Linda AG

Partial

Charlene Weeks

Geriatric

EJ Santos

Adult

Sue DiGiovanni

CPEP

Noni AURELIAN

Partial

Heidi Hakes

Strong BH

Kathy Castle

Collaborative

George Nasra

EAP/BHP

Ann Cornell

Community

Rob Weisman

Strong Recovery

Patrick Seche

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Dramatic rise in cases in US in March 2020

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COVID 19 Challenges to URMC Psychiatry

1. How do we preserve our psychiatry service lines that provides mental

health for our region?

• URMC Psychiatry is the “last line of defense” for regional mental health.

2. How do we protect our vulnerable patients?

• Our patients with SMI are physically vulnerable.

• Our 93 inpatient psychiatric beds are vulnerable ----- how do we bring

in medicine culture to psychiatry?

3. How do we support and protect our staff in terms of health and

employment??

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Clinical innovations in mental health service during COVID-19

Child and Adult Partial Hospital Programs

• Converting to Zoom and telephone-based contacts

• Fully operating 4 hours of program all-online.

What about those who needs to be seen in-person?

• Methadone maintenance therapy – curve-side

• Group therapy – socially distanced, combined therapy

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Resilience – displayed by Department of PsychiatryStrong Recovery Methadone Maintenance TeamCurve-side – “Drive Through”- Methadone Dispensing Program

21

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Telepsychiatry Team Leads

Lara Press-EllinghamLinda WilliamsLynn DejongeSteve FasoneJennifer RichmanMichael Hasselberg

Psychiatry Call Center Leads

Laura InclemaKristy Lamb

Psychiatry Billing / Compliance Lead

Julie Moeller

TeleMentalHealth

Champions

Child PsychiatryDivision

Service Lines

Community Division

Service Lines

Collaborative Care Division

Service Lines

Geriatric Psychiatry Division

Service Lines

CPEP and Mobile Crisis

Service Lines

In-person to Telepsychiatry Conversion

March 2020

March 11-12

Farley-Toombs and Hasselberg

Planning Sessions

March 13

AmbulatoryTelepsychiatry

Meeting

Self AttestationsSubmitted to

OMH and OASAS

March 14

UR Medicine Announces

Postponement of Non-essential In-

person Visits

March 15

Bishop and HasselbergTeleHOME

MeetingMarch 16

Telepsychiatry Team and Dept.

of Psych Call Center

Planning Session

March 16

1st TeleMentalHealth

Champion MeetingMarch 17

Ambulatory Telephone Encounter“Go-Live”March 17

Farley-Toombs and Hasselberg

Planning SessionMarch 17

TeleMentalHealth

Champion MeetingMarch 18

CPEP/Mobile Crisis Telephone

Encounter“Go-Live”March 23

TeleMentalHealth

Champion MeetingMarch 23

Billing / ComplianceTeleHOME

MeetingMarch 24

Hasselberg / KellyTelemedicine

ZoomTraining for ProvidersMarch 24

Switch from TeleHOME Visit

Type to new Dept. of Psych

WorkflowMarch 25

TeleMentalHealth

Champion MeetingMarch 25

Training of Child Psychiatry Division on

Video EncountersMarch 25

Farley-Toombs and Hasselberg

Planning SessionMarch 26

TeleMentalHealth

Champion Meeting

March 17

Ambulatory Video Encounter

MyChart“Go-Live”March 30

TeleMentalHealth

Champion Meeting

March 30

TeleMentalHealth

Champion MeetingMarch 31

Telepsychiatry “Go-Live” by March 17th

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April 2020

April 1

April 2

FinalTeleMental

Health Champion MeetingApril 14

Video EncounterScheduling

Meeting

TeleMentalHealth

Champion Meeting

Ambulatory Video Encounter

Email“Go-Live”April 2

TeleMentalHealth

Champion Meeting

April 3

TeleMentalHealth

Champion Meeting

April 8

Start of Psych AVZoom / Tech Daily 2pm

Office Hours

April 15-present

80% of Ambulatory care was delivered by telepsychiatry by end of March

URMC-wide: 60% of usual Volume: 46% telemedicine by April

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Psychiatry: 96% of usual volume: 80+% telepsychiatry by April

Year-Over-Year % Change in Volume by April

Psychiatry URMC – overall

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Telepsychiatry reduces cancellation and no show rates:

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No show cancellation

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URMC Furlough – May 8th announcement

Total: 3474/17,885 (19.4%)

• About 20% was full furlough

• 80% was partial

Department of Psychiatry (<2%)

• Substantially smaller portion

• Primarily affected clinical admin,

research and education

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COVID-19 Challenge: Inpatient

COVID+ patients needing psychiatric inpatient admissions :

• 3 COVID+ psychiatric patients in CPEP one Saturday in March.

