Are There Risks for Organizations to Promote Mindfulness as a Tool to Manage Stress?

Transcription

1 Are There Risks for Organizations to Promote Mindfulness as a Tool to Manage Stress? Strategies, Interventions and Policies for Health Promotion, High Risk Behavior Prevention and Increased Performance of the DHS Law Enforcement Workforce: A Workshop 17 January 2018 William P. Nash Director of Psychological Health Shulamit Schweitzer Psychological Health Analyst, Booz Allen Hamilton DISCLAIMER: These are our opinions, alone, not official policy.

2 3 rd Battalion, 1 st Marines in the 2 nd Battle of Fallujah, November 2004 Photo by Lucien Reed (Courtesy of Col Willy Buhl, USMC) Stress is a worldwide performance-optimization and health-promotion challenge Stress is both a necessary means to all ends and a toxin for persons and groups High stress is endemic among military, law enforcement, first responder, and healthcare personnel, among others Organizations and their leaders have a fiduciary responsibility to mitigate occupational stressrelated risk 2

3 Mindfulness is a mental state achieved by focusing one's awareness on the present moment, while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations Like slow, deep breathing, mindfulness is a lever persons can use to control their own central nervous systems We do not yet know how mindfulness works Photo by Lucien Reed (Courtesy of Col Willy Buhl, USMC) 3

4 3 rd Battalion, 1 st Marines prepare for the 2 nd Battle of Fallujah, November 2004 Photo by Lucien Reed (Courtesy of Col Willy Buhl, USMC) Stress management is central to organizational approaches to promote Good Psychological Health (IOM 2014) Like all other organizational prevention and optimization efforts, stress management must be evidence based (SAMHSA 2009) Stress and its management span all socioecological domains 4

5 SAMHSA s Strategic Planning Framework 5-Step Strategic Planning Process (adapted from SAMHSA, 2009) 1. Assess populations needs, resources needed to address the problem, and readiness to act 2. Build capacity to address identified needs and problems 3. Develop a comprehensive strategic plan 4. Implement evidence-based programs, practices, and policies 5. Monitor implementation, evaluate effectiveness, sustain effective activities, and fix those that fail Community Logic Model (adapted from SAMHSA, 2009) The problem Levers into the problem Programs, policies, & practices Center for Substance Abuse Prevention. Identifying and Selecting Evidence-Based Interventions Revised Guidance Document for the Strategic Prevention Framework State Incentive Grant Program. HHS Pub. No. (SMA) Rockville, MD: Center for Substance Abuse Prevention, Substance Abuse and Mental Health Services Administration,

6 What Problem Might Mindfulness Address? Maybe it depends on the nature, severity, and duration of the stress. In normal stress, mindfulness might: Prolong resistance to effects of stress Delay or mitigate fatigue Promote recovery from exhaustion In traumatic stress, mindfulness might: Mitigate symptom severity Promote recovery Reduce risk for future similar trauma And these are not the only two stress cases. 6

7 US Marine Corps Stress Continuum READY REACTING INJURED ILL Baseline Good pain Bad pain Diagnosable mental disorder Transient strain Full recovery Caused by: Normal life Negative change Symptoms persist Caused by: Life threat Loss Moral injury Wear-and-tear This is the stress DANGER ZONE! C Combat and Operational Stress Control.pdf 7

8 We may betray the trust of our members if we don t first: Do everything we can to reduce stressors Develop accurate and humane ways to monitor stress levels in real time Provide access to needed care that doesn t destroy careers Without a comprehensive and robust stress management strategy, we may ask way too much of a self-delivered intervention We may increase mental health stigma by implying that a bad stress outcome may be the fault of the member for insufficient or ineffective mindfulness 3 rd Battalion, 1 st Marines after the 2 nd Battle of Fallujah, November 2004 Photo by Lucien Reed (Courtesy of Col Willy Buhl, USMC) Director, Joint Staff. Promoting Trust, Enhancing Resources, and Reducing Risk: Joint Staff High Risk Behavior Working Group Final Report, May 29,

9