The United States has recognized May as Mental Health Awareness Month since 1949. While much has been done to shatter the stigma surrounding mental illness over the past 75 years, a sad reality persists within the nursing profession. Many nurses, the compassionate pillars of our nation's health system, continue to suffer silently.
Female nurses are twice as likely to commit suicide than the general population and three times more likely than female doctors. A lot of nurses experience poor mental health as a result of psychological and physical exhaustion, but even during the COVID-19 pandemic, when exhaustion peaked, only 24% reached out for help.
What could be the issue that separates us, the nurses caring for so many, from caring for ourselves? Is it because of the ongoing and pervasive stigma we associate with having poor mental health? Are we in any way responsible for the problem?
Let's use this Mental Health Awareness Month to focus on why we continue to struggle and how to make an actionable plan to break the mental health stigma in nursing! Because you and I are part of the answer—and collectively, we can make a difference.
A Silent Epidemic: Mental Health Struggles in Nursing
There's a silent epidemic bustling within hospitals and clinics across the country—the mental health struggles of nurses. Despite being the frontline warriors in the battle against illness, we often find ourselves grappling with invisible adversaries that often fall into one of these four categories:
1. Stress and Burnout
Nurses are notorious for prioritizing the care of others over themselves. We come in for extra shifts so our colleagues aren't working short-handed, and our patients receive safe care.
2. Anxiety and Depression
Unsafe staffing and not feeling supported make many of us nurses feel anxious about our upcoming shifts—and depressed because we're so drained and there seem to be no solutions.
3. Compassion Fatigue
Nurses offer compassionate care to patients, but performing futile procedures can be emotionally draining. Afterward, we return home to care for our loved ones, further stretching our emotional capacity.
4. Post-traumatic Stress Disorder
The world is finally recognizing that disturbing sights and traumatic situations that nurses deal with may cause PTSD, a recognized psychiatric disorder.
Mental Health Stigmas Impacting Nurses
Often, mental health stigmas are rooted in a lack of understanding and fear perpetuated by inaccurate or misleading media representations. Studies reveal that while the public may accept the genetic or medical nature of mental health disorders, many individuals still have a negative view of those with mental illness. Here are two types of stigmas:
Public Stigma
The discriminatory and derogatory way we look at someone who displays symptoms of poor mental health or has been diagnosed with a mental illness. If you don't feel like you are part of this group—consider how your reaction would differ if you heard your colleague was admitted to the psychiatric ward as opposed to an orthopedic ward for surgery. Be honest.
Self-stigma
The attitudes of disgrace and shame that we put on ourselves when we struggle with poor mental health or have been diagnosed with a mental illness. Stop for a moment and consider the unkind words your inner critic uses to describe you.
In November 2023, the American Nurses Foundation surveyed over 7,400 nurses, revealing alarming trends in mental health. 40% reported feeling inadequate control over their workload, leading to intense workdays. Shockingly, two-thirds of nurses experiencing mental anguish aren't seeking support. Moreover, 56% cite stigma as a barrier to accessing mental health care, exacerbating their struggles.
Now, let's dive deeper into the public and private self-stigma affecting you as a nurse—beginning with nurse culture. We've absorbed nursing culture from our celebrated forebears, who epitomized strong, versatile, and resilient nurses.
Florence Nightingale pioneered modern nursing principles in a Crimean War hospital. Mary Eliza Mahoney braved racism to become the first licensed black nurse in the United States. Walt Whitman deferred his calling as a poet and journalist to become a male nurse, caring for wounded men during the Civil War.
There's a continued expectation for nurses everywhere to exhibit strength and resilience. It's subtly—and sometimes openly urged upon us by our instructors, administrators, nurse managers, and colleagues. We're told not to drop the ball, and we're nurses, so we can do it when working with unsafe staffing levels. Far be it from us to break the image.
During the COVID-19 pandemic, many people praised nurses for their work, while others heaped public stigma upon those who dared to speak up about their struggles with mental health and depression. Some said that's what nurses signed up for when they chose the profession.
As if we signed not to go home to our families to keep them safe, endanger our lives for days and months without additional compensation, and suffocate behind masks and gowns for hours on end. However, public stigma and self-stigma are effective and keep most nurses from asking for help.
Another reason for not acknowledging or seeking help for poor mental health is that nurses fear it will affect their jobs. How can we break the stigma when we have to answer questions about our mental health to the local Board of Nursing on our license renewal forms?
Real Stories of Overcoming Mental Health Challenges
Here are two real-world stories about healthcare professionals who overcame mental health challenges and kicked back the stigma to share their stories with you.
Louise, a former registered nurse, describes how, after recovering from a traumatic brain injury she incurred from a patient while working on a brain injury unit—she was diagnosed with PTSD and anxiety. She spiraled downward until she hit bottom and only started to recover after asking a friend for help. Today, she practices mindfulness and self-care—although, as a typical nurse, she admits that it's still challenging to prioritize caring for herself.
A healthcare leader facing depression due to personal and professional stress underwent electroconvulsive therapy after medication and counseling failed. Speaking out for the first time about her treatment, she aims to break the stigma surrounding mental illness, urging others to seek help and highlighting the importance of sharing personal experiences to foster support. "People don't usually tell you about their own experiences until they hear about yours," she noted.
4 Strategies to Stamp Out Mental Health Stigma
Can we celebrate these two women courageously sharing their stories? Are you ready to take the next step and help break the stigma that still plagues nurses? Here are four strategies worth taking:
Encourage open communication. Speak openly about stigma with your colleagues. Share your stories about mental health and treatment like any other illness.
Eliminate stigmatizing words. Instead of using words such as crazy, psycho, and insane, use person-first language, such as the patient who has mental illness or my friend who lives with depression. By doing so, you assign dignity and respect to people suffering from poor mental health.
Promote a supportive work environment. Ask your employer for mental health resources. Encourage your exhausted nursing colleagues to practice self-care instead of taking on additional shifts.
Destigmatize mental health through education. Sign up for the World Health Organization Quality Rights e-training on mental health.
Mental Health Support for Nurses
Employees are often reluctant to use the employee assistance program (EAP) because of a perceived lack of confidentiality—a concern employers should address. However, there are many other available resources for nurses suffering from poor mental health, such as:
SAMHSA's National Helpline: A free, confidential 24/7 treatment referral and information service for individuals and families facing mental health disorders.
Therapy Aid Coalition: Free and low-cost short-term therapy for U.S. healthcare professionals and first responders.
The Emotional PPE Project: Champions the well-being of healthcare workers by reducing barriers to seeking mental and emotional healthcare.
The American Academy of Experts in Traumatic Stress®: A multidisciplinary network of professionals committed to the advancement of intervention for trauma survivors.
Moodfit: An app featuring mindfulness tools, nutrition information, and a mood journal. Redeem a free offer to the app, courtesy of the American Nurses Foundation.
Mental Health Awareness Month Conclusion
As we enter another Mental Health Awareness Month, let's be vocal about our silent struggles while caring for others. It's crucial to acknowledge the stigma and silence surrounding mental health within our profession. Together, we can prioritize mental health for nurses, ensuring none of us suffer in silence.
Alice Blackmore, MN, RN, Content Writer
Alice is a registered nurse and healthcare writer. She has more than 20 years of nursing experience, which ranges from labor and delivery to long-term care, with pediatrics, community nursing, and critical care sandwiched in the middle.