• How do we safely care for these patients while protecting the staff?

• Moved 3-9200 Geriatric Psych unit staff and patients to Rochester Psychiatric Center

–unoccupied inpatient unit – and protect the geriatric psychiatry inpatients – the

most vulnerable population to COVID-19 infection

• Developed COVID+ psychiatric unit at 3-9200 with assistance from Med-Psych and

Acute care clinicians.

• This ends up being an expansion of 12 psychiatric inpatient beds during

this challenging time. 30

Inpatient planning for COVID+ Unit

1. Discussion started on 3/25/20

2. Task Force/planning started in 4/2/2020

3. DOH/OMH approval happened on 4/8/2020

4. By mid- April, we were already ready to act on the plan

• 3-9200 as COVID+ unit

• Moving 3-9200 to RPC

5. 2 patient threshold – COVID+ unit plan triggered – patients moved

to RPC on 4/22/20

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Creating a New COVID-19 Positive unit at URMC.

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Inpatient: CoVID-19

Relatively low utilization of COVID+ Unit

• Only triggered the plan twice. Highest number of COVID+ patient

was 6 patients at one point.

Two COVID-19 Outbreaks in inpatient Unit last year

• Had to quarantine an inpatient unit twice.

Remarkable work by the nursing but quite stressful for them.

• Staff wellness and overall level of stress in the unit34

New causes for Concern: Our CPEP

1. We have more “boarded” patients in our CPEP than ever.

• We routinely have 7-15 patients being boarded in our CPEP

• At one point, we had 20 patients boarded in our CPEP

• We transferred several to RRH during the last few weeks.

2. Our outpatients seems to be more anxious and depressed than

before – social isolation, economic downturn, and fear of COVID

• Brooks SK et al. The psychological impact of quarantine and how to reduce it: rapid review of the

evidence. The Lancet. 2020 Feb 26.

• McIntyre RS, Lee Y. Projected increases in suicide in Canada as a consequence of COVID-19.

Psychiatry research. 2020 May 19:113104.

35

A Recent Survey: COVID-19 and Mental HealthCzeisler MÉ. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic—United States, June 24–30, 2020. MMWR. Morbidity and Mortality Weekly Report. 2020;69.

•Surveyed 5.412 above age of 18

•About 40% reported at least one

adverse mental or behavioral

health conditions.

•Suicidal thoughts (11%) were

more common among 18-24

years old, Hispanic or black

persons, “essential worker,” and

“unpaid caregivers.”

Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057

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Patient volume in CPEP has fluctuated

38

195183178

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204

252

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155

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178

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170

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240

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199

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205

164

0

50

100

150

200

250

300

12/29/2019 1/29/2020 2/29/2020 3/31/2020 4/30/2020 5/31/2020 6/30/2020 7/31/2020

Individuals Seen

39

Number of patients admitted to Inpatient unit has been about the same or more.

40

31

38

25 23

3027 25

17

26 27 27 27 29 2831

25 24

34

2026 28

3431

25 2429

24

34

26 2529

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20

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30

35

40

45

50

12/29/2019 1/29/2020 2/29/2020 3/31/2020 4/30/2020 5/31/2020 6/30/2020 7/31/2020

Admissions to Inpatient

YEAR 2020 # of Admissions

Why is our CPEP getting over-crowded?

30-40 patients in our CPEP with 7-15 patients boarding is our norm.

Number of patients being boarded in CPEP has gradually increased

over the last year due to:

• Slowed “throughput” in CPEP and Inpatient Unit – length of stay in

both areas have increased

• Reduced outpatient mental health resources

• Forensic/legal issues related to the bail reform

• Recent closures of inpatient psych units in the region.

• Overall COVID-related stress taking toll on our patient.

41

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Systemic solutions needed

Working with RRH to increase the bed capacity in the region

Working with RPC to transfer long stay patients from our unit

Develop mobile crisis teams to divert patients for ED

Increase staffing (e.g. SW) to improve the throughput issues.

Many meetings these days about the CPEP issues.

43

Racial Injustice/George Floyd Protest in Rochester – May 30th

44

“Acknowledging Pain, Anger and Fear”message from Psychiatry Office of DICE 5/26

Death of George Floyd in Minneapolis, MN

(May 26)

Death of Ahmaud Arbery in Atlanta, GA

(February 20 – May 7th)

AND

Amy Cooper/Christian Cooper incident in

Central Park, NYC (May 25th)

AND

Death of Breonna Taylor in Louisville, KY

(March 13) and others

June 5th, 2020: White Coats for Black Lives demonstration on Brighton Health Campus

46

Shooting of Jacob Blake in Kenosha, WI (8/23/20)

47

Death of Daniel Prude: September 2nd, 2020

48

Death of Daniel Prude and URMC

9/2/2020 – News conference – highlighted the body camera video and

autopsy report of homicide as a result of “complications of asphyxia in

the setting of physical restraint.”

