There are several underlying factors that are driving nurses to stay silent about mental health issues, even if it leads to immense suffering, poor work performance, and other problems. Sometimes, when they do open up about it to coworkers, they’re met with resistance or indifference. One nurse interviewed for a 2014 study explained, “They don’t want to hear about it. They just want to know that everything is fine. As long as you don’t talk about it, you know, everything is working out fine. And that is not true.”
Poor organizational support is a major contributing factor. According to a healthcare worker from the same study, “I’ve been called into the office and told I can’t be upset at work.” Nurses feel pressured to put on a facade of normality, even if they’re struggling internally with anxiety or depression. This is especially problematic for psychiatric nurses, who often feel like their credibility might be damaged if they revealed that they have their own mental health problems.
Another major issue is that psychiatric disorders are often difficult to identify, both for people affected by them and for their coworkers and bosses. Many people associated mental health with obvious and debilitating conditions like schizophrenia, yet aren’t well acquainted with the more subtle signs and symptoms of disorders like depression. People with anxiety or depression aren’t always aware that they have a mood disorder, and often feel guilty for the way they feel.
How Better Organizational Culture can Help
Thousands of nurses are suffering every day from depression, anxiety, substance abuse, and other mental health problems. Research suggests that mentally ill nurses feel stigmatized, and often decline to seek help. When mental disorders go untreated, people suffer from ongoing social and cognitive decline. Very importantly, this could compromise the quality of patient care.
Mental health among nurses and other medical workers needs to be addressed by healthcare organizations. One thing that could help is improving mental health literacy. Workplace initiatives like Mental Health First Aid are designed to provide literacy training for both workers and management. Although healthcare providers may ostensibly have better mental health literacy than the general population, stigmatizing attitudes are often present. One thing that has been suggested for reducing the stigma is an approach called contact-based education, which incorporates positive social contact with peers who have struggled with mental illnesses.
Along with educational initiatives that provide a better understanding of mental illness, changes in organizational policies and structures can also help. Hospitals can be rather bureaucratic, and a focus on performance and productivity can too often take precedence over compassionate understanding. Incorporating management styles that stimulate a supportive atmosphere could be helpful, as can policies that don’t burn out staff with over-scheduling or strongly discourage nurses from taking time off of work.
Nursing is a high-stress job that can take its toll on even the strongest people. Countless nurses are struggling with anxiety, depression, or substance abuse issues that are affecting their work. And yet, mental health problems among healthcare workers are something that’s often swept under the rug. A complex “web of silence” woven through healthcare organizations creates an environment where mental illness is stigmatized. This stops people from getting the help they need. Better mental health literacy among those in management positions, as well as a more supportive team-centered work environment, could help improve this situation. No one should ever be afraid to seek help for a mental health problem, including nurses.