Several days a week, at 2:45 p.m., Ty Crowe leads a 15-minute meditation. He dims the lights and puts on soft music. Laptops click shut, phones are set aside.
“We focus on our breathing, on our bodies,” says Crowe, director of spiritual care for The Johns Hopkins Hospital. “The other thing I emphasize is to remember to be grateful, even for small things.”
The participants are the people in the Unified Incident Command Center who are leading Johns Hopkins Medicine’s response to the coronavirus outbreak. Their daily respite is part of a robust and connected effort to support all Johns Hopkins Health System employees as they cope with the COVID-19 pandemic.
The initiative, led by the Office of Well-Being, is known as MESH (Mental, Emotional and Spiritual Help) and provides resources for employees across the enterprise.
“People have stepped up to the plate in an extraordinary way,” says Cynthia Rand, Ph.D., the office’s interim chief wellness officer. “Those who are not on the front lines caring for patients want to support their colleagues who are, and there are efforts all over the institution to do that.”
MESH weaves together several Johns Hopkins services that support mental and emotional health for employees, including:
- The Department of Spiritual Care and Chaplaincy
- The mySupport employee assistance program, which provides access to free counseling and other resources
- RISE (Resilience in Stressful Events), which delivers peer support to health care workers coping with stressful patient-related events
- The Office of Well-Being, which promotes work-life balance and includes Healthy at Hopkins, which provides wellness support across the institution
The groups have teamed with the Department of Psychiatry and Behavioral Sciences, where more than 30 psychiatrists and psychologists have volunteered their time in order to provide timely mental health care to health system employees at The Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center.
“This is an unprecedented degree of cooperation and collaboration among a number of entities,” says RISE co-founder Albert Wu, M.D., professor of health policy and management and medicine.
A Carefully Woven Safety Net
In early March, the Office of Well-Being began hosting daily conference calls for representatives of the various support groups, who quickly laid out a plan to help colleagues cope with a workplace that, for many, had become uncertain and terrifying.
“We started by asking them to report on what they were hearing from the field so we could bring together coordinated and comprehensive support,” says Deborah Dang, Ph.D., R.N., chief nursing director for well-being in the Office of Well-Being.
The result, she says, is “a standardized triage process and an internal referral workflow to connect the unique offerings of each support service.”
As chaplains and RISE volunteers meet face-to-face with front-line workers, they may see opportunities to direct them to mySupport, which recently added COVID-related online articles and information.
“I always say the bar to use our services is so low it’s on the ground,” says mySupport assistant director Frances Callahan.
“Go ahead and give us a call, either for yourself or because you’re concerned about a colleague or loved one. Family members of employees can call for their own concerns as well,” she says. “The clinicians on our team can help you sort through the range of stressors you’re experiencing and connect you with resources.”
The mySupport team, in turn, can refer Hopkins employees to the psychiatry department’s newly formed COVID Response Clinic. “Ordinarily it takes weeks to get an appointment,” says department director James Potash, M.D., M.P.H. “But we’re making slots available for our staff within a day or two.”
Healthy at Hopkins, a key member of the Office of Well-Being, is adding more online and telephonic options to its well-being programs. “We’ve adjusted our approach so that our Johns Hopkins Medicine community can access stress reduction programs, breathing and other mindfulness exercises through a virtual community,” says Richard Safeer, M.D., chief medical director of Employee Health and Well-being for Johns Hopkins Medicine.
The wellness officials leading those efforts may also see opportunities to refer people to mySupport, he says.
Meeting Unprecedented Challenges
The COVID-19 pandemic can add stress to employees who may be learning new roles, worrying about their own health or struggling with the requirements of social isolation, says Johns Hopkins psychologist George Everly, Ph.D.
MESH is stepping up to meet such unprecedented challenges.
The Office of Well-Being and Healthy at Hopkins have added online resources, including three-times-a-day meditation sessions through Zoom, information about housing for clinical staff who need to isolate from family, and dance classes run by the Peabody Institute of The Johns Hopkins University.
RISE, which has 34 trained volunteers who provide peer support, now gets five to 15 calls a day, says Wu. Before COVID-19, it received that many in a month.
“We’ve also started rounding proactively on the units, including some that are less visible, like laundry, food service and security,” he says. From mid-March to mid-April, RISE served more than 600 people.
Chaplain and spiritual care team members have also seen a quadrupling of staff encounters, particularly in units that have transitioned to caring for COVID patients, says Paula Teague, D.Min, M.B.A., senior director of Spiritual Care and Chaplaincy for the health system.
In one recent week, she says, her team met with more than 150 individuals and counseled more than 100 groups of three people or more across the health system.
Being part of MESH gives her office even more power to help them, Teague says.
“We really are a first filter for referrals,” she says. “We have lots of informal opportunities to say to someone, ‘That was really hard, what you just did. How are you doing?’ Usually, you can see the relief in a person’s face and you know they feel better. But when we see a person who is not recovering like that, we can refer them to mySupport for counseling.
“For the first time, I feel like spiritual care has been integrated with other services. It’s very satisfying to be part of a true partnership.”