Involve All Populations in the Nurse Well-Being Conversation
In the United States, one in five adults (https://www.nami.org/mhstats) experiences mental illness every year. Racial and ethnic populations can face particularly unique and inequitable challenges (https://www.cdc.gov/healthequity/features/minority-mental-health/index.html) with mental illness and caring for their mental health. To raise awareness about mental health barriers in historically underrepresented groups, July is designated as National Minority Mental Health Awareness Month (https://minorityhealth.hhs.gov/minority-mental-health/index.html).
What the Research Tells Us
According to the 2021 National Survey on Drug Use and Health (https://www.samhsa.gov/data/report/2021-nsduh-detailed-tables), the annual prevalence of mental illness among U.S. adults is:
- Non-Hispanic mixed/multiracial: 34.9%
- Non-Hispanic American Indian or Alaska Native: 26.6%
- Non-Hispanic White: 23.9%
- Non-Hispanic Black or African American: 21.4%
- Hispanic or Latino: 20.7%
- Non-Hispanic Native Hawaiian or Other Pacific Islander: 18.1%
- Non-Hispanic Asian: 16.4%
However, historically underrepresented groups face a number of barriers to obtaining mental health care (https://www.psychiatry.org/File%20Library/Psychiatrists/Cultural-Competency/Mental-Health-Disparities/Mental-Health-Facts-for-Diverse-Populations.pdf), including:
- Lack of insurance
- Language barriers
- Mental illness stigma in populations
- Lack of diversity in mental health providers
- Lack of culturally competent care providers
- Distrust in the healthcare system
ONS Members Tell Us How They Support Well-Being for All Nurses
Around the country, ONS members are implementing well-being strategies for their nursing teams and actions that transcend all backgrounds.
ONS member Kristen Gregory, RN, OCN®, an RN at Augusta Oncology Multispecialty Clinic in Georgia, said that being aware of your own mental health while also being culturally aware of how other populations deal with emotions and mental health is vital. Gregory recommended promoting open communication among teams through activities such as decompression sessions or support groups.
“It’s nice to get things off your chest, and it’s great to have support from your team,” Gregory said. “Support groups are often vital in helping with mental health well-being. Being oncology nurses, we deal with death and dying a good bit of the time. This can take a toll on us as humans, and it is refreshing to be able to talk to others going through this with us. Being aware of one’s own mental health is essential to helping others with their mental well-being. Working as a small team of five nurses at our location makes it easier for us to be aware of others' feelings. Talking to coworkers about my day helps make the hard days easier. If it wasn't for my team, I am not sure if I would be able to make it through each day without going crazy.”
ONS member Susan Payne, RN, BSN, a retired oncology nurse and current RN living in Washington, said that offering mental health days for nurses should be a priority for the healthcare industry. It’s important, she explains, because when nurses receive mental health care, they can help others with similar issues.
“Nurses are often the first to respond to patients in crisis, whether it be a hypersensitivity reaction to medication, performing resuscitation, witnessing the deaths of patients that we have taken care of for years, watching families grieve, and more,” she said. “We are also the victims of verbal and physical abuse from patients, family members, and even our coworkers. From these experiences, we may experience post-traumatic stress disorder, low self-esteem, and depression. This can also lead to physical illnesses and missed days from work. It’s great to have health care, but you also must have time and encouragement to use it.”
Resources are an important part of growth and improvement. ONS member Alisha Ellis, OCN®, CHPN, BMTCN®, clinical nurse educator at Franciscan Health Indianapolis in Indiana, recommended the book The Deepest Well: Healing the Long-Term Effects of Childhood Adversity by Nadine Burke Harris, MD, but admitted that she’d like to see more emphasis placed on care for oncology nurses.
“The book shed a lot of light on how adverse childhood events shape us as people and our patients and why trauma-informed care is necessary for all, but especially for marginalized and historically underrepresented populations,” Ellis said. “It would be great to see attention put on trauma-informed care, including for ourselves and our coworkers as oncology nurses.”