Stomp Out the Stigma: Empowering Physician Voices

Setting and Problem

Despite elevated rates of burnout, depression, anxiety, and suicide among attendings and physicians-in-training, many do not seek mental health care due to stigma and fear of professional repercussions.^1,2 Lack of awareness of available mental health resources has been identified as another key barrier in the literature³ and our institutional resident and fellow well-being data. As part of our trainee mental health advocacy efforts, Stomp Out the Stigma was launched at one of our training sites in 2021. Goals include normalizing mental health challenges through shared narratives, encouraging help-seeking behaviors, and increasing awareness of mental health resources.

Intervention

Stomp Out the Stigma is hosted annually in mid-September to align with National Physician Suicide Awareness Day. All residents and fellows are invited, and program directors are encouraged to promote trainee attendance. The 1-hour event features a panel of 3 attendings at varying career stages who share personal experiences of navigating mental health challenges. Each panelist speaks for 8 to 10 minutes. A behavioral health expert then discusses institutional and national advocacy efforts surrounding physician mental health and institutional and community mental health resources. Our Employee and Family Assistance Program provides on-site information on resources and confidential support during and after the event.

This intervention can be easily generalized to other institutions. A facilitator is needed who can identify panelists at the training site, hold individual “prep sessions” with panelists to help refine their narratives, and determine panel order and key takeaways. A behavioral health expert provides information on advocacy efforts and support resources. Food and beverages are funded through the hospital and community donations.

Outcomes to Date

Anonymous pre-event (n=72) and post-event (n=44) surveys were completed by resident and fellow attendees this year. Significant increases were observed in comfort discussing mental health struggles with peers (z=-2.12, P=.034) and program leadership/hospital staff (z=-2.54, P=.011); in the likelihood of reaching out for support if having mental health struggles (z=-2.19, P=.029); and in the awareness of institutional (χ²[1, N=116]=13.74, P<.001) and community (χ²[1, N=116]=10.75, P=.001) mental health resources. All attendees at new sites expressed interest in returning next year, and all would recommend the event to their peers.

Trainee qualitative feedback highlighted appreciation for the event (eg, “Thank you for the chance to listen to these experiences,” “This should be mandatory!”) Panelist feedback underscored the event’s effects on “breaking down stigma” and “strengthening our community.” The event was described as “an extremely impactful experience” that “not only raised awareness around physician suicide but also created a safe space for openness, honesty, and connection… It was both cathartic and energizing to speak candidly, to feel the support of colleagues and to witness the ripple effect that sharing stories and truths can have on others.”

Attendee feedback has helped us refine aspects of the event, such as trainees wanting the event held during the workday (eg, noon conference) and at the local site level. We have expanded panel representation beyond attendings to include a resident and a nurse practitioner, whose narrative on losing one of her physician colleagues to suicide was deeply moving.

Stomp Out the Stigma’s success at the originating site prompted its expansion to 2 additional training sites this year. Following outcomes presentations at our graduate medical education meetings, 6 additional training sites expressed interest in hosting the event next year. Although the event was initially opened only to resident and fellow attendees, attendings were included at one site this year. Trainees and attendings reported that this broader participation furthered the event’s mission of fostering openness and supportive relationships around physician mental health. Stomp Out the Stigma is a feasible, low-resource intervention that can be customized and implemented in small-to-large institutions as part of efforts to normalize physician mental health struggles and help-seeking behavior, and to enhance mental health resource awareness.