In 2009, after experiencing a series of suicides among physicians, medical students and residents, the UC San Diego (UCSD) School of Medicine created the Healer Education, Assessment and Referral (HEAR) Program to address the high prevalence of burnout, stress and depression specific to the medical student, physician and health professional populations.
Before the HEAR Program, barriers to seeking mental health care included associated stigma, cost, and a lack of psychiatrists in the area. When creating a program, they knew they needed to overcome these systemic barriers.
Two of the HEAR Program’s signature suicide prevention strategies are a comprehensive educational program and the American Foundation for Suicide Prevention’s (AFSP) Interactive Screening Program (ISP). The education program educates participants on depression, burnout and suicide, incorporates testimonials from their colleagues to destigmatize seeking support and provides local resources.
UCSD encouraged students, residents, fellows, faculty, hospital staff and all trainees to complete the ISP Stress and Depression Questionnaire, which is anonymous and confidential, to find out how stress and depression may be affecting them. After individuals complete the questionnaire, one of the HEAR counselors sends them an assessment with any recommendations for further evaluation or follow-up.
The HEAR Program has since evolved to focus not only on identifying and destigmatizing depression and burnout and preventing suicide but also on enhancing overall mental and physical wellbeing. It also expanded its program to nurses and other health care staff, after several nurses died by suicide, and to accommodate students and faculty from the schools of pharmacy and public health.
While the data is anonymous, most individuals taking the questionnaire score high on several measures of distress and suicide risk factors. Since the HEAR Program’s inception, over one thousand referrals to mental health providers have been made for individuals, many of whom say they would not otherwise have sought mental health care. In addition, nearly 100 residents and fellows have received ongoing counseling from the Program’s trained professionals in a program specifically designed for physician trainees. While there is no data to back correlation to the HEAR Program, there have not been any deaths by suicide among physicians or nurses since the Program’s launch.
“Burnout and suicide can’t be solved at the individual level, as it is an institutional and societal issue. The complexity makes it difficult to solve, and organizations not only need to commit to prioritizing a culture of wellbeing, but they also need the resources to do so. The multi-pronged approach the HEAR Program utilizes has been instrumental in helping to prevent suicide.”
