The following content is a collaboration between Dr. Amanda Johnson, psychologist, and Phuong Lien Palafox, speech-language pathologist, on the topic of the mental health of speech-language pathologists.

Why Should We Talk About the Mental Health of Speech-Language Pathologists?

You’ve confessed, and things are not okay.  “I got really sick a few months ago.  My doctor said my work stress was a big part of it, and I can only work part time now.”  “I cry everyday at work.”  “My anxiety is so, so bad right now.”  Then, there’s me.  After months and months of being sick and showing up for work, I woke up the morning of April 29th of this year.  My tears would not stop for months, my body was hurting and I could not take another day.  After a decade and a half of being in our profession, I just didn’t show up.  It was the beginning of a conversation I am having with you today.   There is not one single article that specifically addresses the mental health of speech-language pathologists.  So, this is going to change.

What is Mental Health?

The dictionary defines mental health as “a person’s condition with regard to their psychological and emotional well-being.”   I’ll be honest.  Before reading and learning more about mental illness, I held common misconceptions about it.  So, let’s de-stigmatize.  My name is Phuong Lien Palafox, I have depression and anxiety and I am a speech-language pathologist.

The American Psychiatric Association tells us that “mental health is the foundation for emotions, thinking, communication, learning, resilience and self-esteem. Mental health is also key to relationships, personal and emotional well-being and contributing to community or society.”  It impacts our 1) productivity across settings, 2) relationships and 3) ability to adapt, change and cope with adversity.  At this time, approximately 1 in 5 individuals have mental illness.  As speech-language pathologists working within systems that need to change, we are feeling the dismal impact of increased workloads, lack of support and personal illnesses.

Dr. Amanda Johnson, psychologist, states that mental health of SLPs is an ethical mandate.  Our professional Code of Ethics says that “Individuals whose professional practice is adversely affected by substance abuse, addiction, or other health-related conditions are impaired practitioners and shall seek professional assistance and, where appropriate, withdraw from the affected areas of practice.” And, an “Impaired Practitioner” is defined as “an individual whose professional practice is adversely affected by addiction, substance abuse, or health-related and/or mental health–related conditions.”  Know that you do not have to have an official diagnosis to be suffering, and that even sub-clinical mental health symptoms can impair our work.  This means that our mental well-being should be the foundation of our work in order to best serve our humans on their communication journeys.

Most Common Mental Disorders

In this blog post, I want to focus on the two most common types of mental illness,  anxiety and depression.  According to the National Institute of Mental Health, anxiety accounts for the most common mental health disorder impacting 48 million people (19% of the population.)  Additionally, about 7.7 million (7%) of the U.S. population experienced major depressive episodes in the past year.  General anxiety is characterized by: irritability, difficulty controlling feelings of worry, being easily fatigued, feeling “on-edge” and “wound-up.”  Depression is characterized by exhaustion, lack of concentration, feelings of guilt, overall general sadness or numbness, little/low self-worth, loss of pleasure/interest, difficulty sleeping or sleeping too much, physical aches and pains, thoughts of death or suicide, and changes in eating patterns.  It impacts more women than men.  This is important because 96.3% of the professionals in our field are female.

As I have been bringing up this topic these last few months, the response has been mixed.  A strong stigma continues to be associated with mental health and mental illness.  The best way to understand something is to let stories in.  In turn, I have been talking.  I’ve also been listening to stories, and the tales I hear boil down to a potential epidemic of decreased mental health for speech-language pathologists.  I am grateful to Alison for sharing her story as an SLP Intern with an anxiety disorder in our Speech Therapy Blog.  For the record, I need to say that if a person feels safe and tells her/his story to you, acknowledge it.  Sentiments such as, “It’ll get better, this too shall pass, you just need to keep moving forward,” will discount the feelings, potentially make you feel better and let the person know that she/he will not share again with you.

Let’s Talk About Burnout

A majority of the stories told have to do with burnout.  Burnout is a cumulative process marked by emotional exhaustion and withdrawal associated with increased workload and institutional stress.  It happens over time, and it’s caused by:  work-related stressors, a clash of your personal values with the values of the organization and not feeling like you have control over your work environment.  When you feel burnout, SLPs may feel the following:  emotional/physical exhaustion, detachment from your job, reduced performance, increased crying and increased irritability.  Does this sound familiar?