• Daniel Prude was evaluated and discharged several hours prior to

death.

9/4/2020 – URMC statement released to the press.

• “Medically appropriate and Compassionate care” after an internal

review”

4 external reviews – NY State OMH, DOH, Justice Center, and Joint

commission- have concluded and supported the initial URMC statement. 49

Department of Psychiatry Well-being Survey 2020

Results and Future Direction

IDEA CORE Members

50

Gratitude to IDEA (Implementation, Dissemination, Evaluation, and Analysis)Core members

51

Wendy Cross, Ben Chapman, Daniel Maeng, and Patrick Walsh

Survey Goal: Learn about Our level of Stress and Wellness

Background, development

• COVID-19 outbreak declared a pandemic by the WHO (March 11)

• George Floyd murder (May 25)

• Consulted with Psychiatry Office of DICE

• Process required HR review

Constructs, measures

A) Job satisfaction, stress, burnout - [Mini Z burnout survey]

B) General wellbeing (sleep, exercise, perceived stress]) - [Perceived Stress Scale]

C) Experience (impact of COVID-19 and social justice protests, work expectations, working

remotely, Zoom fatigue)

D) Employee feedback: Feeling valued at work, satisfaction at work [Qualitative Items]

E) Work role

Survey administration

Administered from 8/17 to 9/2/20

• REDCap online survey

• 1227 survey invitations (psychiatry all distribution list)

• 10 removed from list (email ‘failures’, no longer work in Psychiatry

Department)

• 13 unavailable during survey period

• 1204 potential participant population

Participation: 603 (50.1%)

Survey participation

Participant population Participation rate (%)

Nonfaculty 46.8

Faculty (self report) 70.7

Faculty by division…

Acute and Adult Psychiatry 83.8

Child and Adolescent Psychiatry 84.4

Collaborative Care and Wellness 64.5

Geriatric Mental Health/Memory Care 73.7

Community Psychiatry 56.5Still looking at which division had staff participation rate

Job Satisfaction: 73.5% (12% - “neutral”)

Overall, I am satisfied with my current job: (missing

n = 5)

Job satisfaction category

(strongly disagree – strongly agree,

5 pts.)

Faculty

(n = 118)

Staff

(n = 437)

Not satisfied n (%) 24 (20.3) 123 (31.4)

Satisfied n (%) 94 (79.7) 314 (71.9)

*Satisfied = agree or strongly agree;

‘Mini Z’

Burnout: 40.9% report symptoms of burnout Using your own definition of "burnout” circle one:

(1-5, from “I enjoy my work. I have no symptoms of burnout” to …

I feel completely burned out. I am at the point where I may need to seek help”)

Job burnout category* Faculty

(n = 118)

Staff

(n = 437)

Not burnout n (%) 77 (65.3) 251 (57.4)

Burnout n (%) 41 (34.7) 186 (42.6)

*Burnout = score 3 – 5.

‘Mini Z’*Linzer et al. (2016). Worklife and wellness in academic general internal medicine: Results from a national survey. Journal

of General Internal Medicine, 31(9), 1004–1010. https://doi.org/10.1007/s11606-016-3720-4

Sleep & Exercise

SLEEP: More or less than before COVID-19?

• More (9.7%)

• Unchanged (61.6%)

• Less (28.6%)

EXERCISE: More or less than before COVID-19?

• More (17.8%)

• Unchanged (40.9%)

• Less (41.3%)

Perceived Stress Scale*

10 items. Scoring range: 0-40, higher > stress

Department Mean=17.2 (SD 6.7)

Faculty = 16.0 (6.3) Staff = 17.4 (6.7)

Perceived Stress Scale by category

Low

(0-13)

Moderate

(14-26)

High

(27+)

Staff 27.7% 62.9% 9.4%

Faculty 34.7% 61.9% 3.4%

Total 29.2% 62.7% 8.1%*Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and

Social Behavior, 24, 385-396

As compared to before COVID-19, work-life balance is: 48.5% - “worse”

14.2%

48.5%

37.3%

IN THE PAST MONTH (August)……how much has COVID-19 and its consequences impacted your:

…how much have recent Black Lives Matter movement and protests against racial injustice impacted your:

None A little Somewhat A lot Extremely

Stress level (%) 4.0 15.9 32.2 36.3 11.6

Overall life Impact (%) 2.5 13.3 34.1 42.0 8.1

None A little Somewhat A lot Extremely

Stress level (%) 18.9 29.7 30.3 15.6 5.5

Overall life Impact (%) 17.2 36.0 28.4 14.4 4.0

* Pre Daniel Prude video (9/2/20)

How have the expectations of your work changed since COVID-19?

