ARPA projects helping build resilience among Nebraska’s behavioral health providers

Everyone who has flown on a plane knows the rule: Put your own oxygen mask on first.

“A person who can’t breathe can’t really help others,” said Jessica Kingsley of Wholeness Healing Center in Grand Island.

That’s the rationale behind a new program at the Wholeness Healing Center. Kingsley, a social worker and mental health practitioner at WHC, uses support from BHECN’s American Rescue Plan Act (ARPA) Program to provide resiliency training to providers at WHC, which serves several Nebraska communities including Grand Island, Kearney, Broken Bow, Ord and Albion.

Common occupational hazards exacerbated by the pandemic

The program helps WHC clinicians deal with issues such as isolation, compassion fatigue and secondary trauma – common occupational hazards for behavioral health professionals that became more prevalent in the wake of COVID, Kingsley said.

These issues became particularly pronounced as people started to reengage in their daily activities, she said.

As more people came out of their homes and reengaged in the world, behavioral health providers, teachers and other helping professionals were hit with a deluge of stories about people struggling with serious behavioral health struggles, abusive situations and other adverse scenarios, Kingsley said.

These reports -- combined with the providers’ own pandemic-related trauma and struggles -- led to many behavioral health workers becoming overwhelmed and burned out, she said.

Reducing burnout and fatigue vital to helping state’s workforce

Combatting this burnout and the potential loss of providers in Nebraska’s workforce was a major reason BHECN funded several projects focused on increasing resiliency among providers with the $25.5 million in ARPA funds it was charged with distributing in 2022, said BHECN Director Marley Doyle, MD.

“Compassion fatigue, burnout and secondary trauma are major issues in terms of sustaining our state’s workforce, which already faces a shortage,” Dr. Doyle said. “Thanks to the ARPA project, we can help providers take steps to address these issues and help more of them stay in the field and continue doing their vital work.”

WHC uses its ARPA award to send clinicians to comprehensive trainings in Colorado that fortify them with tools and community to cope with the feelings, trauma and stress that come with their jobs.

Almost half of the WHC team has attended the trainings and the feedback has been overwhelmingly positive, Kingsley said. Some clinicians have opted to attend the training a second time and many say it has left them reenergized and reengaged with their careers, she said.

Grace Abbott’s Project REST building resilience among supervisors

Another ARPA project that focuses on resiliency is underway at the University of Nebraska Omaha’s Grace Abbott School of Social Work. This project – known as Project REST (Reflect and Explore in Supervision Training) – helps provide resiliency training to those who supervise provisionally licensed behavioral health professionals. The project helps supervisors get tools needed to manage the secondary trauma and stress that comes with their role as supervisors.

Supervisors are often unpaid and do their work on top of their own clinical duties, said Susan Reay, PhD, Director of the Grace Abbott School of Social Worker and leader of Project REST. This frequently creates situations where supervisors have to navigate their heavy caseloads while also trying to find a way to help those they supervise navigate their time as provisionally licensed providers.

“Secondary trauma is a significant issue in supervisory relationships,” Dr. Reay said. “The secondary trauma experienced by the supervisee is transferred to the supervisor when discussing cases. The strain of the work takes its toll.”

A proven model

Through Project REST, Dr. Reay and the Grace Abbott team work closely with the University of Nebraska-Lincoln’s Center of Children, Families, and the Law to provide training that facilitates attuned interactions as part of the Reflective Practice Supervision model, which is proven to reduce burnout, stress and trauma from COVID-19. Project REST participants attend three days of training and individual mentoring sessions over the course of eight months.

Just one year into the project, the results have already shown promise as many participants note the training and the community it is helping them build allows them to better manage their work stress and pressure, Dr. Reay said.

Care for caregivers

Like Kingsley, Dr. Reay also noted that COVID-19 exacerbated the need for resiliency training among providers, particularly as more people started to seek behavioral health care to cope with the stress and trauma of the pandemic.

“The pandemic really did normalize asking for help for many people,” Dr. Reay said. “That’s great news but it also increased the demand for behavioral health services and by extension it exacerbated the need for us to make sure those who provide those services are doing OK, too.”

Or to go back to Kingsley’s airplane analogy, it’s important to help ensure providers can put on their own oxygen masks first.

“I firmly believe better therapy happens after therapists take care of themselves,” Kingsley said.