I want to say, over and over, that the aforementioned outcomes are not a “people problem.”  It’s a “systems problem.”  We acknowledge, over and over, that there are institutional changes that need to be made.  Advocacy and time will help in that arena.  In the meantime, SLPs are continuing to support their students and clients with less, less and less.  We need to unveil the state of our SLP affairs, and we need to concentrate on the SLPs right now.

How to Prevent and Treat Burnout in SLPs

So, what do we do about all of this?  We need small and big changes.  I acknowledge that one blog post will not fix all SLP woes–I really wish it could.  Notwithstanding, change cannot be made without YOU making some change.  Let us begin.  Slowly.

• Talk and De-stigmatize.  We are good at talking.  Let’s talk about ourselves and our needs.
• Build a Support System at Work and Home.  When I feel low, I call my Julie, my Jeremy, my Nada.  Create your village.
• Examine Your Thoughts.  What’s the story you’re telling yourself?  “I am not good enough.  I can’t get things done.”  Remember, feelings and thoughts are not necessarily facts.  The conversations you have with yourself are the most important.
• Protect Your Physical Self.  Sleep is medicinal.  Excercise is only one of two ways to scientifically stop the “stress response.”  Eat regularly and eat healthfully.
• Change Your Behavior.  Protect Your Time.  What if we had SLP office hours?  Teachers do, right?  What if you blocked off time to write a report right after an evaluation?  What if you did not bring the work home.*
• Remember Your Why.  You joined this field to help others.  Do not allow the paperwork and bureaucracy to rule your heart and mind.  Focus on the eyes sitting across from you.  They matter the most.  And so do you.
• Be Mindful.  Mindfulness and meditation is a practice.  I will say that since last spring, I have scheduled a few minutes each morning to meditate, and it has brought healing.
• Be Aware of Emotional Vampires.  This includes social media, the news, and people.  Creating boundaries is important.  Remember, those who are upset with your boundaries were benefiting from them.  You are sacred.  So, create your sacred space and only allow those who fuel you to enter this honored arena.

Let me conclude by saying that YOU are worth all of this work.  I am giving you permission to prioritize yourself.  You give and give and give your time and your energy to others.  Rumi says, “Never give from the depths of your well.  But from your overflow.”  Now, it’s time to turn inward and be kind to yourself.  Our world needs your gifts.  Begin by giving yourself the nourishment you require to do our meaningful work.

*I acknowledge that bringing work home happens.  It should happen infrequently, and it needs to have time parameters.  When we continually bring work home, we tell others that the work is getting done within our typical work day.  This feeds the beasts of being overworked and potentially creates resentment.

Contending with “too much” work is tough and that’s why we created this course too:  Productivity 101 : Be Highly Productive Without Sacrificing Your Health or Homelife

Here is content per ASHA on topics related to stress and mindfulness.  Thank you to Shelley Hutchins, Content Producer and Editor for the ASHA Leader, for culling this information for us:

Breaking Out of Burnout

When a speech-language pathologist saw signs of burnout among her faculty-clinician colleagues, she set out to make over her division.

Stress and the Surfboard

Learning to surf gives an SLP insight into managing stress and overcoming challenges.

Strong Callings

Flailing at work? Determine how your job can better draw on your strengths. If that’s not possible, it may be time to look elsewhere.

Holding On… and Letting Go

When an SLP cared for her father at the end of his life, she came to see palliative rehabilitation as a paradox. The experience transformed her approach from treatment-oriented to well-being-oriented.

3 Steps to Reduce Stress Over the Things You Can’t Change

3 Easy Time-Saving Tips to De-Stress Your Day

Three Out-of-the-Box Mindfulness Hacks

5 Tips for a Smoother Post-Vacation Transition to Work and School

Want more information?  Join us for an in depth conversation with Dr. Amanda Johnson, psychologist and earn ASHA CEUs within our SLP Impact community.