Summary: 72.8% report ‘more’

expectationsFaculty vs Non-Faculty. Work expectations

Work expectation

Faculty

(n = 118)

Staff

(n = 437)

More n (%) 74 (62.7%) 330 (75.5%)

About the same OR less n (%) 44 (37.3%) 107 (24.5%)

More expectations: Staff > Faculty

IN THE PAST MONTH, in a typical week you were working, what percentage of your work time has been spent remotely rather than onsite?

None

NA (2.0%)

1<20%

80-100%

40-<80%

20-<40%

Staff: None= 44.2%Faculty: None = 13.8%

In a typical week, the number of video calls you participated/attended on work days was...

38.6%

23.8%

15.1% 15.7%

6.8%

Faculty: 0/day = 7.6%3+/day = 61.0%

Staff: 0/day = 28.1%3+/day = 31.4%

Not at all A little bit Somewhat Quite a bit Very much

Faculty. &

Staff (%)18.5 20.9 22.0 30.1 8.5

IN THE PAST MONTH, considering the nature, amount, and length of calls, as a result of video call participation…

[respondents that reported 1+/day video calls]

I feel mentally exhausted …

60+% report mental exhaustion

Q1: Impact of COVID-19 and protests

Please use this space to comment, in any way you feel appropriate, on how your experiences have

impacted your well-being IN THE PAST MONTH:

Item respondents: n = 158

Q2: Valued at work

Please take a moment to comment on feeling valued and satisfaction at work.

Please list up to 3 things that contribute to you feeling valued at work:

Item respondents: n = 455

Q3: Improve work satisfaction

Please take a moment to comment on feeling valued and satisfaction at work.

Please list 1 to 3 things that would improve work satisfaction if initiated:

Item respondents: n = 411

Qualitative: Total respondents: n = 487 (to 1+ items), 80.8%

What have we done so far?

Faculty data presented on November 7th – Faculty meeting

Divisional data presented on November 7th – All Chief’s meeting

• Divisional data distributed in early December

The short answer, qualitative data are being analyzed.

• Impact of COVID 19 and Protests

• What makes you feel valued at work?

• Suggestions to improve are listed and acted on.

66

Announcement

• Autumn Gallego is appointed as our new

“Psychiatry Wellness Officer” as of

January 1st, 2021

• Will be in Office of DICE for the role and

develop a bridge to EAP/BHP

• Will coordinate departmental efforts to

assess and improve faculty and staff

wellness

• Will coordinate with URMC Chief Wellness

Officer (to be hired).

67

Example: Strong Recovery Program

“Fun” Committee – three teams, takes turn in chairing.

• Develop “fun” activities.

• Fun Fridays

• NFL Jersey days (Go Bills!), Flannel Fridays, Jeans Day, etc.

• Recognizing “most valuable colleagues” and “Cool under pressure” award.

“Well U” Champion – Itza Morales for SRP

• Disseminate information from the “Well U” program

• Yoga, mindfoolness, meditation, workshops, “water challenges”etc.”

• “Wellness” Room – used to be a storage room

• Decorated and equipped with sound machine, candle (battery) and massage chair68

Wellness Room & SR Latinx Celebration (we had music and outdoor games)

Staff Wellness during COVID-19Work stress and anxiety about Coronavirus?

Life-Work Connections Employee

Assistance Program (EAP)

Created a COVID-19 hotline for UMRC

A voluntary, work-based program that

offers free and confidential

assessments, short-term counseling,

referrals and follow-up services to

employees who have personal and/or

work-related problems70

Lessons learned during the COVID-19

1. Must establish a command structure to process new information and

make appropriate decision quickly.

• Must delegate and empower huddles and work groups and task

forces to achieve maximum efficiency and speed in decision making.

2. Telepsychiatry is here to stay.

• Must incorporate technology and develop new models of delivery to

meet the needs and evaluate for success and failure.

3. We are more connected to each other than ever.

• All “boundaries” are permeable.

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Conclusion

1. COVID-19 has posed tremendous challenge to delivery of mental

health services.

• However, by leveraging technology, innovation and teamwork, we

could overcome COVID-19 imposed challenges.

2. Social isolation, economic downturn, and racial unrest have all

increased mental health service needs in our region.

• It has affected our healthcare workers as well

3. Every crisis is an opportunity.

• Psychiatry has much to improve for our patients and ourselves. 72