What do resilient people do when times get tough? Researchers at Mount Sinai, including Dennis Charney, MD, the Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai and President for Academic Affairs of the Mount Sinai Health System, have a long history of exploring that question.
So when the COVID-19 pandemic arrived in New York City early in 2020, Dr. Charney gathered together Mount Sinai experts in trauma and resilience, who recognized almost immediately what lay ahead. They saw that their staff was at risk for stress-related conditions from the mounting crisis—and they didn’t wait to react.
By early that summer, the Center for Stress, Resilience, and Personal Growth (CSRPG) opened its doors, directed by Deborah B. Marin, MD, the George and Marion Blumenthal Professor of Psychiatry. Over its first few years, the Center has become a firmly established resource available to all Mount Sinai staff, faculty, students, and trainees.
When developing the program, the Center’s leadership, including Vanshdeep Sharma, MD, Craig L. Katz, MD, and Jonathan DePierro, PhD, drew on their collective expertise managing the behavioral health impact of the September 11, 2001, attacks in emergency responders.
“We had existing services that predated this Center, but there was a clear need as the pandemic raged on to have an on-the-ground resource led by mental health professionals,” says Dr. DePierro, the Center’s Associate Director and an Associate Professor of Psychiatry at Icahn Mount Sinai.
The Center was designed to provide evidence-based services to increase resilience and support the psychological well-being of the people who make the Health System function. Three years later, it remains a valuable and effective resource for the Mount Sinai community, and a model for other health systems.
Treating Health Care Provider Stress
Dr. DePierro and his colleagues at the Center set out to create a program that would support staff with mental health needs while also offering preventive measures to reduce the risk of stress-related conditions. Their dedicated team includes clinical social workers, psychologists, psychiatrists, and support staff. Together, that team supports the 43,000 people who work within the Mount Sinai system, including health care workers, administrative and support staff, medical students, and trainees.
Jonathan DePierro, PhD
One of the Center’s earliest offerings was an immediate way to connect to support. “Anyone employed at Mount Sinai can call to be evaluated over the phone and referred for behavioral health care as needed,” Dr. DePierro says.
While some in-person services are available, telehealth options are also available for behavioral health services. That makes care more easily accessible for those who need it—and helps them feel more comfortable seeking services in the place where they work. “We take many efforts to ensure we’re protecting confidentiality,” Dr. DePierro adds. The Center’s faculty practice is led by Clinical Director Ashley Doukas, PhD.
While providers at the Center often help people manage work stress and burnout, their concerns don’t have to be job-related. “We started in the midst of the pandemic, but people are presenting with stress from all sorts of things: exhaustion, relationship problems, sleep problems, depression, anxiety,” he adds. “We take care of you first as a person, and second as a health care provider.”
Boosting Resilience Through Prevention
Treatment is only part of the Center’s scope. The Center’s leadership team also drew from the deep well of scientific literature on resilience to develop training materials that would help employees weather the storm of stress.
Based on that science, the team developed a series of resilience training curricula to give people the tools and skills to manage stress in healthy ways. Since 2020, they’ve led almost 400 resilience workshops with the Mount Sinai community. Those workshops are tailored to the needs and cultures of a given group. Nurses, for instance, may have different needs and stressors than hospital security staff or medical students. “One important lesson to take away from this is that there is not a one-sized-fits-all approach,” DePierro says.
The workshops are customized for each population, but they share a common goal: “They provide the tools people need to manage the ups and downs they deal with on a daily basis,” Dr. DePierro says. Scarlett Ho, PhD, Director of Education, is responsible for the ongoing expansion and evolution of the resilience workshops.
Tools that can boost resilience in the face of stress and trauma include:
- Social support
- Remaining optimistic
- Facing fears rather than withdrawing from them
- Physical exercise
- Having a role model or mentor
- Thinking flexibly about challenges
- Avoiding negative self-talk
Much of the evidence in support of these strategies is described in detail in the forthcoming third edition of the book Resilience: The Science of Mastering Life’s Greatest Challenges, by Drs. Charney, DePierro, and the late Yale University psychiatrist Steven M. Southwick, MD.
An Investment in Health Care Provider Well-Being
The Center continues to grow and expand its offerings. In 2021, the team shared its resilience training program with the broader New York City community, partnering with faith-based organizations in Harlem, the Bronx, Brooklyn, and Queens.
“In 2022, we trained community health advisors and pastors in nine organizations to teach workshops to their congregations, reaching over 1,000 community members,” Dr. DePierro says. This work built on more than a decade of community-based partnerships fostered by Dr. Marin and health care chaplain Zorina Costello, DMin, Director of Community Engagement for the Center and the Center for Spirituality and Health at Mount Sinai.
In 2022, the Center and Mount Sinai’s Office of Well-Being and Resilience jointly received a $2.1 million Health Workforce Resiliency grant from the Health Resources and Services Administration to further develop the resilience training and tools. In collaboration with partners in digital health, including the Hasso Plattner Institute for Digital Health at Mount Sinai, the Center’s leadership also created an app called Wellness Hub. Available to Mount Sinai’s health care workers, the self-guided digital health platform allows users to screen themselves for stress and provides activities to boost resilience.
Staff of the Center for Stress, Resilience, and Personal Growth at Mount Sinai
The Center’s team is collecting data to evaluate the efficacy of their workshops and the app. So far, feedback has been positive. Surveys from workshop participants suggest that following the training, people feel better prepared to manage stressors from their jobs and their personal lives. “They have a better sense that they can bounce back from life’s challenges,” Dr. DePierro says.
As the team collects more data about program outcomes, they are considering packaging the material for other health systems to use to boost resilience among staff. In the meantime, Dr. DePierro says he’s happy to share his knowledge with other health system leaders who want to take steps to invest in the mental health and well-being of their providers.
“We’re exceptionally lucky that Mount Sinai has had the vision to invest in this resource at a time it was badly needed,” he says. But even as the pandemic eases, that investment is paying dividends, he adds. “We’re baked into the system now, and we’re not going anywhere.”